When Should you Worry About Thyroid Nodules? 6 Signs to Know

When Should You Worry About Thyroid Nodules? Look For These Signs

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Is your thyroid nodule actually thyroid cancer in disguise?

This is the question that most people ask themselves and it’s the question we are going to explore today. 

The good news is that most nodules are NOT cancerous and there are certain signs and symptoms, if present, that do increase the chance that your nodule may be harboring cancer. 

Signs your Thyroid Nodule May be Something More

The biggest fear that most people have when it comes to thyroid nodules is whether or not they should worry about it. 

And this makes a lot of sense, considering the thing you should be worried about is your risk of cancer. 


Because each thyroid nodule, regardless of the size, has a small risk of turning into thyroid cancer. 

The good news is that this is actually quite rare. 

If we looked at the population of the world we would find that about 20 to 70% of people (1) have a thyroid nodule!

Obviously, thyroid cancer is not nearly as common which means that most people with thyroid nodules do NOT get thyroid cancer

Having said that, there are some people that will, which is what we are going to talk about now. 

If you have a thyroid nodule AND you have any of these other signs or symptoms, then you may be at a slightly higher risk of thyroid cancer:

  • The size of your thyroid nodule is greater than 2.0 cm or 20 mm (a size greater than 1.0 cm or 10 mm may also be worrisome as well)
  • Unexpected weight loss
  • Difficulty swallowing
  • Changes to your voice or hoarseness when you talk
  • Pain or discomfort in the neck area
  • Enlargement of the lymph nodes in or around your neck
  • A noticeable or irregular lump in your neck
  • Symptoms of hyperthyroidism (weight loss, heart palpitations, sweating, nervousness, heat intolerance)
  • If you have a thyroid nodule and you are younger than 20 years old or if you have a thyroid nodule and you are older than 70

Let me be clear, though, just having these symptoms does not guarantee that you have thyroid cancer. 

But if you do have these signs/symptoms then it’s probably a good idea to get checked out by your doctor with advanced testing such as ultrasound or even a biopsy (more information below). 


Foods to Avoid if you Have Thyroid Problems:

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The Complete List of Thyroid Lab tests:

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Thyroid Nodules are usually Benign and Not Cancerous

The good news is that most people with thyroid nodules do not and will not get thyroid cancer. 

The bad news is that a thyroid nodule is not normal and may be associated with other conditions of your thyroid gland. 

So, even if you don’t have thyroid cancer, you should still have your thyroid nodule evaluated and tested for other conditions which are associated with thyroid nodules. 

Conditions in this category include:

  • Goiter – Conditions such as iodine deficiency can lead to an enlargement of your thyroid gland. This condition may also contribute to the development of nodules. 
  • Thyroid cysts – Thyroid cysts are a type of thyroid nodule but they are filled with fluid. These cysts are often identified very easily with thyroid ultrasound but can present the same way as a thyroid nodule. 
  • Hashimoto’s thyroiditis – Hashimoto’s thyroiditis is an autoimmune condition of the thyroid gland which also causes hypothyroidism. This condition is very common, especially among women. 
  • Other types of thyroiditis – Infections, trauma, and autoimmune attack can all cause inflammation of the thyroid gland. Inflammation triggers damage to the thyroid gland which may lead to the development of a thyroid nodule. 
  • Hyperthyroidism – Most thyroid nodules do not secrete thyroid hormones but some “hot” nodules can actually secrete thyroid hormones which may cause the symptoms of hyperthyroidism. If you have hyperthyroid-Esque symptoms then your doctor should evaluate for these hot nodules. 
  • Thyroid cancer – Some nodules are associated with thyroid cancer but this is actually quite rare. Only about 5-10% of thyroid nodules are cancerous. 

It’s important to realize that many thyroid nodules are just run-of-the-mill nodules that are not associated with thyroid disease of any kind. 

But, in order to be on the safe side, it’s ideal that every patient who has a thyroid nodule undergoes certain tests to ensure that this is the case. 

Tests such as a comprehensive history and physical, palpation of the thyroid gland, tests of your thyroid function through blood work, and even ultrasound may all be warranted. 

