Treatment:

Some thyroid nodules disappear without treatment. Surgery is recommended for nodules that:

• Are cancerous
• Cause symptoms
• Cannot be diagnosed as cancer or non-cancer

Patients with working nodules sometimes receive treatment with radioactive iodine, which reduces the size of the nodule. However, the treatment can cause hypothyroidism and radiation-induced thyroiditis (inflammation of the thyroid gland). Pregnant women should not be given this treatment. Women being treated with radioactive iodine should not get pregnant.

Levothyroxine (Synthroid, Levoxyl, Levothroid, Unithroid) is a drug that suppress the production of the thyroid hormone T4. A doctor may prescribe levothyroxine to treat benign nodules only in special cases, including:

• A growing nodule
• A nodule causing pressure on other structures in the neck
• When many nodules are growing in the thyroid gland

Levothyroxine does not seem to benefit most people with thyroid nodules, and can cause serious complications. Complications include heart problems and loss of bone density.

Careful follow-up is the only recommended treatment for benign nodules that do not cause symptoms and are not growing. A thyroid biopsy may need to be repeated 6-12 months after diagnosis. An ultrasound may be repeated as well.

Newer treatments include ethanol (alcohol) injection into the nodule and laser therapy.

Expectations (prognosis):

Non-cancerous thyroid nodules are not life threatening. Many do not require treatment, only follow-up. Non-cancerous nodules that do require treatment have an excellent outlook.

The outlook for cancerous nodules depends on the type of cancer. See: Thyroid cancer.

Complications:

Hyperthyroidism is a common complication of non-cancerous thyroid nodules. Complications of treatment can include:

• Nodule regrowth
• Scarring from surgery
• Hoarseness or  voice changes as a result of vocal cord damage during surgery -- this happens especially if the nodule is close to the voice box
• Heart-related problems as a result of side effects from medication
• Weak bones resulting from medication treatment
• Hypothyroidism

Calling your health care provider: