Update – Why I Want To Rename “Adrenal Fatigue”December 8, 2019
Is SIBO a real condition?December 16, 2019
Maybe you have never heard this before, but did you know that 40% of women in their 40’s have thyroid nodules? Healing thyroid nodules and learning how to shrink thyroid nodules without surgery is possible, but you need to start by knowing more about it. If you have been concerned about your nodules turning into thyroid cancer – this article is here to help.
What Are Thyroid Nodules?
To put it simply, nodules are abnormal lumps that are made up of thyroid tissue. Scaling back, we need to begin by understanding that the thyroid itself has a normal buildup of cells, called follicles, which:
- Concentrate iodine and Absorb tyrosine
- Make thyroglobulin out of tyrosine
- Use thyroid peroxidase to attach iodine to thyroglobulin making T3 and T4
- Release T3 and T4 based on TSH levels
These small, nest-like follicles of cells actually build hormones in your body. They perform all these steps for your thyroid to function. What happens, though, is that some parts remain uneven or are not the same texture. These are what we call “nodules.”
Bottom Line: Your thyroid has an important job to perform. All the moving parts can result in unwanted bits of follicles that build up. Determining whether or not these nodules are a problem is crucial, but that does not mean that they are destined to be one.
What Causes Thyroid Nodules?
In the modern world, the main cause of thyroid nodules comes from Hashimoto’s thyroiditis. Other causes can include:
- Exposure to radiation
- Iodine deficiency – typically a culprit in the developing world
- Iodine excess – an issue in the developed world (which contributes to Hashimoto’s thyroiditis)
Bottom Line: Iodine can play a critical role in causing thyroid nodules. If you feel like you need a comprehensive refresher on the subject of iodine, my in-depth guide is a fantastic starting point.
Who Gets Thyroid Nodules?
Those who get thyroid nodules parallel the percentage and decade (by age) quite conveniently. With women specifically, we see that their age and their decade corresponds quite clearly with a risk for developing nodules.
Key Insight: If you are 30, there exists a 30% risk of you developing thyroid nodules. If you are 50, there is a 50% chance of you developing thyroid nodules. The same applies to 60 (60%) and 70 (70%). It’s pretty easy to remember, but please do not forget this pivotal trend.
Overall, developing thyroid nodules is three times more common to occur in women over men. For women especially, this means that getting to know more about your thyroid is key.
For men, we need to be aware of the chances of developing thyroid problems and how it changes between genders. It’s just as important to understand the risk as well as the differences.
Are Thyroid Nodules Dangerous?
Most folks are concerned that thyroid nodules are going to inevitably become dangerous for your health. After learning a bit more about them, here is what you need to know…
I will tell you that the safe answer is that thyroid nodules are usually not dangerous and that there are natural remedies for thyroid nodules out there. Oftentimes, 95% (or more) are benign. They pose no risk.
Those who are more at risk for developing cancer from nodules include those who:
- Have Hashimoto’s disease
- Have a history of multiple endocrine neoplasias
- Are under 25 or over 60 (and men of all ages)
It is always worth noting the following. It is less common today, but those who have had significant radiation exposure to their thyroid glands are also more likely to have dangerous nodules.
Bottom Line: Now, you might be worried about thyroid nodules. First, though, you need to determine whether you even have them. Then, know that just because you have them does not mean that they are going to harm you. The vast majority of nodules are harmless.
Can I Have Symptoms From Thyroid Nodules?
I have had lots of people ask me this question, specifically when they are at risk of developing thyroid nodules. If you are concerned that you might “feel” something from your nodules, what you deserve to know is that there are usually no symptoms at all.
If the nodules are on the larger side, and because of where your thyroid sits, they can affect swallowing or speaking. This effect is because of their location near the nerves that control the movement of the tongue.
Nodules that are large and put pressure on the nerves end up altering the signal that they carry. This can cause symptoms like:
- Difficulty swallowing
- A deeper voice
- The feeling of a lump in your throat
Toxic nodules end up creating extra thyroid hormones. They can cause symptoms because they change your thyroid hormone levels.
These are symptoms that are typical of hyperthyroidism, including:
In rare cases, nodules are large enough to where they might even end up causing localized pain.
Bottom Line: If they are really big, or in the wrong place, thyroid nodules might cause some discomfort or changes in symptoms related to speaking or swallowing.
How Do You Know If You Have Thyroid Nodules?
These three methods can determine whether or not you have thyroid nodules, they are:
- A self-examination
- Doctor’s exam
Doctor’s exams are effective at picking up nodules somewhere around 5 – 10% of the time. Self-exams are just as similar (unless you are doing it regularly and can pick up on irregularities with ease). Ultimately, the gold standard is ultrasounds.
Even though they may not be as effective in identifying nodules, self-exams are a good habit to get into. This is because they are helpful for identifying early thyroid cancer.