Your doctor should be walking you through these steps but you can also ask for them if you are worried. 

How Big is Too Big? 

When it comes to thyroid nodules, the size matters quite a bit. 

Studies have shown time and time again that larger thyroid nodules tend to turn into thyroid cancer at a higher rate compared to smaller thyroid nodules. 

The magic number in terms of size is 1 cm or 10mm. 

But size isn’t the only thing that matters. 

For instance:

It has been shown that even small thyroid nodules can be cancerous if they have certain and specific findings on thyroid ultrasound. 

“The number of nodules and their size are not predictive of malignancy, as a nodule smaller than 1 cm is as likely as a larger nodule to harbor neoplastic cells in the presence of suspicious US features.”

Thyroid Nodules by Popoveniuc and Jonklaas (2)

For this reason, you never want to judge the risk of thyroid cancer based on the size of your nodule alone. 

You will notice that while size is certainly a risk factor, you should also look at other risk factors including whether or not the nodule is causing symptoms, your age, and what the nodule looks like on ultrasound. 

As a patient, though, you can use the size of your nodule as a quick and dirty way to assess whether or not you should be worried. 

Thyroid Nodules and Thyroid Cancer

The biggest concern on most people’s minds is probably whether or not their thyroid nodule is actually cancer in disguise. 

As I mentioned previously, most thyroid nodules (about 90% or so) are benign. 

But that leaves another 5-10% which can be cancerous and should be evaluated. 

There are some factors that have been evaluated that can help you understand your risk of thyroid cancer. 

The risk of thyroid cancer increases with these risk factors:

  • Age – The younger or the older you are, the more likely your nodule is to be cancerous. This is true if you have a thyroid nodule are you are younger than 30 or older than 60. 
  • Gender – Women tend to get thyroid cancer more often than men but thyroid cancers in men tend to be more aggressive. 
  • Genetics (family history) – Do you have a family history of thyroid cancers or thyroid nodules? If so, this may increase your risk.
  • Size of the nodule – The bigger the nodule the greater your risk of cancer. 
  • History of radiation exposure – Radiation exposure from things such as X-rays and CT scans may increase your lifetime risk of developing thyroid cancer. If you undergo these types of tests ensure that your thyroid gland is protected with a lead shield. 
  • History of other cancers – Do you have a history of other cancers? Especially endocrine (hormone) cancers such as MEN (3), MTC, or PTC? If so, your risk of developing thyroid cancer is increased. 
  • How fast the nodule is growing – Most thyroid cancers are actually slow growing. This is why doctors recommend that you get frequent ultrasound testing of your thyroid nodule every 6 to 18 months (4). 
  • Symptoms that are associated with your nodule – Symptoms such as a chronic cough, pain in the neck, and lymph node enlargement are all suspicious symptoms. 

Ultrasound Testing & Manual Exams

There are really three different ways to test or evaluate your thyroid nodule. 

The first is with a manual exam, usually performed by your doctor. 

This is an easy way to test whether or not you need further testing. 

Your doctor can do this when you visit him/her in the office. 

This test is usually done by manually feeling or palpating the thyroid gland while the patient (you) is taking a drink of water. 

The second is ultrasound testing, usually performed by an ultrasound technician and read by a radiologist. 

Ultrasound testing can help you to understand if your thyroid nodule looks suspicious or not. 

There are certain factors, or characteristics, which, if present, may increase your risk of having thyroid cancer. 

These factors include: 

  • The presence or absence of calcificationMicrocalcifications (5) found within thyroid nodules may suggest the presence of thyroid cancer. 
  • The shape of the nodule – If your thyroid nodule is taller than it is wide (6) then that is a risk factor for thyroid cancer. 
  • The vascularity of the nodule – The presence of vascularity by Doppler ultrasound (7) is also suspicious for thyroid cancer. 
  • The margins of the nodule – Nodules which have irregular borders, which look ‘infiltrative’ (8), or which have speculated margins are all suspicious. 

Your ultrasound report should include this information and you can request this information from your primary care doctor or your radiologist. 

