Thyroid Nodules Insights on World Thyroid Day

May 25 is World Thyroid Day, so we’re raising awareness around the thyroid gland itself, and in particular thyroid nodules. While many hypothyroid and hyperthyroid patients have never had a thyroid ultrasound, patients who have, commonly display thyroid nodules. Here’s what you need to know when it comes to thyroid nodules, to help you prepare for the possibility of a diagnosis as well as treatment options.

Some fast facts:

• nodules in the thyroid gland may or may not be associated with thyroid hormone abnormalities, (1) meaning they are found in the general population and not exclusively in thyroid patients
• only 5-10% of nodules become thyroid cancer (2)

Risk Factors

Some environmental factors could affect the risk of thyroid nodules, such as: (3)(4)(5)(6)

• Age: nodule incidence increases with age
• Iodine intake: both low and excessive levels of iodine can affect thyroid nodules development
• Gender: TN’s are approximately 4 times more common in women, with females between 35-50 years most commonly affected by multinodular goitre
• Lifestyle: especially smoking and alcohol consumption
• Metabolic Syndrome: thyroid nodules are associated with a higher prevalence of central obesity, hypertriglyceridemia, abnormal blood pressure, and hyperglycaemia
• Ionising radiation: any history of radiation exposure, especially of the head and neck

Investigations and Classifications

Thyroid nodules appear as small lumps, usually benign, which may be solitary or multiple and cystic or solid. (6) Ultrasound is the gold standard diagnostic to identify these abnormal growths. Nodules may also be hyper-functional, hypo-functional or normal. (7) Hyperfunctioning or “hot” nodule is seen as a “hot spot” on thyroid scans. (7) These nodules are ‘autonomously functioning nodules’ as they secrete thyroid hormone independently of normal hormonal regulation mechanisms.

Many TN’s require further investigation. (8) Nodules 1 cm or larger or with suspicious appearance usually involve a fine needle aspiration biopsy (FNAB) technique. (9) Surgical options are used to remove malignant or symptomatic nodules that compress nearby structures. (9) Since 40% of patients receive an inconclusive result from FNAB, (2) a second opinion consult can be valuable in addressing concerns. Additional treatment options, and, in a few cases, recommending against inappropriate surgical intervention may be discussed. (10) A ‘wait and see’ approach may be suggested where a follow up ultrasound is arranged in an agreed time frame to monitor for growth and change of thyroid tissue.

The Naturopathic Approach to Thyroid Nodules

A Naturopath can help to address the cellular tissue change via antioxidants, specific nutrients and dietary approaches. Each individual case is assessed with consideration given to the appropriateness of interventions. Some examples of nutrients which are indicated in TNs include Iodine and Vitamin D.

• Iodine status is the primary nutrient to be considered, as both iodine deficiency and excess are involved in nodule development. With no exact mechanism recognised regarding excessive iodine leading to TN’s (4) it’s one of the many reasons why prescription of iodine is recommended over self prescribing.
• Vitamin D deficiency may be a factor in the development of thyroid nodules. (11) One study found before thyroidectomy (surgical thyroid removal), more than 80% of patients had extreme vitamin D deficiency. (12) A blood test to check levels and discussion with a healthcare practitioner can guide appropriate dosing.

Seeking Help for Thyroid Health

Hormonal health starts with the the gland, and understanding the thyroid gland at a cellular level can help to determine the best course of action. The topic of thyroid nodules is a conversation worth having with a Doctor or Specialist. It’s why we’re creating awareness around this topic, to ensure the best care for our thyroid patients, and that’s certainly a topic we’re passionate about!

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