Thyroid and parathyroid nodules are irregular tissue overgrowths that are mostly benign. Still, in rare cases (less than one in 20, to be precise), they might become cancerous, producing thyroid cancer symptoms.
Some patients may have a single nodule, while others can have several. These conditions are relatively common, with at least half of the population having at least a single nodule by age 60.
In this article, we’ll talk about these nodules, their symptoms, and possible treatment options. Also, we’ll discuss when to worry about thyroid nodules and when they may become potential endocrine cancers.
About the Thyroid and Parathyroid Glands
The thyroid is a gland found on the base of the neck, and it plays an essential role in controlling our metabolism and hormone production. Thyroid hormones regulate myriad functions like breathing, heart rate, the nervous system’s operations, and much more.
The parathyroid glands are located next to the two thyroid gland lobes, and they also produce hormones. These parathyroid hormones are responsible for regulating calcium levels in the body.
Thyroid Nodule Symptoms
In most cases, these overgrowths cause no symptoms, and because of this, they are often only discovered during routine exams or imaging tests performed for other reasons.
When these nodules do produce symptoms, the most prevalent signs are the following:
- Lump in the neck
- Difficulty swallowing
- Neck pain
- Hoarseness
- Difficulty breathing (in the case of larger nodules)
In some cases, these nodules may also interfere with hormone production, secreting too much thyroxine and triiodothyronine that can lead to hyperthyroidism symptoms such as:
- Nervousness
- Anxiety
- Moodiness and irritability
- Profuse sweating
- Rapid heart rate
- Shaking
- Hair loss
- Weight loss
- Diarrhea
- Light periods
- Missed periods
In other cases, these thyroid nodules may also press on the esophagus, which can lead to:
- Swallowing problems
- Discomfort when lying down in specific positions
- Food getting stuck in the throat
- Breathing difficulties
Many parathyroid adenomas also remain undiscovered because they show no symptoms, and health experts only come across them thanks to blood tests that are performed for other reasons.
These adenomas are the most prevalent cause of overactive parathyroid glands, leading to increased calcium levels in the blood. The symptoms of the condition may be the following:
- Constipation
- Muscle pain
- Lethargy
- Decreased appetite or nausea
- Weak bones and bone fractures
- Urinating more often at night
- Confusion
The Causes of Parathyroid and Thyroid Nodules
The exact cause of these nodules is mostly unknown. Sometimes, thyroid overgrowths have a genetic basis and run in families. Iodine deficiency may also cause nodules, although in very rare cases.
People who have been exposed to radiation or have Hashimoto’s thyroiditis may be at higher risk of developing these overgrowths.
Similarly, most parathyroid adenomas develop without identifiable causes, but they can also be traced back to genetic problems, which are the most prevalent causes in young patients.
Still, a few conditions may increase the size of the parathyroid glands and trigger adenoma growth. These include:
- Lithium (drug) abuse
- Genetic disorders
- Chronic kidney problems
- Radiation exposure
- Old age
Diagnosis
Diagnosing a nodule will usually involve the following tests that will also help determine what the next steps should be:
- Ultrasound: This can show the size, location, and other characteristics of the thyroid nodule. Ultrasounds can also check the lymph nodes, which can help determine the presence of cancer as well.
- Blood tests: These tests will measure the levels of specific thyroid hormones and thyroid-stimulating hormones to see whether the nodules interfere with the endocrine system. If you’re wondering when to worry about thyroid nodules turning cancerous, you can be relieved to hear that most of these interfering nodules are benign.
- Biopsy: The procedure involves taking a small tissue sample of the nodule to determine its characteristics and, most importantly, to see whether it’s cancerous or benign.
The most common tests for parathyroid nodules are the following:
- Blood tests: To check for vitamin D, calcium, PTH, and phosphorus levels
- MRI
- Neck ultrasound
- Kidney X-rays: To check for kidney stones
- Kideny CT or ultrasound: To check for calcification or stones
- Bone density exam
- Sestamibi neck scan
Treatment for Thyroid Nodules
Treatment will usually depend on several factors. Suppose the nodule isn’t producing any thyroid cancer symptoms and isn’t causing any kind of discomfort or pain. In that case, the health expert may carefully monitor the nodules yearly and recommend periodic tests to check hormone levels. Surgical removal may be necessary if the nodule grows and starts causing swallowing and breathing problems.
On the other hand, when the nodule displays thyroid cancer symptoms, treatment will definitely include surgery, most often the removal of the entire gland or removing only half of it where the nodule is located.
Lastly, nodules that interfere with hormone production can be treated with surgery to remove the nodule, alcohol ablation injections, and radioactive iodine pills to shrink the nodule.
Parathyroid nodules are most often removed with surgery, but patients may also choose to have their nodules monitored if they don’t produce any or only mild symptoms.
In some cases, doctors may recommend stopping taking vitamin D and calcium supplements to improve the patient’s condition.
When to Worry About Thyroid Nodules?
The majority of nodules won’t cause any problems and will most probably remain untouched unless starting to grow as time passes. Nodules that cause discomfort can be surgically removed or treated with other methods.
Patients concerned about cancer should know that less than 5% of these nodules are cancerous. The majority of these overgrowths are cystic, meaning they are filled with fluid, not tissue.
As said above, thyroid nodules may be removed surgically if they are causing discomfort or interfering with hormone production. Larger nodules may also press on the esophagus or windpipe, which can lead to swallowing and breathing difficulties. Surgery will usually address all of these problems, returning everything to normal.
In the case of parathyroid nodules, the prognosis is generally good after treatment. If left unaddressed, the nodules that interfere with parathyroid hormone production may lead to complications. The most common problem that stems from hormone overproduction is bone fractures, but other issues may arise as well:
- Osteitis fibrosa cystica, or weak, softened areas in the bone
- Nophrocaicionosis or calcium deposits in the kidney which may impair their function
On the other hand, surgery may also produce complications in rare cases, such as:
- Damage to the nerves that control the voice
- Damage to the parathyroid glands that may lead to low calcium levels in the body
Learn More
Most often, these nodules on the thyroid and parathyroid won’t cause any problems. Still, knowing more about them is essential if someone has been diagnosed with the condition. If you wish to learn more about these growths, feel free to reach out to Dr. Omar Rashid Medicus Elite and learn about the latest treatment options.