But, even if you request the information, you should have your doctor also evaluate this information to help you understand it. 

You can also technically evaluate thyroid nodules with other tests such as MRI and CT scans but these are not often recommended. 

The third is with a biopsy, usually guided by an ultrasound. 

Getting a Biopsy (Fine Needle Aspiration)

A biopsy often referred to as a fine needle aspiration or FNA, is the most conclusive way to test your thyroid nodule. 

This procedure can also be done on enlarged lymph nodes in your neck which may be a better way to diagnose thyroid cancer. 

The only problem is that it is also the most invasive procedure out of all three methods. 

It’s really cheap and easy to check your thyroid gland manually at a regular visit with your doctor. 

It’s also fairly easy to get an ultrasound of your thyroid gland. 

Even though getting a biopsy is not technically difficult (it’s easy to find a nodule and stick a needle in it), you don’t necessarily want to get a biopsy of every thyroid nodule that you see (9). 


While a biopsy is conclusive if your thyroid nodule contains cancer cells, there are many times when the results come back as “inconclusive”. 

If you get an inconclusive result then you are stuck in a position where you simply need to monitor the thyroid gland and potentially get a repeat biopsy after some period of time. 

The waiting game can cause unneeded stress and anxiety to you the patient as you wait. 

Furthermore, you don’t really want to get a biopsy unless absolutely necessary because there are small risks involved (10) with any medical procedure. 

The risk of bleeding or infection is small, but they are still real and present. 

For these reasons, you really don’t want to get a biopsy unless absolutely necessary based on the size of your nodule or based on the features your nodule has on ultrasound testing. 

Most recommendations suggest getting a biopsy if your nodule is greater than 1.0 cm by itself. 


Most thyroid nodules are not cancerous and are not something that you should be worried about. 

Even though this is true, it’s still a good idea to get properly evaluated by your doctor to ensure that your thyroid nodule is completely benign. 

When you get your nodule tested, be sure to also look for other thyroid conditions which are frequently associated with thyroid nodules. 

These conditions, if not treated, can lead to quality of life problems such as fatigue, weight gain, and so on. 

Now I want to hear from you:

Do you have a thyroid nodule?

Are you showing signs which are concerning?

Have you had your nodule tested yet?

What did you find?

Leave your comments or questions below! 

#1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5024877/

#2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3575959/

#3. https://www.endocrineweb.com/conditions/multiple-endocrine-neoplasia-men-types-1-2

#4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4729706/

#5. https://www.ncbi.nlm.nih.gov/pubmed/23323040/

#6. https://www.ncbi.nlm.nih.gov/pubmed/21877934/

#7. https://www.ncbi.nlm.nih.gov/pubmed/20308462/

#8. https://www.ncbi.nlm.nih.gov/pubmed/16596732/

#9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3936789/

#10. https://www.ncbi.nlm.nih.gov/books/NBK285544/

when to worry about thyroid nodules

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About Dr. Westin Childs

Hey! I'm Westin Childs D.O. (former Osteopathic Physician). I don't practice medicine anymore and instead specialize in helping people like YOU who have thyroid problems, hormone imbalances, and weight loss resistance. I love to write and share what I've learned over the years. I also happen to formulate the best supplements on the market (well, at least in my opinion!) and I'm proud to say that over 80,000+ people have used them over the last 7 years. You can read more about my own personal health journey and why I am so passionate about what I do.

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49 thoughts on “When Should You Worry About Thyroid Nodules? Look For These Signs”

  1. I had the left side of my thyroid gland removed in 1996 due to a nodule. It contained a pepper grain size capillary cancer so when the nodule on the right side doubled in size the doctor recommended removal a year later. I am now 68 and have experienced accelerated arthritis resulting in total knee replacement in 2003 and 2004 plus a hip replacement in 2016. I am convinced that the removal of my thyroid is the cause of my arthritis. Can you confirm this?
    I’ve been on Synthroid until 2017 when in desperation to feel better I found some information regarding natural thyroid. It’s been stressful finding there is a shortage so whenever I need an adjustment in my meds I have to search for it. I’m very interested in your research and encouraged that someone is actually giving this problem some much needed attention. I’m currently 70 lbs over weight and have a doctor who is doing her best to work with me but she needs to be reminded that I’m not the same as her other patients who have a gland. I’m looking for direction. Can you help?

