I recently had the pleasure of connecting with a lovely lady who was very concerned about her thyroid nodules. She was a new mom who had just given birth and found that the nodules she had on her thyroid had grown. She was planning on getting them biopsied and potentially removing her thyroid, and wanted to know what her options were for addressing this concern.
I frequently receive these types of questions about thyroid nodules — why they happen, and what to do about them. While I personally did not present with thyroid nodules, I have had a few clients and readers with Hashimoto’s and nodules, and was pleasantly surprised when they shrunk their nodules using my recommendations for Hashimoto’s. Don’t you just love these kinds of surprises? 🙂
Up to 65 percent of our population has thyroid nodules. Nodules are also more common in those with Hashimoto’s — so chances are, if you’re reading this article, you may have a nodule (or even multiple thyroid nodules).
This article will cover:
- What thyroid nodules are and why they happen
- Testing for benign and cancerous nodules
- How to shrink thyroid nodules
- The lab results of one of my readers who had been exposed to Chernobyl and was able to get three nodules to disappear!
What Are Thyroid Nodules?
Nodules are defined as “solid or fluid filled lumps” within the thyroid gland and can vary in size and location. Most nodules will not cause symptoms and will only be discovered during a manual examination of the thyroid gland or during a thyroid ultrasound.
However, large nodules may result in a visible swelling of the thyroid or neck; and they can cause pain, difficulty swallowing, and/or difficulty breathing. [1]
Some types of nodules can actually produce thyroid hormones, which can result in hyperthyroidism.
Many people with Hashimoto’s have thyroid nodules, and in fact, detecting the presence of thyroid nodules is a common way to diagnose autoimmune thyroid disease.
Having thyroid nodules is one of the most common endocrine conditions in the United States. Up to 65 percent of American adult ultrasonographic examinations (a safe medical procedure where sound waves bounce off bones and tissues in the body to produce a black and white image on a monitor) reveal thyroid nodules. [2]
Women are four times more likely to have nodules: about 30 percent of women in their 30s will have at least one, and most women will develop a thyroid nodule by the time they are 50. [3]
Types of Thyroid Nodules
There are various types of benign nodules, which I’ve outlined in the following infographic:
Are Nodules Cancerous?
While over 90 percent of thyroid nodules are benign (non-cancerous), certain nodules may be malignant (cancerous). [4]
Some thyroid nodules are actually cysts filled with fluid, rather than thyroid tissue. Purely cystic thyroid nodules (thyroid cysts) are almost always benign.
The complications stemming from inflammation associated with Hashimoto’s can put you at greater risk for other autoimmune diseases, as well as thyroid cancer (including thyroid lymphoma). Research shows people with Hashimoto’s have a much higher risk for thyroid cancer than those without Hashimoto’s (around 22.5 percent versus 2.4 percent). [5]
The risk of having thyroid cancer increases if you have a family history of thyroid or endocrine cancer, if you’re younger than 30 or older than 60 years old, if you are male, or if you have a history of radiation exposure (including dental and chest X-rays). There is typically a delay of 20 years or more between radiation exposure and the development of thyroid cancer. [6]
To learn more about diagnosis, please read my article on thyroid cancer. I’ll detail how to test for cancerous nodules below.
Signs and Symptoms of Nodules
The signs and symptoms of nodules aren’t always so apparent. You may notice them yourself as a lump on your neck, while buttoning your collar. Or, your doctor might only discover nodules during a physical exam or on imaging tests like ultrasounds or CT scans for other reasons.
Fortunately, most nodules are asymptomatic, but rarely, these symptoms can manifest: [7]
- Pain in your neck, jaw, or ear
- Trouble breathing, swallowing, or feeling a tickle in your throat (if the nodule is large enough)
- Hoarseness if the nodule irritates the nerve that controls the vocal cords (Note: This can be related to thyroid cancer.)
- The production of excessive levels of thyroxine, creating symptoms of hyperthyroidism, including tremors, nervousness, unexplained weight loss, and erratic heartbeat
Abnormal thyroid test results may also be an indicator that a person should be examined for nodules.
Testing for Nodules
If you’re wondering how you can test for thyroid nodules, there are several options you can pursue:
1. Conduct a physical self-exam. I created an infographic that details how to perform a simple self-check at home:
2. Check your thyroid hormone levels to ensure they’re in the optimal ranges. Note: Be sure to request a full thyroid panel (TSH, free T4, T3, reverse T3). You can read my article on the top 10 thyroid tests for more information on how to order your own thyroid panels and interpret your results. Should you suspect nodules from your physical self-exam or from suboptimal thyroid hormone levels, you may wish to consult your physician to order an ultrasound.
3. Order an ultrasound from your doctor. Ultrasonography will provide information about the structure or shape of your nodules. It can also help your doctor determine whether a lump is a cyst or a solid nodule, and whether you have multiple nodules. Radiologists can then make recommendations regarding the next steps. Benign and “non suspicious” findings don’t need to be biopsied. Other nodules, however, may need a biopsy or repeat ultrasound depending on size. The goal here is to avoid unnecessary biopsies. However, if there are any suspicious findings, you may have to…
4. Follow up with a fine needle aspiration (FNA) biopsy. If your doctor suspects a nodule might be malignant, he or she might perform a fine-needle aspiration (FNA) biopsy. A FNA is usually only considered when nodules are larger than 10 mm in diameter, unless ultrasound results are otherwise suspicious. Additionally, nodules ≤5 mm are generally monitored rather than biopsied.
A FNA biopsy involves the insertion of a very thin needle into the thyroid, and cells are aspirated (removed) for further evaluation. A FNA biopsy helps determine whether the nodule is a true nodule (malignant) or a pseudo-nodule (benign).
While this is the gold standard to differentiate between benign, inflammatory, or malignant nodules (classifying them as either true nodules or pseudo-nodules), it is invasive. A more non-invasive technique to differentiate pseudo-nodules and true nodules is sonoelastography, where ultrasonography imaging is used to evaluate the mechanical properties of soft tissue.
Research shows sonoelastography can be an effective alternative to avoid using invasive biopsies or surgical interventions to detect a true nodule diagnosis. [8] Once your physician determines you have nodules, he or she will likely refer you to an endocrinologist for further treatment.
Newer tests can also help specialists better determine whether nodules are benign or cancerous. One of them is the American College of Radiology (ACR)’s Thyroid Imaging, Reporting, and Data System (TI-RADS). This test scores various features of nodules on an ultrasound, and assigns points to help users of the report with recommendations. The higher the total score, the higher the chances of malignancy.
The American College of Radiology’s TI-RADS assigns points to thyroid nodules based on five features:
- Composition (how “cystic” a thyroid looks)
- Echogenicity (the ability to bounce back an echo during an ultrasound exam)
- Shape (wider-than-tall, or taller-than-wide)
- Margin (how far the thyroid extends around surrounding organs)
- Echogenic focus (bright spots or shadows seen on an ultrasound)
Based on that ratings scale, nodules are then classified as:
- Benign (non-cancerous)
- Not suspicious
- Mildly, moderately, or highly suspicious
5. Another method of diagnosis is to get a thyroid scan done. An isotope of radioactive iodine is injected into a vein in the arm to find nodules that produce an excess of thyroid hormone. (These will take up more isotope than normal thyroid tissue.) You may find cold or hot nodules. Cold nodules are non-functioning and appear as defects or holes in the scan. Hot nodules are almost always non-cancerous, while only some cold nodules are cancerous.
The Conventional Approach to Thyroid Nodules
Most conventional doctors will recommend the following options for treatment of thyroid nodules:
1. Observation. When you have benign nodule, most doctors will recommend monitoring your thyroid with regular checkups (i.e. physical exams, thyroid tests, and follow-up biopsies) to check for malignancy. This is especially important for those with Hashimoto’s, as they are at an increased risk of thyroid cancer. An increase in size or symptoms may demand a repeat biopsy or another treatment, but nodules that don’t change over the years might not require any additional treatment.
2. Thyroid hormone suppression therapy. Prescribing thyroid hormone replacement medications can lower the production of TSH from the pituitary gland, and thus decrease the growth of thyroid tissue. Some practitioners may even attempt to suppress TSH with thyroid medications, to reduce nodule size. One double-blind, placebo-controlled study looked at 123 patients with a single palpable benign nodule, using levothyroxine therapy to suppress their TSH below 0.3 mIU/L over 18 months. The study found that those in the medication group had a significant decrease in the size of their largest nodules, while the placebo group saw an increase in nodule size. [9]
3. Surgery. Surgery may be recommended when a benign nodule is large in size and causing difficulty when breathing or swallowing, when there are diagnosed large multinodular goiters, or when goiters constrict airways, the esophagus, or blood vessels. Surgery is also recommended when nodules are suspected to be cancerous. Options include a total thyroidectomy (where the entire thyroid gland is removed) and a partial thyroidectomy (where only parts of the thyroid are removed).
