Just as with goiter formation, the formation of all types of thyroid nodules is most commonly due to insufficient iodine in the diet. 5 In order to compensate this deficiency, the thyroid cells grow; this can lead to goiter or nodule formation in the tissue – either as an individual (solitary) nodule, or as several (multiple) nodules.6 Nodules can also form in a thyroid of normal size. In most cases, however, they occur in conjunction with goiter 7

Thyroid nodules are differentiated as “cold” or “hot” nodules. In fact 85% of “cold” nodules and 95% of “hot” nodules are non-cancerous. 8 However the latter which can produce thyroid hormones in unchecked amounts can lead to hyperthyroidism. “Cold” nodules cause no overproduction of thyroid hormones – but they can grow unchecked. Therefore, it is particularly important to identify the type of nodule in order to avoid any possible risks.

Initially, most thyroid nodules do not cause any noticeable symptoms. Therefore, they often go undiscovered until the next routine medical examination9 — if, for instance, a particular lab test result as part of a blood test indicates an abnormal thyroid. As the thyroid nodules grow further, the following symptoms can occur (this is rather rare):

  • Pain
  • Joint or muscle pain
  • Difficulty swallowing/pain upon swallowing
  • Laboured breathing
  • Hoarseness
  • Symptoms of hyperthyroidism

Upon the onset of laboured breathing, hoarseness, severe pain and/or general signs of illness such as fever and joint pain (since these symptoms are possible signs of fast-growing nodules, an enlarged thyroid or thyroid inflammation), a physician should be consulted immediately. If you believe that a nodule has formed in your own thyroid, you can perform the so-called Neck Check as set forth by the American Association of Clinical Endocrinologists (AACE).10

Did you know?

Iodine can commonly be found in sea fish, seafood, bread, cheese, cow’s milk, eggs, yoghurt and seaweed.2


  • 5McDougall I.R.: Management of Thyroid Cancer and Related Nodular Disease. Springer; 1st Edition (2005)
  • 6Skugor M., Wilder J.B.: Thyroid Disorders: A Cleveland Clinic Guide. Cleveland Clinic Press (2006)
  • 7Henderson K.E.: The Washington manual endocrinology subspecialty consult. Lippincott Williams & Wilkins; Second edition (2008)
  • 8McDougall I.R.: Thyroid Cancer in Clinical Practice. Springer; 1st Edition (2007)
  • 9EndocrineWeb. Fine Needle Biopsy of Thyroid nodules. URL http://www.endocrineweb.com/conditions/thyroid/fine-needle-biopsy-thyroid-nodules. (Accessed April 2011)
  • 10American Association of Clinical Endocrinologists (AACE). Neck Check Card (Accessed November 2010)