A thyroid nodule is a growth (lump) in the thyroid gland. The thyroid gland is located at the front of the neck, just above where your collarbones meet in the middle.
Thyroid nodules are caused by an overgrowth of cells in the thyroid gland. These growths can be:
Not cancer (
), thyroid cancer (malignant), or very rarely, other cancers or infections
Fluid-filled (cysts)
One nodule or a group of small nodules
Producing thyroid hormones (hot nodule) or not making thyroid hormones (cold nodule)
Thyroid nodules are very common. They occur more often in women than in men. A person's chance of getting a thyroid nodule increases with age.
Only a few thyroid nodules are due to
. A thyroid nodule is more likely to be cancer if you:
Have a hard nodule
Have a nodule that is stuck to nearby structures
Have a family history of thyroid cancer
Have noticed a change in your voice
Are younger than 20 or older than 70
Have a history of radiation exposure to the head or neck
Are male
Causes of thyroid nodules are not always found, but can include:
(a reaction of the immune system against the thyroid gland)
Lack of iodine in the diet
Most thyroid nodules do not cause symptoms.
Large nodules can press against other structures in the neck. This can cause symptoms such as:
A visible
(enlarged thyroid gland)
Hoarseness or changing voice
Pain in the neck
Problems breathing, especially when lying down flat
food
Nodules that produce thyroid hormones will likely cause symptoms of an
, including:
Warm, sweaty skin
Fast pulse and palpitations
Increased appetite
Nervousness or anxiety
Restlessness or poor sleep
Skin blushing or flushing
More frequent bowel movements
Irregular or lighter menstrual periods
Older people with a nodule that produces too much thyroid hormone may have only vague symptoms, including:
Fatigue
Palpitations
Chest pain
Memory loss
Thyroid nodules are sometimes found in people who have Hashimoto disease. Hashimoto disease may cause symptoms of an underactive thyroid gland, such as:
Constipation
Dry skin
Hair loss
Feeling cold when other people do not
Irregular menstrual periods
Very often, thyroid nodules produce no symptoms. Health care providers often find thyroid nodules during a routine physical exam or imaging tests that are done for another reason. A few people have thyroid nodules that are big enough that they notice the nodule on their own and ask their provider to examine their neck.
Your provider may recommend
surgery to remove all or part of your thyroid gland
if the nodule is:
Due to thyroid cancer
Causing symptoms such as swallowing or breathing problems
Biopsied and the biopsy is inconclusive, and your provider can't tell whether the nodule is a cancer
Making too much thyroid hormone
People with nodules that are making too much thyroid hormone may be treated with radioiodine therapy. This reduces the size and activity of the nodule. Pregnant women or women who are still breastfeeding are not given this treatment.
Both surgery to remove thyroid gland tissue and radioactive iodine treatment can cause lifelong
(underactive thyroid). This condition needs to be treated with thyroid hormone replacement (a daily medicine).
For noncancerous nodules that do not cause symptoms and are not growing, the best treatment may be:
Careful follow-up with a physical exam and
A thyroid biopsy repeated 6 to 12 months after diagnosis, especially if the nodule has grown
Noncancerous thyroid nodules are not life threatening. Many do not require treatment. Follow-up exams are enough.
The outlook for thyroid cancer depends on the type of cancer. For the most common kinds of thyroid cancer, the outlook is very good after treatment.
Contact your provider if you feel or see a lump in your neck, or if you have any symptoms of a thyroid nodule.
If you have been exposed to radiation in the face or neck area, contact your provider. A neck ultrasound can be done to look for thyroid nodules.
Thyroid adenoma - nodule; Thyroid carcinoma - nodule; Thyroid cancer - nodule; Thyroid incidentaloma; Hot nodule; Cold nodule; Thyrotoxicosis - nodule; Hyperthyroidism - nodule
Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016;26(1):1-133. PMID: 26462967
pubmed.ncbi.nlm.nih.gov/26462967/
.
Paschke R, Eszlinger M, Kopp P. Euthyroid and hyperthyroid nodules and goiter. In: Robertson RP, ed. DeGroot's Endocrinology. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 77.
Pearce EN, Hollenberg AN. Thyroid. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 207.
Updated by: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.