      • I had a few tests done. And at first they found one 5mm nodule on left side of thyroid. Few months later they found the 5mm was now 1 3cm and I had two more. One 3mm a d the other 4mm. And they also found two nodules on lower left and one on the upper right lobes. What’s the chances it’s anticancer?

  2. I was told after an Ultrasound that I have a 6 mm benign nodule on my Thyroid. I am 45 in extremely good health but have a sensation when I swallow. No history in the family at all and I have a good balanced diet. Should I worry or not?

  3. Further to my last message. Although I train like mad and eat relatively small but balanced diet I find it difficult to lose weight and I feel exhausted all the time. I usually put the muscle pain and exhaustion down to having Glandular Fever leading to CFS / ME and training. But could this be due to my Thyroid? I have been told from bloods my Thyroid is normal.

  4. How often should a thyroid nodule be biopsied? I have a large solid hypervascular nodule – just one – it is over 2.6 cm wide and 1.4 cm high. It has been biopsied two times with “favored benign” results. I just had another ultrasound, it has stayed the same size – no other changes. I have Hashimotos and take both levothyroxin and cytomel. Is it appropriate to biopsy again? Or just watch… Thank you for your advice.

    • Hi Natalie,

      It really depends but if it’s not enlarging or growing or changing on ultrasound then the frequency with which you need a biopsy is very low.

  5. I am a 68 year old female diagnosed with Hashimoto’s with all the classic symptoms. My quality of life is continually suffering. I’ve had nodules on my thyroid for a number of years. I have just recently switched endocrinologists & this new doctor is doing a biopsy tomorrow. I don’t think there is reason to worry but this us the first time being biopsied. If the result is inconclusive should I get a second opinion?

  6. I have 5 nodules one that was biopsied [1cm] 5 years ago. Several ultrasounds 3 yrs ago showed no change. I have since found I have the genetic CHEK2 variant with increased risk of thyroid cancer. I have a maternal aunt and cousin w/ papillary thyroid cancer. My Dr does not seem concerned, though did order ultrasound at my insistance. Is this something I should worry about or not?

  7. I’m a 62 year old woman with subclinical Graves disease–little to no symptoms but suppressed TSH. Ultrasound shows that I have a 2.5 cm nodule that has been reported to me as being “highly suspicious”. It is solid, hypoechoic, has irregular borders and some microcalcifications. It’s wider than tall. An FNA has been suggested ou and is scheduled and I am a nervous wreck! Would you be worried given this information?

  8. I am 66 yrs. old. I just had bloodwork done and my TSH is elevated (4.87). An ultrasound showed 3 nodules, one that is 1.0 cm and meets the criteria for biopsy (solid, very hypoechoic, wider than tall, lobulated or irregular). A radiology consult has been ordered. Also, the report stated prominent left-sided lymph nodes but none pathologically enlarged. The other 2 nodules are 0.7, 0.9 cm in size. Do you recommend the biopsy of the largest? What about the 2 following closely in size?

  9. I am 66 years old and have a nodule on the right side. It was discovered about 6 years ago? and is now 5.5cm. The Afirma FNA indicated it was suspicious. I was told to have surgery within the next 6 months or sooner and to “prepare my loved ones”. A surgeon had already called me before I even got home from my appoint re: the biopsy results. The second surgeon said that there was a 49% chance it was malignant. 49%??? I have asthma, I am terrified at the idea of someone “cutting my throat”, and feel that there have to be other options. These same doctors including my primary who just refers me to other doctors, have not even referred me to the lab for a full thyroid panel…just a TSH, or the very minimal. Any suggestions? Someone else referred me to Dr. Clayman’s Thyroid Cancer Center in Tampa, FL.

