Cauliflower “Potato” CakesSeptember 29, 2017
Note From Dr. COctober 4, 2017
You might not know this, but 40% of women in their 40’s have thyroid nodules. What causes them, and what can we do about them? Today, we are going to take a deep dive into the full story behind thyroid nodules and how to treat them naturally. If you have been concerned about nodules turning into thyroid cancer, then this article has you in mind.
What are thyroid nodules?
To put it simply, nodules are abnormal lumps of thyroid tissue. The thyroid itself has a normal buildup of cells, called follicles, that:
- Pull in iodine
- Take tyrosine
- Make thyroglobulin
- Utilize thyroid peroxidase
These little nest-like follicles of cells actually build hormones in your body, performing all of these steps in order for your thyroid to function as it should. What happens, though, is that some parts remain uneven or are not the same texture – we call those “nodules.”
Bottom Line: Your thyroid has such an important job to perform, all of the moving parts can sometimes result in unwanted bits of follicles that simply build up over time. Determining whether or not these nodules are a problem is important, but that does not necessarily mean that they are going to be one.
What causes thyroid nodules?
The main cause of nodules in the modern world is Hashimoto’s thyroiditis. The other causes can also include:
- Exposure to radiation
- Iodine deficiency (a common culprit in the developing world)
- Iodine excess (more of an issue in the developed world – contributing to Hashimoto’s thyroiditis)
Bottom Line: What we need to know is that iodine can play an important role in causing thyroid nodules. How much do you know about iodine? If you feel like you are really starting from scratch, take a moment to read my previous in-depth guide about iodine (1).
Who gets thyroid nodules?
The people who get thyroid nodules parallel percent and decade by age quite conveniently. What we see is, especially with women, is that their age and their decade corresponds quite clearly with their risk for developing nodules.
Key Insight: If you are 30, there is about a 30% risk of you developing thyroid nodules. If you are 50, there is a 50% chance of you developing thyroid nodules. The same applies for being 60 (60%) and 70 (70%). Pretty simple to remember, but absolutely crucial to not forget.
Overall, developing thyroid nodules is three times more common to occur in women over men (2). This means that for women especially, getting to know more about the status of your thyroid is important. For men, it is obviously still important, but we need to be aware of the chances of developing thyroid problems and how it changes between genders.
Are thyroid nodules dangerous?
After learning a little bit more about where they come from, you might be concerned that thyroid nodules are going to be especially dangerous for your health. What I am here to tell you is that the safe answer is that thyroid nodules are usually not dangerous. Often, 95% or more are benign – meaning that they pose no risk.
Bottom Line: If you are worried about thyroid nodules, and having them, first you need to determine whether or not you have them definitively. Then, know that just because you have them does not mean that they are necessarily going to cause you harm. The vast majority of nodules are harmless.
Can I have symptoms from thyroid nodules?
This is often the question for those who are at risk of developing thyroid nodules, and want to know whether or not they might “feel” something due to the thyroid nodules being present on their thyroid. What you need to know is there are usually no symptoms.
If the nodules are very big, and because of where your thyroid sits, they can affect swallowing or speaking. If they are really big, and I mean really, they can affect the nerves that allow your tongue to move properly. This is more rare, and they are rarely ever painful.
Bottom Line: If they are really big, or in the wrong place, nodules might cause some discomfort on certain levels. What you need to know is that this is pretty unusual, and is probably not something you need to be actively concerned about.
How do you know if you have thyroid nodules?
There are really three big methods that you can consider when it comes time to find out whether or not you are dealing with thyroid nodules:
- Self exam
- Doctor’s exam
Doctor’s exams are effective at picking up nodules somewhere around 5 – 10% of the time. Self exams are just as similar, unless you are doing it regularly and can pick up on any irregularities with ease. The gold standard is, ultimately, ultrasounds.
Bottom Line: I do actively encourage all of those with thyroid disease to have a screening ultrasound to determining the state of your thyroid (3). This is where you have the chance to definitively find out whether you have a suspicious, and potentially dangerous, nodule that you might not have ever noticed before.
What steps can I take to treat thyroid nodules?
So, what do you do if you have a thyroid nodule. Well, that depends entirely on the state of your nodule – again, here is my opportunity to advocate for ultrasounds – but there are some things you can consider should the need arise.
Do you need to have a biopsy? Well, that relies on multiple factors, such as:
- Your nodule is well over 1 centimeter in size
- If your nodule has calcified (with lots of calcified spots)
- If your nodule has exaggerated blood vessels (hypervascular)
At this point, considering all of these factors, you may want to have your nodule biopsied. This is only because the nodule, at this point, looks suspicious for developing into cancer.
Key Insight: This is a pretty important collection of conditions for any thyroid nodule to be considered for a biopsy. Keep that in mind, and that typically you need to have some sort of combination of these three to require surgery of any kind.
