Symptoms:

Most thyroid nodules produce no symptoms.

Large nodules can press against other structures in the neck. Symptoms may include:

• Difficulty breathing  
• Difficulty swallowing  
• Hoarseness or changing voice   
• Pain in the neck
• Goiter

Nodules that produce thyroid hormones will cause symptoms of hyperthyroidism, including:

• Weight loss 
• Increased appetite 
• Nervousness
• Restlessness 
• Clammy skin
• Skin blushing or flushing
• Bounding pulse

Thyroid nodules resulting from Hashimoto's disease may cause symptoms of hypothyroidism, including:

• Intolerance to cold
• Fatigue
• Dry skin
• Hair loss
• Unintentional weight gain
• Facial swelling

Signs and tests:

Very often, doctors will find thyroid nodules only during a routine physical exam, because the nodules produce no symptoms. When a doctor finds a nodule, or when there are symptoms that suggest a nodule, your doctor may order the following tests:

• TSH level
• Fine needle aspiration biopsy
• Thyroid ultrasound
• Thyroid scan -- a nodule that works apart from the thyroid gland is said to be "warm" or "hot," and will appear darker on the scan. Only 1% of working nodules are cancerous. Approximately 20% of cold (non-working) nodules are cancerous.
• T3 and T4 levels