    • Hi….my husband went to Dr. Tobias Carling when he was at Yale. He opened the Tampa center in Florida, to reassure you…ABSOLUTELY go to this group!! Google him….he is amazing!! My husband had half his thyroid removed by Dr. Carling, kindest caring Dr…I wish he didn’t leave CONNECTICUT, but if need be, we would definitely travel to wherever he is!!

  10. I am 77 yrs old.
    I have hypoechoic, ill defined isocehoic/ hypoechic nodule. right side:
    4.9x2x2cm. 1.8×1.3×1.2 was 0.8×0.8×0.08. 1.1×2.1×0.8cm was0.7×0.6×0.6 additional one 0.6×0.5×0.5cm thyroid isthmus measures 3 mm. right side:lesion with punctate densities measuring 1.3.finding could represent microcalification witin nodule. left side: 5.7×1.9×2.6cm 2.3×1.1×1.8cm 1.2×0.9×0.9 no microcalification or internal vascularity identified. these are partially calcified 1.2×0.9×0.9. no increased vascularity. nodule without vascularity thrroiss ishmus no evidence of thickening. color doppler appearance. I have F.A.P., and men1 thyroid cancer in family. What do you recommend?

  11. My doctors nurse called me with results from an ultrasound that was done on my thyroid.. she said the doctor said I have three lesions and a cyst but that they were to small to biopsy and that was it… my concern which I called the doctor back is this… I am a breast cancer survivor 2014 had my treatment and bilateral so I am concerned that these may be cancerous… should I be worried… I feel very sickly and tired all the time.. what should I do because I have yet to hear back from the doctor and it’s been two days…

  12. I am 39 and noticed a rather large lump in my neck about 2 months ago now. Looking back at photos of myself it seems to have first started appearing in September of last year and is about 5 cm in size as I measure it. As a result of the size the Doctor referred me for an ultrasound which came back ‘suspicious’ but the Doctor has advised that cancer is not likely. Now I am awaiting a biopsy. Other than the lump though I have no other thyroid symptoms and am wondering if that should be a concerning factor since it looks to have been growing for about 10 months now.

  13. Will being vascular always be cancerous? I have a 4.1 vascular nodule. My thyroid levels are all normal expect for my TSH are non existent. I changed my eating 3 years ago, only organic, no processed foods, water & shower filter, removal of mercury fillings, no toxic products, literally everything possible. This past year I did Ozone IVs & UV and high dose Vit C IV to treat for mold exposure. I actually got my period last month after not having one for 4-5 years. A few months before that period I had weight gain, nails grew, swelling in lower extremities and after that period my thyroid has been swelling in the evenings.

  14. So. I had an ultrasound in February. I had a spot that was about 1.1 mm. in August I had another ultrasound and that spot grew to 7mm and I have another one that is about 5mm. This was to give perspective on timeline. I have 1 lymph node that is noticeably swollen. Would this be any concern?

  15. do i need to worry. I have a goiter which i was diagnosed with when i was a kid. Now at the age of 60 i have 4 nodules on right lobe and 4 on the left lobe and now a new 1 on the Ishimus. They average in size from 10x8x9mm, 12x6x10mm, 6x4x4mm, 15x7x11mm on the right and the left they average 12x7x10mm, 30x21x28mm, 33x23x27mm, 10x8x13mm, and 8x5x7mm. could you tell me if this is normal or something to be concerned about. have been getting these checked for several years and they do keep getting bigger

  16. Hi, I’m a 45 yr female. I Hashimoto’s with hyperthyroid. I take 125mg of Synthroid. I had a ultrasound last year 12/2019 and I had 2 nodules. One was a TR4 Solid, hypoechoic, smoothly marginated, wider than tall. 0.4X0.5X0.3. The Second one was a TR3 Soild, isoechoic, wider than tall. 0.6x.07x.07.
    I f/u up this week and the TR4 nodule grew to .07x.06x.07 and 2nd one stay about the same.
    I have a strong family history both side of family. I have 3 1st degree relatives that have had thyroid cancer. Do you think they will do a FNA. Last year they said it was to small even though it was label as moderately suspicious.

  17. I recently had an Ultrasound on my Thyroids and the Technician stated the left thyroid was to big to measure and the right was slightly smaller but big as well. The tech also mentioned i would have to see and Endourologist to be properly examined and have an accurate course of action to decrease the size. She mentioned iodine and radiation. My follow up appointment with my pcp in 02/2021…With these new findings should i request an earlier appointment and what should i be looking for?

  18. I had a partial thyroidectomy, my right lobe with large nodule. Had multiple benign fine needle biopsies but nodule had grown to over 4 cm. Doctor removed right lobe and nodule as outpatient in hospital setting. I now have insurance wanting me and doctor to justify why it had to be done in hospital setting rather than a surgery center. They are trying to charge me a $1000 copay since it was done in hospital rather than surgery center. My surgeon used a NIM tube (spelling) to help keep nerves safe in my neck. Could you please help explain why this surgery needs to be done in hospital setting vs. surgery center?

    • Hi Sonya,

      It’s a complicated issue and has to do with the preference of your doctor, the complexity of your surgery, and other factors including monetary incentives from the doctor. Some doctors own partial ownership in surgery centers so they make money doing surgeries there, others prefer to do it at a hospital because it’s safer even though it’s certainly more expensive.

  19. My dentist found a lump in my next, and told me to tell my doctor who ordered an ultrasound.

    The 1st ultrasound 2 years ago they stated it was a calcification. I recently went in early March 2021 and now they stated it is a 1.17 cm nodule. They were borderline on whether I should do a biospy or not. At this time I have scheduled a biopsy on March 29th and wondering if you think there is a need for this or if I should cancel.

    I am not a fan of needles and scared I will not remain still nor swallow.

    Would you have the biopsy with this information?
    Thank you for your assistance!!

  20. Could you please give me your opinion of this interpretation?



    Study Result

    Unremarkable thyroid ultrasound.

    NOTE: Permanent recorded sonographic images were taken.

    CLINICAL DATA: Sensation of lump in throat


    TECHNIQUE: Multiple sonographic images of the thyroid gland were


    The isthmus measures 1.8 mm. There is a 7 mm hypoechoic nodule.

    The right thyroid lobe measures 4 x 1.2 x 1.1 cm. There is an
    ovoid hyperechoic 8.6 x 3.4 mm nodule. This demonstrates no
    increased Doppler flow.

    The left thyroid lobe measures 3.9 x 0.9 x 1.3 cm. Normal
    echogenicity without mass or nodule.

    No lymphadenopathy or parathyroid nodule identified.

  21. Hey there!
    39 year old female recently diagnosed with Hashimotos after seeking treatment and help for diffuse hair loss over 2months.

    Labs showed TPO antibodies were increased (27) but TSH 1.070 and T4 0.93 normal. Ultrasound showed enlarged thyroid mildly heterogenous…left lobe nodule 0.7X0.4cm circumscribed parallel hypoechoic nodule lower pole without punctate echogenic foci.

    Bilateral cervical chain lymph nodes incidentally noted largest on right measuring 2.2cm long axis.
    Impression:small TI-Rads 4 nodule left lobe , heterogeniety of thyroid may reflect chronic thyroiditis. Repeat ultrasound in 1 year.

    Any thoughts?
    Thanks so much for your videos!

  22. Hello Dr.
    My Mother was dx at around my age (58) with thyroid cancer (actually she had two different cancer cells in her thyroid. My younger sister also dx thyroid cancer in her 40s.
    Recently during an MRI a nodule was found, and it was suggested by the radiologist to have an US to further study the nodule.
    Findings “High-resolution transducer is utilized for evaluation of the thyroid gland, nonuniform echopenic nodule in the right lobe posteriorly in the mid-portion of the gland measures 11x7mm. The right lobe measures 5.6×1.6×1.0 cm. The left lobe measures 5.1×1.7×1.9 cm, a complex solid nodule in the mid-portion of the gland measures 2.8×2.7×1.8cm, this is better seen on the MRI to compress the trachea. Follow-up thyroid uptake and scan could be useful for further evaluation”
    I just finished the Nuclear Thyroid Uptake this morning, and my Primary Dr office called saying that the results were I had a cold Thyroid and I was being referred to a general surgeon. I am currently in WV and the healthcare is not optimal here, with a lack of specialists and long wait times, etc. My question is this: Should I try to travel out of the area to have an endocrinologist surgeon do the consult/biopsy/procedure/s or is it customary to have a general surgeon handle this case?
    I do have hoarseness, a lump feeling when I swallow, and it grew rather quickly to the size reflected above, as it was not detected in 2017. If I was your family member, what would you suggest? Thank you for your time and this informative article. Kim