If you have a nodule that is biopsied, the next consideration is removal. How do you know when to remove, though? Consider this:
- If you have had an abnormal biopsy
- If the nodules are growing quite quickly
- If there are abnormal lymph nodes nearby
- If the nodule is putting pressure on vessels or nerves
- If we see high levels of thyroglobulin
All of these factors could play a role in deciding whether or not the nodule, or portions of the thyroid, need to be removed.
How do you reduce nodules naturally?
So, apart from all of this sharp, scary stuff, what can we do to deal with thyroid nodules in a natural way? Is there anything we can do? There is! The two biggest factors that play a role in handling thyroid nodules are:
- Dialing in your TSH
- Dialing in your iodine (4)
- Reverse insulin resistance
When it comes to your TSH, let’s think about the “normal/optimal” range. What we have is a very broad “normal” range, and a very slim “optimal” range. What we want to do, when it comes to nodules, is get even narrower (between 0.5 and 0.9 – but not lower). The concept here is that TSH stimulates the thyroid, and while that might be great for a thyroid that is perfectly healthy, it can also play a role in stimulating nodules.
Think about it like a garden. Let’s say you have the most beautiful tomato plants in your garden. Could you put Miracle-Gro on it to make it grow faster? Sure, you could, but what if you had weeds in your garden? What if the Miracle-Gro made them grow as well, instead of killing them off – at that point, you might need to ask yourself whether the Miracle-Gro is worth it, or whether or not it is actually making things worse.
Key Insight: TSH and your nodules do not get along, in the sense that more TSH causes your nodules to grow and can potentially make them problematic were they to become big enough. The lower you get your TSH into that “optimal” range, the better chance you have of suppressing the growth of any potential nodules.
We also know that when your iodine is properly dialed in, you have the opportunity to decrease your risk for thyroid nodules. Iodine is important, and it’s even more important to know how much you are getting in your diet already – low iodine intake can lead to an increased potential for thyroid nodules (5). You do not want to get too much, but you also do not want to have too little.
Key Insight: Iodine – too little definitely is not good, and so is too much, and even a responsible change can be dangerous for certain segments of the population. That balance is so delicate, it is so important that you get it right.
What we also want to do is reverse our insulin resistance. There is data suggesting that when your body has a more difficult time dealing with blood sugar, that is when you are more apt to grow nodules on your thyroid (6). When we are better able to deal with how our bodies deal with insulin, it can go a long way in managing our risk for developing nodules.
What else do we know? We have seen that large amounts of produce in the diet can cut the risk of nodules – while suppressing the growth of nodules, and ultimately helping reverse them altogether. We obviously know the benefit of getting more produce into your diet, but this is just one more reason to add a little bit more fresh fruit into your life!
Here’s a wild thing, though, that this data also applies for cruciferous vegetables. Many have talked about cruciferous vessels as goitrogens (7), and while that is a bit of a separate topic, it has been shown that cruciferous vegetables have the ability to reduce nodules.
Bottom Line: Have your produce, and do not be worried about it! You are better off having more and more types than fewer and fewer types. If you get more into your diet, you ward off nodules that might start appearing in a natural way. It can be a helpful, and tasty, way to keep your thyroid in check.
What You Can Do About Nodules Starting Today
Do you want to start checking for thyroid nodules right away, while looking to start taking the steps to handling any potential nodules that might creep up? Here is what I want to leave you with, so that you can start taking more steps towards better health today. Start:
- Get in the habit of performing monthly self examinations.
- Get a doctor’s exam of your thyroid.
- Have an ultrasound done of your thyroid.
- If you do have nodules, take the steps you need to cut your risk (cutting your TSH and getting it into that optimal range, dialing in your thyroid, and enjoying a diet that is high in produce and cruciferous vegetables).
Bottom Line: Keeping on top of thyroid nodules simply comes down to being aware about the state of your thyroid. When you have followed the proper procedures, you should be able to get a pretty good read of whether or not you have nodules almost immediately. Keep in touch, literally, with your thyroid and it will pay dividends.
Better Thyroid Management Today
Today, we talked all about thyroid nodules and what you can do to start treating them naturally. The first thing I did mention, though, was how important it always is to understand your body and to know when your body is trying to tell you something.
Consider taking the Thyroid Quiz (8) today. It is a collection of very simple questions, which can go a long way in helping to determine the health of your thyroid. Consider it a launchpad for better health, starting today, and start to understand a little bit more about your thyroid. Afterwards, follow the action steps I outlined and get back to feeling more like yourself today.
Dr. Alan Glen Christianson (Dr. C) is a Naturopathic Endocrinologist and the author of The NY Times bestselling Adrenal Reset Diet.
Dr. C’s gift for figuring out what really works has helped hundreds of thousands of people reverse thyroid disease, lose weight, cure diabetes, and regain energy. Learn more about the surprising story that started his quest.