I’ve seen countless times where people have had their thyroid glands removed due to thyroid disease (most commonly Graves’ and thyroid cancer). In the case of autoimmune thyroid disease, removing the thyroid with a thyroidectomy eliminates thyroid antibodies, as there is nothing left to attack. However, life is not always roses with a thyroidectomy, as it does not remove the autoimmunity. Furthermore, a thyroidectomy may result in difficulty breathing, bleeding or infection, injury to the parathyroid glands near the thyroid (which could cause low blood calcium levels or neuromuscular symptoms), and permanent hoarseness or voice changes due to nerve damage. You can check out my article about getting a thyroidectomy for Hashimoto’s for more information.
While those with co-occurring Hashimoto’s and thyroid cancer may wish to follow this approach, I do not generally recommend this strategy for Hashimoto’s in most cases, as there are so many dietary and lifestyle interventions that can be implemented to prevent the progression of autoimmunity and reduce the size of nodules. (I’ll discuss this more below!)
The Root Cause Approach to Thyroid Nodules
Although the above treatment options can reduce or remove thyroid nodules, I have heard many success stories of people reducing or eliminating their nodules with dietary and lifestyle interventions.
Shrinking Nodules – A Success Story
I’d like to share the success story of a client who was able to reverse her nodules with nutrition, supplements, and treating a Blastocystis hominis gut infection. Her thyroid antibodies are also now in the remission range (she is not taking any thyroid medications). This 60-year-old woman with asthma, Hashimoto’s and past exposure to Chernobyl had consecutive ultrasounds on an annual basis to monitor her thyroid nodule. As of 2018, this person still does not have any nodules on her thyroid ultrasound. She did, however, have a flare of asthma and thyroid antibodies in 2017 after having dairy. As a side note, I think the significant dairy reactivity may be due to the Chernobyl exposure and the radioactive toxins concentrated in the milk from cows in Eastern Europe. My theory is that this exposure made people highly sensitized to dairy proteins.
Here are the results from her first test:
11/5/10: First ultrasound (before diet)
FINDINGS: There is a 6 x 3 x 4 mm hypoechoic solid nodule in the right lobe with multiple small but discrete hyperechoic foci likely due to calcifications. There is a 2 x 4 x 2 mm partly calcified solid nodule in the left lobe that demonstrates shadowing.
IMPRESSION: There are bilateral calcified thyroid nodules. The nodules measure under 1 cm in diameter. The nodules are nonspecific in appearance and results should be correlated with clinical and laboratory data. Follow up ultrasound needed in 12 months due to the calcifications.
She started with having elevated TPO antibodies and saw that her nodule had consistently increased in size with every subsequent ultrasound scan. Deciding to take her health into her own hands, she removed gluten and dairy (two common food sensitivities in those with Hashimoto’s) from her diet. Six months after starting the gluten-free diet, her ultrasound showed a decrease in the size of her nodules:
11/20/14 – After starting a gluten and dairy-free diet
FINDINGS: The right lobe of the thyroid measures 1.4 x 1.3 x 3.8 cm. Left lobe of the thyroid measures 1.6 x 0.9 x 3.9 cm. The isthmus measures 3 mm in thickness.
Right lobe: Lower pole, posterior, lateral, well circumscribed intermediate echogenicity. Central calcification. No increased vascularity. 0.3 x 0.4 x 0.3 cm. Prior studies do not demonstrate a nodule in this location, however a larger calcified nodule was identified previously in a more superior location of the thyroid gland. The previously measured nodule is not demonstrated on this exam. It is possible that the small nodule measured today represents a decrease in size of the previously seen nodule, and the change in location relates to imaging technique. This nodule is indeterminate. Continuing thyroid ultrasound follow-up is recommended.
Left lobe: Mid thyroid, mid gland well-circumscribed. Intermediate echogenicity. Calcified. 0.2 x 0.3 x 0.1 cm. Previously measured 0.3 x 0.2 x 0.1 cm. This calcification/nodule is stable to decreased in size compared to prior ultrasound consistent with a benign finding.
IMPRESSION: I suspect that the right-sided calcified nodule described above in the lower pole today represents the previously measured thyroid nodule and has decreased in size consistent with a benign finding, however, the differences and described location of the nodule may make direct correlation difficult. Continued ultrasound follow-up is recommended.
After being gluten-free for 1.5 years, her thyroid nodule shrunk! Her TPO levels also decreased from 120.7 IU/mL to 42.6 IU/mL. Here’s what her most recent ultrasound test said:
1/29/16 – After treating Blastocystis hominis
FINDINGS: The right lobe measures 3.4 x 1.2 x 0.8 cm. The left lobe measures 3.8 x 1.0 x 0.9 cm. The isthmus measures 0.3 cm in AP dimension. The gland is mildly heterogeneous. Color imaging demonstrates increased vascular flow bilaterally. A coarse calcification in the left lobe measures 3 mm, interpolar. This is stable. There is no discrete nodule.