    • Hi Kimberly,

      I don’t think I’ve ever met an endocrinologist that does his own biopsies. Endo’s spend most of their day seeing patients and writing prescriptions. General surgeons spend most of their days cutting people open! A general surgeon doing a biopsy shouldn’t be an issue. I would personally feel more comfortable with a surgeon over an endo doing that procedure. The only exception would be if you can find a general surgeon that does ONLY thyroid gland procedures.

      • Hi Dr. Child’s
        I found your article about nodules very helpful. Thank you. I be seen by an End in a large Hospital. She suggested to do the procedure ( biopsy) my 2 nodule the ultrasound finding are 2.5 cm. Reading your reply to Kimberly above worries me now a little. You suggested a General Surgeon that does only Thyroid gland procedures.
        I value your advise and thank you in advance.

        • Hi Gee,

          It’s often best to have someone do the procedure who has done it hundreds if not thousands of times. That usually means a surgeon but sometimes an endo could do it.

  23. Hello Dr.
    I am a 56 year old male who was diagnosed with bile duct cancer in June of this year. I had surgery on the 28th of July and they removed 20 % of my liver. The doctor ordered a cat scan of my chest and they found a 2.5 cm hypodense left thyroid nodule. What are the chances that it is cancerous since I had bile duct cancer? Should I be concerned and should I ask for a pet scan of my whole body to see if there is anything else to worry about. I start chemo July 31st. Had many chest cat scans and it never showed up on any of them till now.

  24. 72 yr old male, ultrasound showed 4 thyroid nodules 1 of which was 3.1 cm & suspicious. I have now had 2 FNA biopsies & both have been inconclusive because too much blood & not enough cellular mat. I also was diagnosed with hypothyroidism
    do you recommend surgery or monitor ?

  25. I am a 56yo male. I had 2 PEs in my right lung and my Primary Dr saw a knot on my thyroid. I had an ultrasound done an it was just over 3cm. They sent me to have a FNA. The Dr pulled 3 syringes out then the lab said he needed 2 more. Its been 2 weeks and havent heard anything. My neck hurts and ive gained 30 lbs and sweat all the time. Im starting to get worried.

  26. Hi Doctor Childs. Love, Love your blogs. Great information on thyroid. Here is my story: I have had thyroid nodules since I was in my twenties. I am now 56. Within the past 7 years is when they became solid, so I have been getting regular monitoring much frequently. In 2021 my last biopsy found that some of the nodules were developing cancer cells so my doctor scheduled me for a surgery which I later cancelled and started doing therapy.. I talked to a naturopath doctor and this is what he suggested I take: Kyo greens which I take 3 tablespoons a day with 2 0z of Aloe Vera juice and 1000 mg of emergence 1 pack 3 times a day. I also take zinc 50 mg 3 times a day, intestinal clenz 1 tsp 3 times a day. these get mixed up.
    I also take Bataine HCL iw/pepsin 650mg 2 each 3 times a day, Progest 1teaspoon 2xday cream that I rub, Salmon oil 1,000mg 2-3xdaily,Magnesuum citrate 800 mg, 2 with each meal. I also started some liquid iodine but was afraid I was taking too much. so when I don’t take the KYO Greens then I will take the liquid Iodine.
    I started taking these in mid November when my cells started changing. my TSH results: 2018: 1.21, 2020: 1.38, 2021: 1.12, and 2022: 1.11. these are results for past 4 years. I have never been diagnose of low or high thyroid.
    I most recently did a biopsy on the 3 of the 4 nodules: 1.6×1.5cm, 5.6cm, and 1.6 x 1.7cm. was sent out for AFIRMA test which came back ad benign with 4% rate of becoming cancer . I have to go back in 4 to 6 months for follow up and this is why I stumbled on you website because I am trying to eat a lot better with more vegetables less meats etc. Any thoughts? Am I on the right track? any information will greatly be appreciated.

