Thyroid Nodules

These nodules can be hard to detect because they’re often too small to notice — and might not even cause symptoms. Sometimes, if the nodule is large enough, you might be able to feel it or see it in the mirror or a photo of yourself.

But, in most cases, your primary care provider will often discover you have thyroid nodules during a routine physical exam or an imaging scan like an X-ray, CT scan or MRI. If they do, they’ll ask you to get more testing. That’s where we come in.

At your first appointment, we’ll take a look at your thyroid and its nodules. We’ll also talk with you about your medical history and symptoms. We may have you do some bloodwork and other testing, too.

An ultrasound will help us figure out how many nodules you have and how big they are. We might also do a thyroid biopsy, where we’ll remove a small sample of the nodule. This lets us take a closer look at the cells to confirm or rule out cancer. You might also have an imaging test called a thyroid uptake and scan that checks how well your thyroid works to help us confirm or rule out cancer.

Meet Our Team

When you come to Cleveland Clinic for thyroid nodule diagnosis and treatment, you’ll get expert compassionate care from a team of skilled providers. This team could include:

• Endocrinologists.
• Surgeons.
• Radiologists (imaging specialists).
• Pathologists (tissue specialists).
• Anesthesiologists.
• Advanced practice providers (certified nurse practitioners, physician assistants).

Once we get a better idea of how many nodules you have, how big they are and what’s causing them, we’ll talk with you about treatment. We craft a personalized treatment plan for you. There are several treatment options we might use. We’ll explain these options and talk about what’s the best fit for you. Treatment options can include:

Monitoring

It might seem odd to do nothing. But if you have no symptoms and benign thyroid nodules, your provider may suggest keeping an eye on them — or “watchful waiting.” You’ll have regular follow-up visits where your provider will look for any changes in the nodules. If your thyroid nodules stop growing or go away on their own, you won’t need further treatment.

Hormone treatment

During testing, your provider might discover your thyroid doesn’t work the way it should. They might prescribe thyroid hormone therapy pills to raise or lower your body’s thyroid hormone levels to proper levels. If you take this medication, your endocrinologist will check in with you regularly to make sure you’re managing your symptoms and your thyroid hormone levels stay within an ideal range.

Radioactive iodine

If your thyroid nodule is cancerous or causing problems like hyperthyroidism, your provider may recommend radioactive iodine treatment. Typically, this single treatment shrinks the nodules and relieves hyperthyroidism within a few months. To do the treatment, you’ll swallow a radioactive iodine capsule and drink lots of water to flush any extra radioactive iodine from your system.

Radiofrequency ablation

Benign nodules larger than 2 centimeters (a little bigger than a penny) may respond to radiofrequency ablation (RFA). Your provider does this minimally invasive surgery in the office, using a local anesthetic to numb the area around your thyroid. You’ll be awake but won’t feel any pain. They’ll place a needle in the thyroid nodule, destroying the cells with heat. After the procedure, your provider will check your nodules every three to six months with ultrasound to see if they have stopped growing.

Surgery

If you have cancerous thyroid nodules, you’ll most likely need surgery. Sometimes even noncancerous thyroid nodules may need to be surgically removed if they’re too large, cause issues with how you breathe or swallow or don’t respond to other treatments. Your surgeon may remove part or all of your thyroid gland — depending on where and how big the nodules are — using innovative techniques like robotic thyroidectomy.

Taking the Next Step

Learning you have thyroid nodules — and getting treatment for them — can be stressful. But you don’t have to feel like you’re facing the unknown. The experts at Cleveland Clinic are here to answer your questions and help you feel like yourself again. From innovative diagnostics to skilled, caring providers, we’ll work with you to create a treatment plan that works for you.