IMPRESSION: No suspicious nodule identified. The previously described right thyroid nodule is no longer seen. A coarse calcification on the left measures 3 mm, nonspecific but stable and of doubtful significance. This is unchanged dating to the earliest available exam of 11/05/2010.
As you can see, her latest ultrasound test showed that her nodule had disappeared!
What Causes Nodules?
Many people with Hashimoto’s have nodules, as the root causes of thyroid nodules are often the same root causes of their own autoimmune condition, including:
- Chronic inflammation of the thyroid (thyroiditis) – The chronic inflammation associated with autoimmune thyroid conditions increases the risk for thyroid nodules and can further enlarge nodules. [10] With Hashimoto’s, the body develops antibodies to normal proteins produced by the thyroid gland, which in turn can result in the development of malignant (possibly cancerous) nodules. Your thyroid might also form pseudo-nodules (or benign nodules) that come and go.
- Nutrient deficiencies in iodine, selenium, and vitamin D – Iodine deficiencies typically occur in diets lacking iodine, and can result in a multinodular goiter. [11] However, this is unlikely to occur in North America where iodine is added to foods, as is the case with iodized salt. With Hashimoto’s, iodine excess is far more likely to create nodules. You can read more about how iodine affects Hashimoto’s. That said, vitamin D deficiency is quite common in those with Hashimoto’s and those with thyroid nodules. [12] This vitamin controls the way in which cells grow and divide, and insufficiency increases one’s risk of nodules, fibrosis, and polyps in many areas of the body. Selenium deficiency is also a potential cause of nodules, as studies suggest that selenium supplementation can result in improved thyroid ultrasound features and smaller nodules. [13] It’s also a common nutrient deficiency seen in those with Hashinoto’s. [14]
- Toxins – This is oftentimes an overlooked culprit for nodules. A 2015 study in Sicily found that people living closer to a petrochemical complex, and thus are subject to its pollution, were more likely to have a greater frequency of thyroid nodules as well as Hashimoto’s. [15] Radiation exposure, such as being exposed to Chernobyl, can also cause nodules. [16] Additionally, a 2017 study found that thyroid nodules were more likely to be found in those with both autoimmune thyroid disease and a nickel allergy. [17] Further research is needed, but this supports the idea that toxic exposure, like nickel toxicity, may play a role in the development of nodules in those with Hashimoto’s.
- Pregnancy and hormonal changes – Oftentimes, women develop thyroid nodules during pregnancy, and pre-existing thyroid nodules may grow during pregnancy. A recent study done in Hong Kong saw an increase in the number and size of thyroid nodules over a period of 10 to 12 weeks apart each trimester of pregnancy. [18] The growth of the nodules appeared to be much faster than what is normally seen in non-pregnant women. While the cause of nodules during pregnancy remains unclear, the study suggested that this could be due to negative iodine balance associated with pregnancy.
- Estrogen dominance – Over the years of working with people with thyroid conditions, it has become clear to me that there is a strong relationship between sex hormones and thyroid hormones. Estrogen dominance can even be a trigger for Hashimoto’s. Too much estrogen in the body can cause a number of symptoms, including PMS, PMDD, fibroids, endometriosis, ovarian cysts, uterine polyps, fibrocystic breasts, various cancers, elevated thyroid antibodies, and yes – thyroid nodules. [19] Estrogen is a potent growth factor for thyroid cells that may lead to thyroid nodules (and thyroid cancer).
- H. pylori infections – H. pylori infections have been considered a trigger of Hashimoto’s and have been found in almost 50 percent of patients with Hashimoto’s in one Iranian study. [20] (You can read more about that in my article on Hashimoto’s and H. pylori.) A 2013 study found that H. pylori infections were associated with the presence of thyroid nodules in individuals, despite having normal thyroid function. [21] A 2023 study in Northwest China determined that the incidence of thyroid nodules was significantly higher in those with persistent H. pylori infections. [22] Still, there is other conflicting data on the association between H. pylori and the presence of thyroid nodules. Given that the theory of molecular mimicry suggests that the immune system may attack its own thyroid gland when it is infected with a pathogenic organism that looks similar to components of the thyroid gland, it’s possible that such an infection increases the autoimmune attack on the thyroid, resulting in the development of thyroid nodules.
