As small as the thyroid glands are – as soon as their function is disturbed, those affected notice this considerably. The symptoms range from inner restlessness to depression. The disorder is often triggered by knots in the tissue. But: Nodules in the thyroid gland are malignant in the rarest of cases. dr Axel Döhrmann is chief physician at the clinic for general and visceral surgery at the AMEOS Klinikum St. Clemens Oberhausen. He explains how to treat and gently remove knots.
Dr. Döhrmann, how do lumps form in the thyroid gland?
Axel Doehrmann: First of all, a distinction is made between cold and hot knots. Hot lumps, often caused by iodine deficiency, are tissue changes in which the thyroid gland overworks and produces hormones out of control. In many cases, this leads to overfunctioning. Incidentally, hot nodes are almost always benign. Cold nodes, on the other hand, are inactive and no longer produce hormones. They are much more common and are caused, for example, by cysts or inflammation in the thyroid gland. While cold nodules can indicate a tumor, it is very rare. Thyroid disorders are much more common as a result of an autoimmune disease.
What are typical symptoms?
Axel Doehrmann: It depends on the disease and how it affects hormone production. An overactive thyroid typically leads to restlessness, trouble sleeping, irritability, diarrhea, and other symptoms. An underactive thyroid often shows opposite signs. Those affected are constantly tired, cold and can tend to listlessness and depression. If the thyroid gland enlarges significantly, a goiter develops, which causes difficulties in swallowing and breathing, among other things. But there are also completely harmless nodules that do not affect the function of the thyroid gland and do not cause any symptoms.
How are thyroid nodules detected?
Axel Doehrmann: Nodules in the thyroid gland can be felt and the findings can then be confirmed with an ultrasound examination. Sometimes we also take a tissue sample during the sonography. Using a scintigram, we can definitely find out whether the nodules are hot or cold. A low-level radioactive substance is administered, which makes the inactive or overly active thyroid tissue visible. The method is gentle and harmless.