Management Options for Thyroid Nodules
AWARENESS
SUPPORT
ADVOCACY
for Western Australians
              Written by Monique Atkinson and endorsed by Dr Hieu Nguyen
Observation

If the nodule is benign and does not cause any symptoms then the nodule can be self
checked on a regular basis. An ultrasound can be used to see if the nodule is growing in size.
If the nodule increases in size or produces symptoms, such as swallowing and breathing
difficulties, then you should consider surgical removal.


The Thyroid Neck Check – Self Monitoring

  1. The best way to check for thyroid “lumps” is to sit in front of the mirror with a glass of
    water.
  2. Look into the mirror and make sure you can clearly see your neck. Your thyroid gland
    (a butterfly shaped gland) is located just above the collarbone and just below your
    Adam’s apple.
  3. Tip your head back and keep looking at your thyroid gland.
  4. Take a sip of water and swallow. While you swallow the water, focus on the area below
    the Adam’s apple and watch for any lumps, bulges, enlargements or unusual
    appearances. A thyroid nodule is likely to move while you swallow.
  5. If you find anything unusual report it to your doctor right away.


Thyroid Hormone

Few doctors still prescribe thyroxine (thyroid hormone) in the hope that a benign nodule
decreases in size. However the results have been disappointing and it is no longer
mainstream treatment.


Radioactive Iodine

Hyperthyroidism caused by hot nodules can be treated with radioactive iodine which may
shrink the nodules.  However the radioactive iodine may damage adjacent thyroid tissue. If
too much thyroid tissue is destroyed then the patient may become hypothyroid and will need
thyroid hormone replacement therapy for life.


Alcohol Ablation

Another treatment for hot nodules is alcohol ablation. Alcohol (ethanol) is injected into the
nodules which makes them shrink. It can cause significant pain and discomfort. Escape of the
alcohol may also cause recurrent nerve injury (causing voice impairment). You may need one
to eight injections depending on the size of the nodule. This treatment does not cause
increased risk of hypothyroidism. This is not a mainstream treatment and may not be
available in Western Australia.


Surgery

Surgery is usually recommended for a large multinodular goitre that causes breathing or
swallowing difficulties. It is often the treatment of choice for ‘hot’ (toxic) nodules as it does not
cause collateral damage to the contralateral lobe of the thyroid, hence no increased risk of
hypothyroidism. If the whole thyroid gland is removed then the person will need thyroid
hormone replacement therapy for life. The surgery should be performed by an experienced
endocrine surgeon. If the nodule is cancerous then surgery is always recommended. See
treatment for thyroid cancer.

Thyroid WA Support Group Inc.  -  ABN  84 263 220 330
"Mackenzie EJ and Mortimer RH. 6: Thyroid Nodules and Thyroid Cancer. MJA 2004; 180: 242-247. ©
Copyright 2004. The Medical Journal of Australia – reproduced with permission”

Disclaimer  The information provided is for educational purposes only and is not intended to be medical
advice. The contents must not be relied upon in place of advice and treatment from a qualified medical
practitioner. Thyroid WA Support Group Inc. and the author disclaim any liability whatsoever. Copyright ©
Monique Atkinson 2011
Algorithm for assessing a thyroid nodule