Hi, I'm Dr. Michael Via, with Beth Israel Medical Center, Division of Endocrinology and Metabolism.What are thyroid nodules, lumps and goiter and what can be done about them?A goiter is an enlargement of the thyroid gland or lump(s) in the neck, resulting is a swelling of the neck.The thyroid is a gland located at the base of the neck, right below the Adam's Apple or thyroid cartilage; it is responsible for producing hormones that regulate metabolism.Nodules are growths of cells and tissue within the thyroid. Sometimes they can occur in a cluster. They are also commonly called lumps or goiter, when very large.They are, for the most part, benign, asymptomatic, and can remain undetected for many years. Most nodules are not felt by touch and their existence is only revealed incidentally via imaging tests that are often performed for other medical reasons.Sometimes, however, the nodules will grow large enough so that they put pressure on surrounding structures such as the trachea or esphagus and can cause difficulty with breathing, swallowing, or can cause hoarseness in the voice. Rarely, they can be a source of neck pain.The incidence of thyroid nodules is increased in areas where dietary iodine consumption is low.Thyroid nodules are also associated with several conditions: hyperthyroidism, where the production of thyroid hormones is accelerated either by the nodule, or by underlying thyroid disease, resulting in severe symptoms including weight loss, tremor, palpitations, which are the sensation of a rapid heart rate, and heat intolerance, among other signs.Hypothyroidism caused by Hashimoto's thyroid disease, is also associated with increased rates of thyroid nodules.Sometimes thyroid nodules can be malignant and represent thyroid cancer. A family history of thyroid cancer and previous and repeated exposure to radiation are risk factors for the development of thyroid cancer. As mentioned, the majority of thyroid nodules do not represent thyroid cancer, however, when a nodule or group of nodules is found, a medical workup under the direction of your doctor or a thyroid specialist is recommended. Commonly performed tests include: blood tests, especially TSH level, thyroid ultrasound, thyroid uptake and scan, and possibly biopsy.To find out more, go to About.com.
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