Finding a lump anywhere can produce feelings of anxiety – especially somewhere as sensitive as the throat. Nodules found on the thyroid are quite common.
What are Thyroid Nodules?
Thyroid nodules are abnormal growths on the thyroid gland. They can feel like a lump in the throat. The thyroid is a butterfly-shaped gland located at the front of the neck, adjacent to the trachea. You can feel it between the voice box and the collarbones. Thyroid nodules are lumps which usually present on the outer-edge of the thyroid, and may be felt or seen under the skin. They are very common, and become more-so with increasing age – it's estimated that 50% of older adults may have thyroid nodules, but as the smaller kinds of lumps are usually asymptomatic, there may be even more of us out there with undiagnosed nodules [1].
Thyroid nodules can feel soft when they are made of an overgrowth of thyroid cells, or firm if they are cysts full of blood or fluid. While most nodules are benign, malignant nodules may feel stony and hard, and fixed in place to the surrounding tissue.
Nodules can be very small, or they can grow quite large and form tumours. Investigations such as blood tests, ultrasounds and possibly aspiration and biopsy is sometimes required to rule out malignancy. Even benign nodules can cause significant symptoms such as pressure in the throat and difficulty swallowing or speaking if they grow too large; disruption to thyroid hormone levels (also known as “autonomous” nodules) that contributes to a hypo- or hyper-thyroid state; or serious throat pain and tenderness if inflamed [1].
What Causes Thyroid Nodules?
Experts don't know the exact root of thyroid nodules, but there are a few causes that have been identified:
Hypothyroid Disease
In hypothyroidism, the thyroid does not produce enough thyroid hormone. With low thyroid hormone levels, there is a characteristic increase in secretion of TSH (thyroid stimulating hormone) which stimulates growth of the thyroid tissue. This growth can cause tissue to can clump together to form nodules.
The most common cause of thyroid nodules is Hashimoto's thyroiditis, an autoimmune condition where the immune system attacks an otherwise healthy thyroid gland, resulting in hypothyroidism – a decrease in thyroid hormone production, and an increase in TSH. Other causes of hypothyroidism and subsequent thyroid nodules include:
- Radiation therapy to the neck area
- Radioactive iodine treatment (often prescribed for hyperthyroid conditions)
- Thyroid surgery
- Iodine deficiency (which is very common in Australia)
Genetic Abnormalities
A type of nodule called an adenoma nodule can develop due to genetic abnormalities. This kind of thyroid adenoma is a benign tumour of the thyroid, which initially presents as a small nodule before increasing in size.
Iodine Deficiency
A colloid nodular goitre, or multi-nodular goitre, can develop due to iodine deficiency. The thyroid tissue proliferates in order to try and “capture” whatever iodine is available in the blood. Colloid nodular goitres are more common in developing nations with poor iodine content in the soil, but they are still seen in countries like the United States, most commonly amongst women over 40 with genetic predisposition.
Entangled Qi
According to Chinese Medicine, thyroid nodules represented entangled qi that has become stuck or lodged in a phlegm-like lump. Emotionally, nodules may be a result of pent-up, long-term anger or chronic trauma [2].
Natural Therapies for Thyroid Nodules
Nurtients for Thyroid Nodules
Iodine is an essential nutrient needed for thyroid hormone production. Nodules can develop as a result of a mild iodine deficiency, and boosting levels can help to stabilise or shrink existing growths. While it can be risky to take an iodine supplement (did you know it can cause hypothyroidism?), it is perfectly safe to eat large amounts of iodine-rich foods – the body will regulate how much it absorbs from the food, making sure that you don't absorb too much. Seaweeds, especially dulse, kelp and wakame should make it onto your plate every day to support a healthy thyroid.
Other nutrients required for thyroid health include:
- Selenium can help to boost iodine uptake[3], and is prominently found in brazil nuts.
- Zinc is needed for healthy thyroid tissue, and can be found in oysters, nuts and seeds.
- Vitamin A helps to prevent hypothyroidism by keeping thyroid tissue healthy, particularly through menopausal years [4] . Vitamin A is found in dairy and meat, but carotenoids from colourful fruits and vegetables are effectively metabolised into vitamin A in the body too.
- Vitamin D Vitamin D deficiency is extremely common and low levels may increase the risk of nodules and polyps in your body.
Anti-Inflammatory Foods
Thyroiditis is an inflammatory condition, and inflammation supports overgrowth of tissue. Reducing inflammation throughout the body may help to prevent or even treat nodules.
Focus on eating plenty of green, red and orange vegetables and fruits. Boost your diet with healthy fats from fish and avocado, along with anti-inflammatory spices like turmeric and garlic.
Reduce or eliminate dairy products, wheat /gluten and avoid processed foods and refined sugars.
While no studies have been done to date to confirm a direct link between gluten and thyroid nodules, there is plenty of evidence showing that nodules thrive in an inflammatory environment, and that gluten can contribute to inflammation in some individuals. Leaky gut (or intestinal hyperpermeability) may be the link, with the gluten molecules being said to weaken the bowel wall and triggering inflammatory immune activation throughout the body.
