Thyroid nodules are common, small growths that can form within the thyroid gland in the neck. Most thyroid nodules are benign (non-cancerous) and don’t typically cause symptoms. However, some may grow large enough to create cosmetic concerns or, in rare cases, produce excess thyroid hormones, leading to hyperthyroidism. Several non-surgical treatments are available to manage non-cancerous thyroid nodules.
Thyroid Hormone Replacement Therapy: For nodules associated with hypothyroidism (an underactive thyroid), levothyroxine—a synthetic thyroid hormone—may be prescribed. This can help suppress the growth of certain nodules and relieve hypothyroid symptoms.
Radioactive Iodine Ablation (RAI): Administered as a pill, radioactive iodine is naturally absorbed by the thyroid gland. This treatment can shrink thyroid nodules, especially those causing hyperthyroidism or noticeable cosmetic issues.
Ethanol Ablation: This minimally invasive procedure involves injecting ethanol (alcohol) directly into the nodule under ultrasound guidance. Ethanol ablation is especially useful for cystic or predominantly cystic nodules, shrinking the nodule and alleviating related symptoms or appearance concerns.
Thyroid Suppressive Medication: Medications like methimazole or propylthiouracil suppress the production of thyroid-stimulating hormone (TSH), reducing the stimulation of toxic nodules that produce excess hormones. This approach is generally reserved for nodules causing hyperthyroidism.
Ultrasound-Guided Laser Ablation: A thin laser fiber is inserted into the nodule via a small needle, and the laser heats and destroys the nodule tissue. Ultrasound guidance allows for precise targeting, minimizing damage to surrounding thyroid tissue.
Watchful Waiting: For small, asymptomatic nodules that aren’t causing cosmetic or functional issues, a “watch-and-wait” approach may be appropriate. Regular check-ups and ultrasound imaging monitor the nodule’s stability and detect any changes.
Non-surgical treatments can effectively manage many non-cancerous thyroid nodules, especially those causing symptoms or aesthetic concerns. Treatment choice depends on the nodule’s characteristics, the patient’s health, and personal preferences. Close follow-up with a healthcare provider is essential to monitor the nodule’s response to treatment and detect any potential changes.