It is best to do one each month. If you are already in the habit of doing self-breast exams (and you should be), perform your neck exam at the same time. Well, not the exact same time, that would require extra arms!
Here is how you can perform an easy self-examination on your thyroid:
- Take a handheld mirror and a glass of water.
- Hold the mirror in your hand and look at the area of the neck below your Adam’s apple and immediately above your collarbone.
- While looking in the mirror, tip your head back and take a drink of water.
- As you swallow, keep a close eye on your neck and keep a close eye out for any protrusions or bulges.
- If you see anything different than usual, you may have a nodule or an enlarged thyroid gland.
Bottom Line: I actively encourage all of those with thyroid disease to have a screening ultrasound to determine the state of your thyroid. This is where you have the chance to find out whether you have a potentially dangerous nodule that you might have never noticed.
How Are Thyroid Nodules Treated?
In conventional medicine, nodules are commonly approached with the following steps of treatment:
- Monitoring through routine screening
- Given closer examination with biopsy
- Removed surgically or reduced with ablation
In most cases, conventional medicine simply does not treat nodules that are below 1 centimeter. It is instead recommended that doctors repeat screening on intervals of 6 to 12 months. In many cases, though, this does not happen.
Nodules that have suspicious characteristics are recommended to be biopsied to see if they already contain cancer cells. Suspicious nodules are those that are large (over 1 centimeter in diameter).
Key Insight: Nodules that have large amounts of calcification or large numbers of blood vessels are also more worrisome for having cancer.
Biopsies are not perfect, because they are only checking a small number of cells from a large area. If they do identify cancer, they are accurate 90% of the time.
However, if they fail to see cancer the rate of false negatives can be as high as 40%. It is common that 30% of biopsies result with data that is inconclusive.
Surgery is not commonly used for benign nodules. This is unless they are large enough to cause significant pain or impingement on the muscles, nerves, or blood vessels of the throat.
This is a non-surgical option for those with nodules large enough to cause local problems but lacking in signs suggesting they may be cancerous (and therefore do not warrant excision).
In a recent, large study, radio ablation has been shown to reduce nodule volume by a substantial percentage (typically 60 to 80%).
It has also been shown not to alter thyroid function. Those who had normal thyroid function before ablation retained it afterward.1
How Does Radio Ablation Work?
It works by generating heat within the nodules. This heat causes the breakdown of some of the tissue which the immune system can eliminate in a matter of days/weeks.
The procedure itself does not use radiation. Typically it is complemented by an ultrasound to help the operator hone in on the right location.
Major side effects are not known to happen. Minor side effects, though, do have the potential to occur (from irritation on the site of treatment).2
There is another technique called sonoelastography. This has been studied as an alternative to biopsy for low-to-moderately-suspicious nodules.
Basically, this is a method of ultrasound using physical compression against the nodules to get more data about their density.
This technique is not clinically available, because studies have shown this method to be less effective than biopsies (both in terms of identifying cancer and in avoiding false negatives).3
What Steps Can I Take To Treat Thyroid Nodules?
So, what do you do if you have a nodule and need a natural cure for thyroid nodules? Well, that depends entirely on the state of your nodule. This is another opportunity for me to advocate on behalf of ultrasounds.
Do you need to have a biopsy? Well, that relies on multiple factors, such as:
- Your nodule is well over 1 centimeter in size
- If your nodule has calcified (with lots of calcified spots)
- If your nodule has exaggerated blood vessels (hypervascular)
Considering all these factors, you may want to have your nodule biopsied. This is only because the nodule looks suspicious and could run the risk of developing into cancer.
Key Insight: This is a pretty important collection of conditions for any thyroid nodule to be considered for a biopsy. Keep that in mind. Typically, you need to have some sort of combination of these three to require surgery.
If you have a nodule that is biopsied, the next consideration is removal. How do you know when to remove, though? Consider the following:
- You have had an abnormal biopsy
- The nodules are growing quickly
- There are abnormal lymph nodes nearby
- The nodule is putting pressure on vessels or nerves
- We see high levels of thyroglobulin
All of these factors could play a role in deciding whether or not the nodule, or portions of the thyroid, need to be removed.
How Do You Naturally Reduce Nodules?
Let’s take a step away from the sharp, scary stuff. What can we do to deal with thyroid nodules in a more natural way? Do we have options? Of course we do.
The two biggest factors that play a role in handling thyroid nodules are:
- Dialing in your TSH
- Dealing with your iodine4
- Reversing insulin resistance
When it comes to your TSH, let’s think about the “normal/optimal” range. What we have is a very broad “normal” range, and a very slim “optimal” range.
Bottom Line: What we want to do, when it comes to nodules, is to get even narrower (between 0.5 and 0.9 – but not lower).
How Does TSH Effect Nodules?
What we know about TSH is that it stimulates the thyroid. While that might be great for a thyroid that is perfectly healthy, it can also play a role in stimulating nodules.
