Your treatment will depend on how your thyroid nodule affects you. If your thyroid nodule is not cancerous (benign) and is not causing any problems, your doctor will watch the nodule closely before doing anything else. If your thyroid nodule is causing problems, you may need to take medicine or have surgery.

Antithyroid medicine and radioactive iodine can treat benign nodules that are causing your thyroid gland to make too many hormones (hyperthyroidism). For more information on hyperthyroidism, see the topic Hyperthyroidism.

Surgery is usually only necessary if your thyroid nodule is so large that it causes problems with breathing or swallowing or if your nodule is cancerous. After a cancerous nodule is surgically removed, you may need radioactive iodine to destroy any thyroid tissue or cancer cells that are still causing problems. If you need to have your entire thyroid gland removed, you will need to take thyroid hormone medicine for the rest of your life.

For information about thyroid cancer and its treatment, see the topic Thyroid Cancer.

Initial treatment

When you know you have a thyroid nodule, your treatment options include:

• Observation. If your thyroid nodule is not cancerous, your doctor may choose to check it every 6 to 12 months for changes in size. Many noncancerous thyroid nodules stay the same size or shrink without treatment.
• Thyroid biopsy. Your doctor may drain a fluid-filled nodule with a needle. Some fluid-filled nodules will not come back after they are drained, but most do come back.
• Surgery (thyroidectomy). Not all thyroid nodules need surgery. You will need to have surgery to remove part or all of your thyroid gland if:
  • Your nodule is cancerous or suspected to be cancerous.
  • Your nodule is so big that it makes it hard for you to breathe or swallow.
  • You have a fluid-filled nodule that returns after being drained one or two times.
• Thyroid-stimulating hormone (TSH) suppression therapy may be used to shrink a nodule if:
  • Your thyroid nodule is not cancerous, but is large or growing, or if you have a goiter and multiple nodules.
  • Your thyroid nodule is cancerous or suspected to be cancerous, and you are not healthy enough to have surgery.
• Radioactive iodine. Radioactive iodine may be used to destroy thyroid tissue if:
  • Your nodule is noncancerous but is making too much thyroid hormone, causing hyperthyroidism. If you have hyperthyroidism because of your nodule and you are pregnant, it is not a good idea to have radioactive iodine treatment. Your doctor will recommend surgery instead of radioactive iodine.
  • You have several nodules (multinodular goiter) and surgery is not a good idea because of other health problems you have. Radioactive iodine can shrink nodules that cause problems with breathing or swallowing, but your nodules may come back after treatment.

Ongoing treatment