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Thyroid Nodules & Cysts: When Is Surgery Necessary?

Published December 18 2011

Some people with thyroid and autoimmune thyroid conditions have thyroid nodules and cysts.  And while sometimes surgery is recommended to remove the thyroid nodule or cyst, in many cases surgery isn’t necessary.  So the goal of this article is to discuss when surgery is truly necessary to remove thyroid nodules and cysts.

But before I discuss this, you might be wondering what the difference is between a thyroid nodule and a thyroid cyst.  They are actually very similar, as a thyroid cyst is fluid-filled, while a thyroid nodule typically is solid.  Both can be malignant, although it’s more common for a thyroid nodule to be malignant than a thyroid cyst.  The only way to confirm a malignancy is through a fine needle aspiration.

Most Thyroid Nodules and Cysts Don’t Need To Be Removed

In most cases, a thyroid nodule or cyst doesn’t need to be surgically removed.  And most of the time medical doctors won’t recommend surgery unless the nodule or cyst is malignant, or if it is benign but causing other severe symptoms.  On the other hand, there are some medical doctors who will recommend that thyroid nodules and cysts be removed regardless of the patient’s symptoms.  Of course this is true not only when it comes to thyroid nodules and cysts, but other areas of the body as well.  For example, many hysterectomies are performed unnecessarily as well.  Obviously in some cases a hysterectomy is necessary, but some medical doctors do this surgery as a precaution in order to prevent future problems from occurring, while others will recommend them because they are profitable.  I’m not going to get into detail about this right now, but we all know that not all of the surgeries performed are necessary, and I’m not suggesting that profit is the sole driving force behind these surgeries, but it is one big factor.

The same can be said of surgery for thyroid nodules and cysts, as while sometimes this surgery is necessary to perform, sometimes such a procedure isn’t necessary.  Of course some patients aren’t sure when it’s necessary or not, and so most people will just follow the advice of their medical doctor and receive the surgery.

When Is Surgery Necessary For Thyroid Nodules & Cysts?

There are only a few occasions when surgery is necessary to remove a thyroid nodule or cyst:

1. When the thyroid nodule or cyst is malignant. If the thyroid nodule or cyst is malignant, then there is a high probability it will need to be removed through surgery.  Frequently they will remove not only the thyroid nodule or cyst itself, but will perform a partial or complete thyroidectomy.

2. When the nodule or cyst is causing an obstruction. If the thyroid nodule or cyst is causing difficulty breathing and/or swallowing, then this is yet another reason why surgery might be required.  Once again, sometimes they will surgically remove part or all of the thyroid gland, and not just the nodule or cyst.

3. When the nodule or cyst is causing the thyroid gland to secrete an excess amount of thyroid hormone. Occasionally the thyroid nodule or cyst will press on the thyroid gland, causing it to secrete an excess amount of thyroid hormone.  So the thyroid nodule or cyst will essentially lead to a hyperthyroid condition.  When this happens, removing the thyroid nodule or cyst is frequently necessary.

Removing The Nodule/Cyst vs. Removing The Thyroid Gland

You might wonder why in many cases medical doctors choose to remove the thyroid gland itself, rather than just surgically remove the thyroid nodule or cyst?  I’m of course not a surgeon, and so I can’t tell you from self-experience why this happens when it seems like it’s unnecessary.  I’m sure sometimes it can be a challenge to specifically remove the thyroid nodule or cyst, and so this can be one reason why some surgeons choose to perform a partial thyroidectomy.  Why some choose to completely remove the thyroid gland is because many people will become hypothyroid when receiving a partial thyroidectomy, and because of this many surgeons will choose to remove the entire thyroid gland.  The problem is that not every person who receives a partial thyroidectomy will become hypothyroid.  Once again, in certain cases a complete thyroidectomy might be necessary.  However, it seems like in many cases this procedure isn’t necessary, and just is the case with recommending RAI, many medical doctors don’t think it’s too big of a deal for someone to be without a thyroid gland and have to take thyroid hormone for the rest of their life.

Once again, there are obvious emergency situations when partial or complete removal of the thyroid gland is the best option.  But just as is the case with other types of surgery, it just seems like some doctors are a bit too hasty when it comes to removing the thyroid gland.  So before you receive any type of thyroid surgery it’s a good idea to at least seek the opinion of one or two other doctors.

The Role Of Natural Thyroid Treatment Methods

Since this website focuses on the benefits of natural thyroid treatment methods, you might wonder whether following a natural thyroid treatment protocol can help someone who has a thyroid nodule or cyst.  It really does depend on the situation.  While natural thyroid treatment methods can potentially help to shrink thyroid nodules, there is no guarantee this will happen.  And even when it is successful in doing this, it will of course take time for this to occur.  But there is no specific supplement or herb which shrinks thyroid nodules.  Some sources suggest that castor oil packs can help to shrink thyroid nodules.  While in most cases it probably won’t hurt to give this “remedy” a try, I’m not aware of any evidence which proves that castor oil packs will help to shrink thyroid nodules.

In summary, most people who have one or more thyroid nodules or cysts will not require surgery.  However, there are some circumstances when surgery is necessary.  But just as is the case with other types of surgery, one can argue that not all cases of these surgeries are truly required.  And even when they are, it’s questionable whether surgery of the thyroid gland is necessary, rather than the nodule or cyst itself.  And as for natural thyroid treatment methods, although many people can benefit from following a natural treatment protocol, there is no guarantee that natural treatment methods will shrink a thyroid nodule.  So those people who require immediate attention probably will need some type of medical intervention, while those who don’t have any serious problems due to the thyroid nodule or cyst might want to give natural treatment methods a try.