Do thyroid nodules hurt?

Written by Zhao Xin Lan
Endocrinology
Updated on June 22, 2025
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Thyroid nodules generally do not cause pain. However, pain may occur if the nodules are due to subacute thyroiditis or if there is suppurative thyroiditis. Another possible cause of pain is the rapid enlargement of the thyroid due to a ruptured cyst, which can lead to severe pain. Additionally, most thyroid nodules are painless. Pain might occur when there is a change in the nodules, such as rapid growth, or if cancerous changes develop, potentially leading to localized pain.

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Written by Hu Jian Zhuo
Nephrology and Endocrinology
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Differentiation between benign and malignant thyroid nodules

Generally speaking, whether benign or malignant, thyroid nodules show blood flow signals. For benign nodules, blood flow signals can be seen around the perimeter, with internal blood flow no different from normal thyroid tissue. In such cases, the nodules are typically diagnosed as thyroid adenomas, and they usually appear round or oval in shape with a uniformly echoic internal substance. If liquefaction occurs, mixed or cystic changes can appear; the tumor’s capsule tends to be intact, with clear boundaries. If a nodule has abundant internal blood flow with disorganized vessel distribution and high flow velocity, showing a high-resistance flow pattern, and has relatively less peripheral blood flow, it generally needs to be assessed for thyroid cancer. These nodules are often hypoechoic with irregular shapes, and the ratio of their longitudinal to transverse diameter is greater than 1. They have unclear boundaries, lack a capsule, and have no halo. In typical cases, microcalcifications like sand grains can also be observed. From the above analysis, we can see that the blood flow signals in thyroid nodules are complicated and reflect the extent of the nodular pathology. These signals can help in differentiating benign from malignant nodules, but when a rich and disorganized blood flow is observed, the nodule is more likely to be malignant.

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Written by Gan Jun
Endocrinology
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Can thyroid nodules heal themselves?

Thyroid nodules cannot heal on their own, but with appropriate treatment, good recovery can be achieved. Thyroid nodules are a common clinical disease, with many causes. Nodules can be either solitary or multiple, and the incidence of multiple nodules is relatively higher. Regardless of the cause, thyroid nodules are more common in middle-aged women, with the most common symptoms including thyroid enlargement, neck discomfort, and localized thyroid pain. When people are diagnosed with thyroid nodules, there is no need to be overly worried. If the color ultrasound and thyroid function tests show no abnormalities, it is possible to observe the condition dynamically, with a follow-up check about once a year. If there is a high suspicion of malignant nodules, it is advisable to opt for early surgical removal, which typically yields very satisfactory results.

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Written by Hu Jian Zhuo
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Probability of thyroid nodules becoming cancerous

The malignant manifestation of thyroid nodules is thyroid cancer. Thus, thyroid nodules are divided into two major categories: benign and malignant. Benign nodules generally make up the vast majority, with malignancies accounting for less than 5%. Malignant thyroid nodules are cancerous. Some benign thyroid nodules may also become malignant over time. Generally, small nodules do not show obvious clinical symptoms during the cancerous transformation, but their nature changes. When a nodule compresses surrounding tissues and causes certain symptoms, such as hoarseness, tracheal compression, and difficulty swallowing, it often indicates that the tumor is in the middle or late stage. Overall, the chances of benign nodules becoming cancerous are very small. The malignancy rate of benign nodular goiter is about 5%, and the possibility of adenomas turning malignant is around 10%. As the diameter increases, the possibility of adenomas becoming malignant gradually increases. There are several high-risk factors for the malignant transformation of thyroid nodules: for instance, having a history of radiation exposure to the head and neck area during childhood or adolescence, patients who are younger than 14 or older than 70; the rate of malignant transformation of thyroid nodules significantly increases; and the rate of malignant transformation in male nodules is significantly higher than in females. Also, patients whose nodules significantly increase in size in a short period during regular check-ups are also considered high-risk for malignancy.

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Written by Chen Xie
Endocrinology
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The difference between thyroid enlargement and thyroid nodules

Thyroid enlargement generally refers to simple thyroid enlargement, which is typically diffuse thyroid enlargement, mainly caused by iodine deficiency, commonly seen in endemic goiter and physiological thyroid enlargement. Thyroid nodules, on the other hand, are nodular hyperplasia of the thyroid caused by certain physical and chemical factors. Thyroid nodules can manifest as benign hyperplasia or malignant hyperplasia. Therefore, the risks associated with thyroid nodules are relatively greater than those of thyroid enlargement. However, some patients with thyroid enlargement, as the disease progresses, can develop nodular hyperplasia of the thyroid. These are the differences between the two.

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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.