** Please note: If you want the longer version of this article with full details, then please click here **

Thyroid Nodules – What are they?

A thyroid nodule is a growth of thyroid cells that forms a lump within the thyroid (Smith-Bindman R, 2013). Most nodules are cysts filled with fluid or with a stored form of thyroid hormone called colloid (American Cancer Society, 2019). Solid nodules have little fluid or colloid and are more likely to be cancerous. However, most solid nodules are not cancer (American Cancer Society, 2019).

How common are Thyroid Nodules?

Frequency ranges from 4-7% by palpation of the thyroid and from 20-76% by ultrasound in the adult population (Fröhlich E, 2019).

Thyroid nodules found in either surgery or autopsy are reported to be between 50-65% (Fröhlich E, 2019).

They are most common in women (Popoveniuc G, 2012).

The great majority, 95%, of thyroid nodules are benign (Smith-Bindman R, 2013). The remaining 5% are malignant and are among the most successfully treated endocrine cancers (Stancioiu F, 2019).

What Causes a Thyroid Nodule?

The root causes of benign thyroid nodules are not entirely clear. There is research showing a number of factors that are likely contributing to the development of benign thyroid nodules. A thyroid nodule is basically inflammation so we need to identify what is causing the inflammation. We need to get to the root cause. Possible causes are:

Chronic inflammation of the thyroid, due to Hashimoto’s

• Iodine deficiency
• Radiation exposure
• Obesity: There is a positive association between total body fat percentage and thyroid nodules (Andrade de Siqueira R, 2019). Severely obese and obese people are be more likely to develop thyroid nodules (Andrade de Siqueira R, 2019).
• Metabolic syndrome: Metabolic syndrome is a grouping of abnormalities; abdominal obesity, high blood glucose levels, dyslipidemia (high cholesterol), insulin resistance (IR) and hypertension (high blood pressure). The aspects of metabolic syndrome that are most associated with thyroid nodules are hypertension and abnormal glucose metabolism (Mousa U, 2019).
• Abnormal glucose tolerance (diabetes type 2 or pre-diabetes)
• High blood pressure
• Insulin resistance (IR): There is a relationship between IR, thyroid volume and the formation of thyroid nodules in those with metabolic syndrome (Andrade de Siqueira R, 2019).
• IGF-1-related mechanisms: IGF-1 is Insulin Like Growth Factor, a protein that is similar to insulin (Mousa U, 2019). It stimulates cell growth and decreases cell apoptosis or cell death (Mousa U, 2019). It increases the risk of developing thyroid nodules, as does higher insulin levels seen in people with IR (Mousa U, 2019).
• Vitamin D: Lower vitamin D3 levels, in the presence of metabolic syndrome, has also been observed to be associated with thyroid nodules in severely obese patients (Andrade de Siqueira R, 2019).
• Gut Microbiome: Thyroid disorders are linked to the composition of the gut microbiome (Fröhlich E, 2019). In fact, thyroid nodules, specifically, are associated with the composition of gut microbiome (Zhang J, 2019).

Solutions for a Benign Thyroid Nodule

Standard Treatment

Benign thyroid nodules can usually be left untreated and monitored closely, as long as they are not growing in size or causing symptoms.

Treatment strategies include surgery and some non-invasive procedures including radiofrequency ablation, alcohol injection, high intensity-focused ultrasound or laser ablation. Performing any type of procedure or surgery should be based on the risk of malignancy and symptoms from the nodule (Durante C, 2018).

FM Solutions to Thyroid Nodules

As always, we strive to bring you natural solutions to consider which can help to avoid surgery, procedures or medications. One key to thyroid nodules is to reduce inflammation. How can you reduce inflammation?

• Reduce Risk of Metabolic Syndrome
• Balance Blood Sugar and Follow an Anti-Inflammatory Diet
• Fix Gut Health
• Consider an Iodine Deficiency
• Manage Stress Levels
• Check for Chronic Viral or Bacterial Infections
• Avoid Toxins
• Get Adequate Sleep

Supplements: 

A combination of spirulina-curcumin–Boswellia decreases the size of benign thyroid nodules (Stancioiu F, 2019). The mechanisms through which the supplement works is likely due to the anti-inflammatory effects and improved antioxidant status of the supplement combination (Stancioiu F, 2019).

• Iodine: Thyroid nodules are related to an iodine deficiency. It is therefore advisable to have iodine levels tested through a urine test and to supplement if necessary, with the help and expertise of your FM practitioner.
• Vitamin D: Vitamin D is associated with thyroid nodules. Have your D levels tested and supplement if necessary.

*** This is the end of our Thyroid Series. ***

In future blog articles and series, we will cover varied topics such as Sports Nutrition, MS and others. Please stay with us each week for more info on how to apply Functional Medicine to different health conditions.