Do thyroid nodules affect pregnancy?

Written by Hu Jian Zhuo
Nephrology and Endocrinology
Updated on September 21, 2024
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This decision should be based on the nature of the thyroid nodules. If the thyroid nodule is benign, pregnancy generally will not be affected, and it is possible to conceive. However, if the patient has malignant thyroid nodules, I would advise against rushing into pregnancy. Firstly, prioritize treating the malignant thyroid nodules promptly. If you become pregnant during this time, the risks associated with surgery and medications for both the pregnant mother and the fetus are very high. Nevertheless, after receiving timely and standardized treatment and once the patient's condition has stabilized, it is possible to conceive. However, it should be noted that surgery may lead to reduced thyroid function. In the first 12 weeks of pregnancy, the fetus relies on the mother for thyroid hormone supply. If the mother's thyroid hormone levels are too low, it can lead to delayed fetal development, and even abnormal brain development, resulting in a baby born with intellectual disabilities. Therefore, women with a history of thyroid disease should develop a treatment plan under the joint collaboration of an endocrinologist and an obstetrician-gynecologist.

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Thyroid Nodule Classification Standard

To standardize the diagnosis of thyroid diseases, we have categorized thyroid nodules into six levels, with the severity and the likelihood of malignancy increasing with each level: Grade 1 refers to normal thyroid tissue; Grade 2 indicates benign changes in the thyroid, with the risk of malignancy increasing over time. For example, simple thyroid cysts, which require an ultrasound check every 1-2 years; Grade 3 refers to the presence of nodules in the thyroid with a malignancy possibility of

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Where to do acupuncture for thyroid nodules?

Thyroid nodules do not require acupuncture treatment. The vast majority of thyroid nodules are benign, with only a small portion, about 5%, being malignant. We generally determine the treatment approach based on whether the nodule is benign or malignant. For benign nodules, we typically follow up with observation, while malignant nodules require surgical treatment and oral medication, or Iodine-131 radiotherapy. The primary evaluation for distinguishing between benign and malignant nodules relies on the results of color Doppler ultrasound and the pathology results from thyroid fine-needle aspiration.

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Written by Liang Yin
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Can thyroid nodules be detected?

Some thyroid nodules can be observed through visual inspection, while others cannot be seen as they vary in size, and most are very small. These nodules are often discovered during medical check-ups, specifically through ultrasonic imaging of the thyroid. Unless a thyroid nodule is particularly large, or grows outward prominently on the front surface of the neck, it can be visibly detected in a clinical setting. Thyroid nodules are quite common in thyroid diseases, and most are benign and do not require treatment, only regular follow-up examinations.

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Do thyroid nodules require surgery?

Whether thyroid nodules require treatment generally depends on medical guidelines. Thyroid nodules larger than 1cm with malignant features typically require biopsy. The decision for a biopsy should be made by a professional ultrasonographer after examination. Therefore, upon detecting a nodule, it is crucial to visit a specialized hospital for further ultrasound examination. If the nodule is malignant, we recommend surgical removal. If it is benign, close observation is advisable. However, treatment is necessary under the following conditions: First, if the nodule is too large and compresses other organs, causing breathing difficulties, localized swelling, pain, or other discomforts. Second, if the nodule grows quickly, increasing in volume by more than 50% within six months, the possibility of malignancy should be considered and treatment is needed. Third, if the thyroid nodule is located behind the sternum, which is called an ectopic thyroid nodule, surgical treatment is necessary. If the thyroid nodule is large enough to affect the aesthetics of the neck, surgical treatment may also be considered.

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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.