Similarly, no studies have correlated dairy consumption with thyroid nodules, but there may still be a link. All dairy (even the organic “no hormones added” brands) contains sex hormones, particularly oestrogen, which causes excess inflammation throughout the body, particularly in glands [9,10,11]. Dietary hormone ingestion has been linked to proliferation of tissue and many hormone-dependant cancers, possibly due to the inflammation caused by this excess oestrogens.
Supplements with clean, potent fish oil rich in anti-inflammatory omega-3 fatty acids can help to reduce systemic inflammation that may cause thyroid nodules. These fats have been shown to reduce inflammation in leaky gut, and may help to support production of thyroid hormone[13] .
Herbal Medicine
Turmeric
Curcuma longa (turmeric) is a medicinal phenol found within turmeric, a potent antioxidant that has been thoroughly studied for its anti-tumour and anti-cancer properties.
Evidence suggests that cucumin extract may prevent cell proliferation, and could prevent or even reverse thyroid nodule growth [5] [6]. It also has immune modulating and anti-inflammatory actions that could help to regulate thyroid functio, is a popular spice that has been associated with reduced goitrogenisis. It has powerful anti-inflammatory properties and is used for a number of inflammatory conditions in the body.
Ashwagandha
Withania somniflora (Ashwagandha) is an anti-inflammatory, anti-oxidant herb that also helps to regulate hormonal balance throughout the body, including thyroid hormones.
Green Tea
Epigallocatechin-3-gallate (EGCG), the major catechin in green tea, has been shown to have significant anti-tumour and anti-proliferative qualities in thyroid cancer [6] that may also help to slow the progression of non-cancerous nodules and may even reverse their growth.
The first thing to do if you think you have found a thyroid nodule is to stay calm. Follow protocol and get it checked out to rule out the (very rare!) chance that it is malignant. Then reach for your natural remedies, and professional advice.
Maintaining a healthy diet rich in thyroid-supportive nutrients and supplementing with herbal remedies may help to reduce the size and progression of thyroid nodules. It is always important to seek advice that is appropriate for your particular circumstances as thyroid conditions can easily “swing” from hypo- to hyper- from inappropriate treatment.
Reference
- [1] Merck Manual Professional ed. (2016) Approach to a patient with a thyroid nodule. http://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/thyroid-disorders/approach-to-the-patient-with-a-thyroid-nodule
- [2] Dharmananda, S. (2015) Treatments for thyroid diseases with Chinese Herbal Medicine. ITM Online. http://www.itmonline.org/arts/thyroid.htm
- [3] Higdon, J. (2003) An evidence-based approach to vitamins and minerals. Iodine. New York: Thieme, 130-7. http://iucat.iu.edu/catalog/12503236
- [4] Farhangi, M. A., et al. (2012) The effect of vitamin A supplementation on thyroid function in premenopausal women. J Am Coll Nutr., 31:4, 268 – 274. https://www.ncbi.nlm.nih.gov/pubmed/23378454
- [5] Gururaj, A., et al. (2002) Molecular mechanisms of anti-angiogenic effect of curcumin. Biochem Biophys Res Commun, 297:4, 934–42. https://www.researchgate.net/publication/11098834_Molecular_mechanisms_of_anti-angiogenic_effect_of_curcumin
- [6] Mohan, R., et al. (2000) Curcuminoids inhibit the angiogenic response stimulated by fibroblast growth factor-2, including expression of matrix metalloproteinase gelatinase B. J Biol Chem, 275:14, 10405 – 10412. http://www.jbc.org/content/275/14/10405.full
- [7] Lim, Y. C. & Cha, Y. Y. (2011) Epigallocatechin-3-gallate induces growth inhibition and apoptosis of human anaplastic thyroid carcinoma cells through suppression of EGFR/ERK pathway and cyclin B1/CDK1 complex. J Surg Oncol., 104:7, 776 – 780. https://www.ncbi.nlm.nih.gov/pubmed/21725973
- [8] Myles, I. A. (2014) Fast food fever: reviewing the impacts of Western diet on immunity. Nutrition Journal, 13:61. http://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-13-61
- [9] Janowski, T., et al. (2002) Mammary secretions of oestrogens in the cow. Domest Anim Endorcrinol., 23, 125 – 137. https://www.ncbi.nlm.nih.gov/pubmed/12142232
- [10] Downer, M. K., et al. (2017) Dairy intake in relation to prostate cancer survival. Int J Cancer, 140:9, 2060 – 2069. https://www.ncbi.nlm.nih.gov/pubmed/28187509
- [11] Ji, J., et al. (2015) Lactose intolerance and risk of lung, breast and ovarian cancers: aetiological clues from a population-based study in Sweden. Br J Cancer, 112:1, 149 – 152. https://www.ncbi.nlm.nih.gov/pubmed/25314053
- [12] Vitetta, L., et al. (2014) The gastrointestinal tract microbiome, probiotics and mood. Inflammopharmacology, 22:6, 333 – 339. https://www.ncbi.nlm.nih.gov/pubmed/25266952
- [13] Taraghijou, P., et al. (2012) The effect of n-3 long chain fatty acids supplementation on plasma peroxisome proliferator activated receptor gamma and thyroid hormones in obesity. Journal of Research in Medical Sciences, 17:10, 942 – 946. https://www.ncbi.nlm.nih.gov/pubmed/23825994
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2779458/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4366771/
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