Think of it like a garden. Let’s say you have the most beautiful tomato plants. Could you put Miracle-Gro on it to make it grow faster? Sure, you could, but what if you had weeds in that same garden?
Instead of killing those weeds off, what if the Miracle-Gro made them grow? At that point, you might need to ask yourself whether the Miracle-Gro is worth it, or whether it is actually making things much worse.
Key Insight: More TSH causes thyroid nodules to grow and can potentially make them problematic. The lower you get your TSH into that “optimal” range, the better chance you have of suppressing the growth of potential nodules.
Iodine can be a culprit for thyroid nodules. The odd thing is that too much can be bad, but too little can also be a culprit5. However, this is not relevant in a modern world where we have iodine fortification. Here, our risk is more commonly on the side of ‘too much.’
The best range for those with nodules is between about 100 to 300 micrograms daily (from all combined sources).
if you are on thyroid medication, you are already getting at least as much iodine as you need. Any extra amounts found in things like:
- Sea vegetables
- Other high-iodine foods
All of these things only push you above the best levels.
Key Insight: When it comes to iodine, too little is definitely not good, and so is too much. Even a responsible change can be dangerous for certain segments of the population. That balance is so delicate, and it is pivotal that you get it right.
There is data suggesting that when your body has a more difficult time dealing with blood sugar, it is more likely to grow nodules6.
When we are better able to deal with how our bodies deal with insulin, it can go a long way in managing our risk for developing nodules.
We have seen that large amounts of produce in the diet can cut the risk of nodules – while suppressing the growth of nodules, and ultimately helping reverse them altogether.
People who have insulin resistance have been shown to have a greater risk for nodules even if they do not otherwise have thyroid disease. This is true for both adults and children.7
It has also been shown that reversing insulin resistance can be one of the factors that help nodules shrink. There is speculation that diabetic medications may be useful for this but there are safer ways to reverse insulin resistance.
Key Insight: The Metabolism Reset Diet has been shown to be consistently effective at reversing insulin resistance within 4 weeks (in over 90% of participants).
The Metabolism Reset Diet consists of plant-protein-based shakes for breakfast and lunch that contain resistant starch along with one healthy evening meal and unlimited snacks if they are needed.
When insulin resistance is reversed, people find that they can keep it steady with a healthy diet even if that same diet was not enough to reverse it in the first place.
Once you complete the Metabolism Reset Diet, there are also some recommendations for simple maintenance ideas keep your body stable.
If you are concerned about insulin resistance, we even offer a free challenge each month for those who would like to learn more about the diet or try it out (Click Here).
There is also an overarching benefit of getting more produce into your diet, and nodules are just one more reason to add a little bit more fresh fruit into your life!
Many have talked about cruciferous vessels as goitrogens, and while that is a bit of a separate topic, it has been shown that cruciferous vegetables have the ability to reduce nodules.
Bottom Line: Have your produce, and do not be worried about it! If you get more into your diet, you ward off nodules that might start appearing in a natural way. It can be a helpful, and tasty, way to keep your thyroid in check.
Do you want to start checking for thyroid nodules right away while seeking out natural thyroid nodule treatment?
Here is what I want to leave you with so that you can start taking more steps towards better health today. Start:
- Getting in the habit of performing monthly self-examinations
- Scheduling a doctor’s exam of your thyroid
- Having an ultrasound done of your thyroid
- If you have nodules, take the steps you need to cut your risk (cutting your TSH and getting it into that optimal range, dialing in your thyroid, and enjoying a diet that is high in produce and cruciferous vegetables)
Bottom Line: Keeping on top of thyroid nodules simply comes down to being aware of the state of your thyroid. Keeping in touch, literally, with your thyroid and it will pay dividends.
1 – https://www.endocrineweb.com/conditions/thyroid/thyroid-nodules
2 – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5905420/
3 – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5455047/
4 – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4809115/
5 – https://www.ncbi.nlm.nih.gov/pubmed/21513914
6 – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3575959/
7 – https://www.ncbi.nlm.nih.gov/pubmed/26618447
8 – https://www.healio.com/endocrinology/thyroid/news/in-the-journals/%7B6b85f598-d4cf-4f09-8503-658fae4b942c%7D/extreme-insulin-resistance-influences-thyroid-nodule-growth-in-children
P.S. Whenever you are ready, here is how I can help you now:
1. Schedule a Thyroid Second Opinion with me, Dr. C, Click Here for Details
2. Download and use my Favorite Recipes Cookbook Here
3. Check out my podcast Medical Myths, Legends, and Fairytales Here
Dr. Alan Glen Christianson (Dr. C) is a Naturopathic Endocrinologist and the author of The NY Times bestselling Adrenal Reset Diet, The Metabolism Reset Diet and The Thyroid Reset Diet.
Dr. C’s gift for figuring out what really works has helped hundreds of thousands of people reverse thyroid disease, lose weight, diabetes, and regain energy. Learn more about the surprising story that started his quest.