  27. Thanks for posting this article it was very helpful. I am currently scheduled for a biopsy. I have a 1.6 cm nodule that is vascular. and I have difficulty swallowing. Is there anything you should do in preparation for a needle point biopsy?

    • Hi Raven,

      Your doctor/surgeon will give you some instructions that you should follow prior to your surgery. Other than those, there isn’t much you need to do to prepare.

  28. Hello,
    I had the right thyroid lobe removed mid-late 1980’s. Late 2021 I had a total left shoulder replacement. All went well and by early 2/22 I was completely pain free, range was back to normal but I needed to regain muscle and so I continued PT. About 3/1/22 the arm, shoulder and neck pain was daily. This began to include the right shoulder and arm as well.

    Today I had a second MRI to determine why I continue to have 24/7 pain in both arms, (bicep and triceps) shoulder joint and across my neck.

    Part of the results indicate ‘heterogeneous enlargement of the left lobe of thyroid’. Is it possible this enlargement is contributing to the pain I am experiencing?

    I am 69 years old.

    • Hi Sue,

      It’s unlikely that your thyroid nodule is contributing to the pain in your arms unless the nodule is massive but even then it would only impact one side (not the other). It’s far more likely that something like degenerative disc disease or osteoarthritis of the cervical spine is partly responsible for those symptoms. There are many other potential causes of muscle pain, though, so you’d need a comprehensive exam and history to figure it out.

  29. Hi
    I had tongue cancer (non HPV) in 2017 and in the process of being diagnosed with that they found a nodule on my right thyroid which turned out to be what my doctor called a micro-cancer (papillary). Just had an ultrasound that found a 0.5×0.4×0.3 nodule on my left thyroid. It was not there two years ago when I had my last ultrasound. Should I be worried? I am planning to request a biopsy and thinking they will need to remove the left side of my thyroid based on my history. Does that sound about right to you?

    • Hi Julia,

      It depends on the characteristics of the nodule found on ultrasound. This article contains a list of “concerning” findings on ultrasound that you can compare your results to. If present, these characteristics slightly increase the risk that the nodule is cancerous.

  30. Hello Dr. Childs,
    I really hope you see my comment. I am kind of worried. My doctor found a nodule on the right side of my thyroid and ordered an ultrasound. She informed me of my results this past Monday. Said it is a suspicious nodule that is almost 2cm and referred me for a biopsy. How often does a suspicious nodule turn out to me cancer? Thank you so much for taking the time to answer our questions!

  31. I had a thyroid nodule discovered during a doppler of my carotid. Further ultrasound found an additional nodule. The larger is approximately 2 x 1.5 cm and solid composition. The smaller is 1.5 x 1.6 cm and solid. Family history of cancer but not thyroid – my mom died of lung cancer but never smoked. I’m 63 and good health. I do have a cough that has never been diagnosed but because I have asthma, it was clinically associated with that. Based on the scale from radiologist, the TI RADS are 4 on both nodules which I understand to be moderately high risk. Do they normally do FNA on both the large and small nodule since they both score 4?
    Thank you!

  32. Hello:

    I have multi-nodules. One in right lobe, upper 2.9 x 1.6 x 1.5 cm, solid, hyper/isoechoic with vascular. TSH levels are 1.324 presently. Left lobe nodule #1 1.5 x 1.4 x 0.7, cm, solid, hypoechoic, vascular. #2 2.1 x 1.3 x 1.1 cm hyper/isoechoic, vascular. They have been doing ultrasounds since 2016 and all 3 nodules have been growing. They found in a test that they are cold nodules. I am 62, female. I have had 3 thyroid storms treated with steroids since 2012.


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