How to treat thyroid nodules?

Written by Hu Jian Zhuo
Nephrology and Endocrinology
Updated on September 03, 2024
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Clinically, if a thyroid nodule is confirmed to be a benign tumor, generally speaking, if thyroid function is normal and the nodule is not large, urgent treatment is not necessary, and regular follow-up is sufficient. If the thyroid nodule significantly enlarges, causing compression of the trachea or nerves, surgery should be considered. Furthermore, for ectopic growth of thyroid tissue behind the sternum, surgical removal is also considered necessary. Another scenario that requires special mention is if a thyroid nodule grows rapidly in a short period and ultrasound suggests calcification or bleeding within the cyst, thyroid cancer should be suspected. In this case, it's advisable to have the nodule surgically removed.

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Written by Hu Jian Zhuo
Nephrology and Endocrinology
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How to treat thyroid nodules?

Clinically, if a thyroid nodule is confirmed to be a benign tumor, generally speaking, if thyroid function is normal and the nodule is not large, urgent treatment is not necessary, and regular follow-up is sufficient. If the thyroid nodule significantly enlarges, causing compression of the trachea or nerves, surgery should be considered. Furthermore, for ectopic growth of thyroid tissue behind the sternum, surgical removal is also considered necessary. Another scenario that requires special mention is if a thyroid nodule grows rapidly in a short period and ultrasound suggests calcification or bleeding within the cyst, thyroid cancer should be suspected. In this case, it's advisable to have the nodule surgically removed.

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Written by Li Jin Quan
General Surgery
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Diet for thyroid nodules calcification

Patients with calcified thyroid nodules need to be cautious about their diet. Firstly, they should avoid irritating foods such as chili peppers, ginger, garlic, strong tea, coffee, and alcohol. Secondly, they should not consume foods high in fiber as these can cause diarrhea. Instead, they should eat foods rich in carbohydrates and fats, which provide energy and reduce the consumption of proteins in the body, as proteins play an important role in physiological regulation. Additionally, these patients should consume foods rich in vitamins and minerals to aid physiological metabolism. Lastly, it is beneficial for patients with calcified thyroid nodules to include animal organs in their diet.

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Written by Hu Jian Zhuo
Nephrology and Endocrinology
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Effects after thyroid nodule removal

Thyroid surgery often leads to postoperative bleeding as a common complication. Bleeding may compress the trachea, causing difficulty in breathing. If a patient exhibits severe breathing difficulties along with significant bleeding from the drainage tube post-surgery, emergency hemostasis should be performed. Secondly, tracheomalacia. Long-term compression from the mass softens the tracheal wall, leading to a collapse due to inadequate support from surrounding tissues. Thus, after removing thyroid nodules, the thyroid and adjacent tissues fail to support the softened trachea, resulting in breathing difficulties. Thirdly, pharyngeal edema. During surgery, inflammatory stimulation can cause edema in the surrounding tissues, which may lead to difficulty in breathing. Therefore, after ruling out possibilities of postoperative bleeding, tracheomalacia, or vocal cord paralysis, pharyngeal edema should be considered. Nebulization therapy can be administered. Fourthly, vocal cord paralysis is common due to accidental damage to the recurrent laryngeal nerve during surgery, causing hoarseness. Generally, patients may gradually recover over three to six months, and symptoms can improve. The fifth effect is damage to the parathyroid glands. If the parathyroid glands are damaged, it may lead to abnormal blood calcium levels and symptoms of hypocalcemia, such as tetany and spasms. Most cases are due to vascular damage to the parathyroid glands resulting in temporary hypofunction, which often recovers shortly. The sixth possible outcome is a thyroid storm. Some patients with hyperthyroidism may experience a sudden release of large amounts of thyroid hormone into the bloodstream post-surgery, causing high fever, irregular heart rate, restlessness, nausea, vomiting, coma, and even death. The seventh effect is that removal of the thyroid gland leads to a deficiency in thyroid hormones, resulting in symptoms of hypothyroidism.

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Written by Zhang Jun Jun
Endocrinology
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The difference between thyroid nodules and nodular goiter

Thyroid nodules are the clinical manifestations of nodular goiter, and nodular goiter is the cause of thyroid nodules. Nodular goiter generally occurs in iodine-deficient areas, forming these partial or multiple thyroid nodules. Thyroid nodules are the clinical manifestations of nodular goiter; the nodules in the thyroid can be single or multiple and can cause abnormal thyroid function, although thyroid function can also be normal in the early stages. Therefore, when performing an ultrasound, if thyroid nodules are discovered, it is necessary to further assess thyroid function and dynamically track changes in the size of the thyroid nodules to determine whether it is nodular goiter.

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Written by Luo Han Ying
Endocrinology
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Post-thyroidectomy complications

In clinical practice, for large thyroid nodules that cause compressive symptoms, such as difficulty swallowing, breathlessness, and hoarseness, thyroid nodule excision surgery can be performed. However, this surgery can have sequelae. First, if the excised thyroid tissue is too large, it can easily lead to reduced thyroid function, requiring lifelong supplementation with thyroid hormones for treatment. Secondly, due to the sensitive location of the thyroid gland, which is surrounded by various glands and nerves, injury during surgery can lead to complications such as seizures and hoarseness, which are considered post-surgical sequelae.