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Thyroid Nodules Treatment

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Thyroid Nodules Treatment

Thyroid nodules treatment depends on the negative effects of these nodules. If the thyroid nodule is benign and does not cause any heath problems, it will be closely monitored without using any treatment . If symptoms are present drugs or surgery may be necessary. Antithyroid drugs and radioactive iodine can treat nodules that cause hyperthyroidism.

Surgery is required only if the thyroid node is so great that it interferes with normal breathing or swallowing or if it the thyroid nodule is malignant. After surgical removal of a malignant nodule, administration of radioactive iodine to destroy any remaining tissue or cancer cells that create problems may be also necessary. If total thyroidectomy is needed (excision of the whole thyroid gland)  thyroid hormones will be given for life.

Thyroid Nodules Treatment

Thyroid Nodules Initial Treatment

  1. Observation of a benign nodule which can be followed every 6 or 12 months for any change in shape (many thyroid nodes doe not change in size or diminish without any treatment)
  2. Thyroid Biopsy: Your doctor may drain fluid with a needle from a cystic nodule, sometimes after drainage the thyroid nodule may disappear, but most thyroid nodules recover
  3. Thyroidectomy, which is not always necessary, and is required if:
  • Node appears or is cancerous
  • Due to the size the thyroid node interferes with breathing or swallowing
  • Cystic nodule recovers after drainage

4.  Hormone suppression therapy is used to shrink a nodule if:

  • Thyroid nodule is benign
  • Node appears or is cancerous, but the patient can not withstand surgery

5. Radioactive iodine can be used to destroy thyroid tissue if:

  • The thyroid nodule is benign but is producing too much thyroid hormone, causing hyperthyroidism, and if this situation occurs during pregnancy, treatment with radioactive iodine is not indicated
  • Multinodular goiter is present and surgery can not be performed due to other diseases, radioactive iodine will shrink nodules that interfere with breathing or swallowing, though they can recover after completing therapy.

Thyroid Nodules Maintenance Treatment

  • Follow the prescribed hormone therapy at the same time every day, without omitting any dose
  • Call your doctor if symptoms of hyperthyroidism, such as nervousness, tachycardia, sweating, and weight loss, are present (sometimes hyperthyroidism occurs after taking thyroid hormones or when a node produce excess thyroid hormones)
  • Call your doctor if symptoms of hypothyroidism, such as fatigue, feeling cold, unmotivated and weight gain (hypothyroidism can occur after treatment with radioiodine or after surgery)
  • Schedule regular checkups to a specialist as even benign nodules should be examined by the doctor.

Treatment if the condition gets worse

  • Hormonal treatment is administered at the same time every day;
  • Pursue any symptoms of hyperthyroidism, such as nervousness, tachycardia and palpitations, sweating and weight loss, a benign nodule can produce excess thyroid hormones causing hyperthyroidism, as well as hormonal medication
  • Pursue hipotirodism symptoms as fatigue, sensitivity to cold and weight gain. The specialist will announce the appearance of these symptoms, radioactive iodine or surgery may be needed in this case.

If no the thyroid nodule does not change it can be kept under observation. Any change in size will require another biopsy may, hormone testing and even excision of the nodule (thyroidectomy). Partial or total removal of the thyroid gland will also require radioactive iodine to destroy any remaining tissue. Hormone suppression therapy to prevent recurrence and growth of other cancer cells.

Thyroid Nodules Drug Treatment

Most thyroid cancers grow slowly and disseminate slowly, so surgery can be delayed for a short period of time, if the thyroid node does not cause symptoms. If you choose to postpone surgery, the thyroid nodule should be evaluated regularly by an endocrinologist. Sometimes thyroid nodules are treated using hormone suppression therapy (levohyroxin) to stop the body from producing the hormone and prevent the thyroid gland from growing.

This therapy is recommended if

  • Health does not allow surgery for a nodule that is suspected to be malignant
  • Intervention was performed by excision of multiple thyroid nodules. Suppressive therapy is sometimes used to prevent recurrence of thyroid nodules.

Medication Choices

Thyroid Hormone suppression therapy is done with:

  • Levothyroxine sodium
  • Liothyronine sodium.

Mode of action of suppressive therapy on the benign nodules is not fully elucidated. Hormone suppression may increase the risk of heart or bone problems, especially if they existed prior to the thyroid pathology. If you heart disease is present this therapy may aggravate chest pain or heart rhythm disorders. It also increases the risk of stroke. If you have osteoporosis, hormone suppression therapy may worsen bone demineralization.

Hormone suppression therapy, even in small doses often causes hyperthyroidism, especially if there multiple thyroid nodules are present (multinodular goiter). Therefore regular visits to your doctor will be required for dose adjustment and hyperthyroidism prevention. If a lump is benign, but produce excess hormones that lead to hyperthyroidism, before radioactive iodine treatment, antithyroid medication is mandatory.

Thyroid Nodules Surgical Treatment

Surgical excision is recommended for cystic nodules that recur, especially those more than 4.1 centimeters in diameter. Hypothyroidism occurs in about 10%,  5 years after treatment with radioactive iodine. Thus thyroid hormone levels will be reviewed regularly post-therapy.

It is the best treatment option for thyroid nodules that are:

  • Malignant (cancer)
  • Suspected to be malignant
  • Benign but large enough to interfere with breathing and swallowing

People who develop thyroid nodules after radioactive therapy of the head, neck or chest, most likely will require surgery because the risk of developing thyroid cancer is higher although most nodules in  irradiated people are benign.

See also:  “Thyroid Nodules Causes, Symptoms And Risk Factors”