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Thyroid nodules
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Thyroid nodules

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DIABETES AND ENDOCRINE SYSTEM

Endocrine System

 

Treatment

You and your doctor will work together to determine the best treatment for you. Depending on the type of thyroid nodule you have, your options may include:

  • Watchful waiting. If an FNA biopsy shows you have a benign thyroid nodule, your doctor may suggest simply watching your condition, which usually means having a physical exam and thyroid function tests at regular intervals. You're also likely to have another biopsy if the nodule grows larger. If a benign thyroid nodule remains unchanged, you may never need treatment beyond careful monitoring. Talk to your doctor if you're not comfortable with this approach. He or she can discuss other options with you.

  • Thyroid hormone suppression therapy. This involves treating a benign nodule with levothyroxine (Synthroid, Levoxyl), a synthetic form of thyroxine that you take in pill form. The idea is that supplying additional thyroid hormone will signal the pituitary to produce less TSH, the hormone that stimulates the growth of thyroid tissue. Although this sounds good in theory, levothyroxine therapy is a matter of some debate. There's no clear evidence that the treatment consistently shrinks nodules or even that shrinking small, benign nodules is necessary. What's more, levothyroxine therapy isn't without risks. Excess doses can lead to heart problems and osteoporosis, although these problems can usually be avoided with careful monitoring. In addition, levothyroxine therapy isn't recommended for older adults or for people with thyroid cysts or nodules that produce thyroid hormone.

  • Radioactive iodine. Doctors often use radioactive iodine to treat hyperfunctioning adenomas or multinodular goiters. Taken as a capsule or in liquid form, radioactive iodine is absorbed by your thyroid gland, causing the nodules to shrink and symptoms of hyperthyroidism to subside, usually within two to three months. But because thyroid hormone is released into your bloodstream as the nodules are destroyed, in rare cases your symptoms may worsen for a few days or weeks after therapy. You also might experience neck tenderness or a sore throat. And because this treatment eventually causes thyroid activity to slow considerably, you may develop hypothyroidism.

  • Alcohol ablation. In this procedure, small, hyperfunctioning nodules are injected with ethyl alcohol (ethanol), which helps shrink the nodules and improve symptoms of hyperthyroidism. Although some people may need up to eight injections — usually given at two-month intervals — other people require only one. You receive these treatments on an outpatient basis and unlike some other treatments, alcohol ablation doesn't cause hypothyroidism. Side effects of the procedure include headache and burning pain at the injection site that may radiate to the jaw. The pain rarely lasts more than a few days.

  • Surgery. The usual treatment for malignant nodules is surgical removal, often along with the majority of thyroid tissue — a procedure called near total thyroidectomy. Occasionally, a nodule that's clearly benign may require surgery, especially if it's so large that it makes it hard to breathe or swallow. Surgery is also considered the best option for people with large multinodular goiters, particularly when the goiters constrict airways, the esophagus or blood vessels. Nodules diagnosed as indeterminate or suspicious by FNA biopsy also must be surgically removed so that they can be examined more thoroughly for signs of cancer. Risks of thyroid surgery include damage to the nerve that controls your vocal cords and damage to your parathyroid glands — four tiny glands located on the back of your thyroid gland that help control the level of calcium in your blood. After thyroidectomy, you'll need lifelong treatment with levothyroxine to supply your body with normal amounts of thyroid hormone.

 

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This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.
In no event will The DrEddyClinic.com be liable for any decision made or action taken in reliance upon the information provided through this web site.

 


 



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