When to worry about thyroid nodules

Medically reviewed on August 17, 2022 by Jordan Stachel, M.S., RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

• You have difficulty swallowing and breathing
• You’re showing symptoms of hyperthyroidism
• You’re showing symptoms of hypothyroidism
• You’re showing symptoms of thyroid cancer
• How to check your thyroid nodules
• Test Your Thyroid Levels with Everlywell

For years, you avoided everything from the common cold to scrapes and bruises. Then, one morning, you see a lump at the base of your neck. Alarmed, you visit the doctor and learn you have a thyroid nodule.

Fortunately, most thyroid nodules aren’t a cause for concern. However, some thyroid nodules may show compressive symptoms, and a small percentage may even be cancerous. [1]

The good news is that harmful nodules are relatively easy to detect, and thyroid cancer is one of the most treatable types of cancer. [1] That said, knowing the symptoms of harmful or cancerous thyroid nodules can help you seek treatment before they become serious—let’s dive in.

1. You have difficulty swallowing and breathing

Located at the base of the neck, the thyroid is an endocrine gland that helps regulate metabolism. [2] When healthy, the thyroid gland shouldn’t cause any difficulty breathing or swallowing.

However, large thyroid nodules may make breathing and swallowing difficult. That’s because the thyroid gland covers the windpipe on three sides. Healthcare providers call this inability to breathe and swallow efficiently a globus sensation. [3]

In addition to difficulty breathing and swallowing, globus sensations symptoms appear in the following ways: [4]

• A “lump” in the throat
• Swelling
• Itching
• Hoarseness

While some globus sensation symptoms may be benign, difficulty breathing and swallowing means you may need to see your healthcare provider as soon as possible.

2. You’re showing symptoms of hyperthyroidism

In many ways, the thyroid functions as an important biological “factory,” producing the essential hormone thyroxine. Thyroxine helps with the following: [5]

• Digestion
• Metabolism
• Growth
• Bone density

However, some thyroid nodules may produce too much thyroxine. When this occurs, patients may show signs of the thyroid disease known as hyperthyroidism. [6]

In short, hyperthyroidism is a condition caused by the excess production of thyroxine. So, can hyperthyroidism cause weight gain? It may, and other common symptoms of hyperthyroidism include: [6]

• Constitutional symptoms – Constitutional symptoms are symptoms that impact many bodily systems. From a constitutional perspective, hyperthyroidism can cause weight loss, heat intolerance, and increased sweating.
• Neuromuscular symptoms – Hyperthyroidism can also cause neuromuscular symptoms. These overactive thyroid symptoms include tremors, anxiety, nervousness, and fatigue.
• Cardiovascular symptoms – From regulating your heartbeat to influencing your blood pressure, thyroxine plays a major role in your heart health. As a result, too much thyroxine can cause cardiovascular problems. Palpitations and irregular heartbeats are two of the most common symptoms of thyroxine overload.

This type of thyroid disease can also impact the gastrointestinal, pulmonary, and reproductive systems. [6]

3. You’re showing symptoms of hypothyroidism

Knowing when to worry about thyroid nodules also means understanding hypothyroidism. If hyperthyroidism results from too much thyroxine production, hypothyroidism results from too little. Thyroid nodules may play a prominent role in limiting thyroxine production. [7]

Common symptoms of hypothyroidism include: [7]

• Fatigue
• Weight gain
• Depression
• Dry skin
• Constipation

Given the often serious symptoms associated with hypothyroidism, it’s important to test your thyroxine levels. That way, you can see if your thyroid nodules are contributing to your hypothyroidism.

Want to know how to check your thyroid at home? At-home thyroid tests that measure thyroid hormone levels are excellent places to start. These tests can let you know if you’re at risk of developing hyper or hypothyroidism. They can even walk you through your treatment options.

4. You’re showing symptoms of thyroid cancer

As stated above, most thyroid nodules are benign. However, around five percent of thyroid nodules are cancerous. [1] Common symptoms of cancerous thyroid nodules include: [8]

• Pain at the base of your neck
• Swollen lymph nodes
• Increased hoarseness
• A large lump at the base of your neck
• Trouble swallowing
• Your clothes feel tighter around your neck

If you suspect your thyroid nodules are cancerous, it’s important to see your healthcare provider as soon as possible for a physical examination.

How to check your thyroid nodules

One of the easiest ways to check your thyroid nodules is to feel the base of your neck. If you feel or see a large lump, you may need to visit your healthcare provider Your healthcare provider may then have you undergo one or more of the following tests: [9]

• Physical exam – During a physical examination, your healthcare provider may have you swallow while they inspect your enlarged thyroid gland. They may also look for constitutional, neuromuscular, and cardiovascular symptoms of hyperthyroidism.
• Ultrasound – Ultrasounds can be especially helpful when trying to detect thyroid cancer in patients. That’s because this imaging technique maps thyroid nodules, allowing healthcare providers to see nodules’ shapes and sizes.
• Fine-needle aspiration biopsy – During a fine-needle aspiration biopsy, your healthcare provider will use a needle to extract thyroid cells from your nodules. They will then analyze the FNA biopsy samples to look for cancerous thyroid cells.

Your healthcare provider may also measure the levels of your three main thyroid hormones. You can also measure these hormones at home using an at-home lab test.

Test Your Thyroid Levels with Everlywell

In most cases, thyroid nodules are nothing to worry about. However, some thyroid nodules can be harmful. Harmful thyroid nodules can contribute to hyperthyroidism, hypothyroidism, and thyroid cancer. As a result, testing your vital thyroid hormone levels is one of the best ways to stay on top of your nodules.

No one understands this better than Everlywell. Our Thyroid Test measures three main thyroid hormone levels. We’ll even send you personalized, actionable results after a CLIA-certified lab reviews your sample.

Test your thyroid levels the right way with Everlywell.

Related content

How to test for hypothyroidism

How to balance thyroid hormones and possible treatments

How to check thyroid at home

References

1. Johns Hopkins Medicine. Thyroid Nodules: When to Worry. URL. Accessed August 17, 2022.
2. Physiological Reviews. Thyroid Hormone Regulation of Metabolism. URL. Accessed August 17, 2022.
3. European Federation of Oto-Rhino-Laryngological Societies. Characteristics of thyroid nodules causing globus symptoms. URL. Accessed August 17, 2022.
4. British Journal of General Practice. Globus pharyngeus: an update for general practice. URL. Accessed August 17, 2022.
5. StatPearls. Physiology, Thyroid Hormone. URL. Accessed August 17, 2022.
6. Lancet. Hyperthyroidism. URL. Accessed August 17, 2022.
7. Cleveland Clinic. Thyroid Nodules. URL. Accessed August 17, 2022.
8. Mayo Clinic. Thyroid cancer. URL. Accessed August 17, 2022.
9. Mayo Clinic. Thyroid nodules. URL. Accessed August 17, 2022.