- Blastocystis hominis infections – I have heard anecdotal stories from my clients and readers claiming that addressing a Blastocystis hominis infection resulted in the elimination of their nodules. I suspect the reason behind this is similar to why H. pylori infections are associated with the development of thyroid nodules. Another hypothesis I have relating to the role of infections in thyroid nodules, is that nodules may be created when a foreign substance (like bacteria) is inserted into the body and the body reacts by trying to wall it off by forming a capsule of scar tissue around it.
- Food and diet – We know that food sensitivities can exacerbate the attack on the thyroid and increase one’s levels of chronic inflammation, which, as I mentioned earlier, has been linked to the development and enlargement of nodules. Additionally, based on anecdotal stories from clients who have shrunk their nodules through dietary interventions that remove common inflammatory foods, it’s possible that food sensitivities contribute to the development and growth of thyroid nodules. I’ve received numerous reports from clients and readers who were surprised that their nodules disappeared after following the Paleo or Autoimmune Paleo diet.
- Please note: this approach works over months, sometimes years. Additionally, blood sugar imbalances can also lead to a greater risk of thyroid nodules. [23]
Ways to Shrink Benign Nodules
That is why I believe that a number of dietary and lifestyle changes can help improve symptoms of Hashimoto’s and reduce the size of thyroid nodules.
As mentioned above, many root causes of Hashimoto’s are associated with the development of thyroid nodules, so addressing them may reverse their growth and shrink them! Here are some tips that may help to reduce the size of your thyroid nodules:
- Address nutrient deficiencies in iodine, selenium, and vitamin D – While iodine deficiency is rare in those with Hashimoto’s, those that are indeed low in iodine may benefit from taking a multivitamin with iodine, like Nutrient 950 from Pure Encapsulations. A dose of up to 250 mcg of iodine per day has been found to be helpful and beneficial in people with Hashimoto’s; however, doses above 300 mcg can be potentially inflammatory.
Vitamin D and selenium supplementation may also help. As mentioned, vitamin D deficiency is common in those with Hashimoto’s and thyroid nodules. I recommend getting your levels tested before starting supplementation. While the conventional reference ranges define vitamin D deficiency as under 30 ng/mL, vitamin D levels should be between 60 and 80 ng/mL for optimal thyroid receptor and immune system function. Spending time in the sun is one of the best ways to boost your vitamin D levels (safely of course – 15 minutes outside around noon with no sunscreen should be helpful for most), and the other option is to take an oral vitamin D3 supplement. You can read more about addressing vitamin D in this article.
Selenium is another common nutrient deficiency seen in those with Hashimoto’s, that may be helpful in reducing or eliminating thyroid nodules. While doses of 200 mcg of selenium per day have been found to decrease thyroid antibodies, combining selenium with myo-inositol can be even more helpful for thyroid health. [24] Research has shown that a combination of selenium and myo-inositol can have a synergistic effect that maximizes the benefit to thyroid function — consuming both of these together may not just reduce thyroid antibodies, but can also reduce TSH by an average of 30 percent. In some cases, this can normalize TSH levels (both for low and high TSH levels), reduce the risk of developing overt hypothyroidism, and improve overall well-being for those who have Hashimoto’s. [25] A 2018 study showed that patients with subclinical hypothyroidism who were given an oral supplement containing selenium and myo-inositol daily for six months, were able to reduce the size, number, and elasticity score of their thyroid nodules, as well as reduce their TSH levels. [26] I recommend Rootcology’s Selenium + Myo-Inositol, which contains clinically studied doses of each nutrient to support optimal thyroid function.* [27] You can read more about addressing selenium deficiencies in my article.
- Clear out toxins – Supporting your liver’s detoxification pathways as well as opting for non-toxic, natural personal products, can greatly reduce your body’s toxic burden and result in optimal thyroid health. Check out my article on liver support for more information. Liver support is also a key way to balance estrogen dominance.
- Address underlying infections – As I mentioned earlier, infections like H. pylori and Blastocystis hominis are a common root cause and trigger for Hashimoto’s, and can contribute to thyroid nodules. Addressing these infections may eliminate your thyroid nodules, as well as the autoimmune attack on the thyroid.
When it comes to thyroid nodules, there is conflicting data on their connection to H. pylori, but since it’s a known Hashimoto’s trigger, and I have personally observed so many people improve their thyroid condition by eliminating H. pylori, I still recommend addressing it.
Blasto is another gut infection that can be a trigger for Hashimoto’s, and while the studies only support remission of Hashimoto’s with Blasto treatment (and no studies on nodules and Blasto currently exist), clinically I’ve seen people’s symptoms, antibodies and nodules improve dramatically after they eliminate Blasto.
To find out whether you have a gut infection, I recommend stool testing with tests such as the GI-MAP. You can read more about treating Blasto and H. pylori infections in my articles.
- Change your diet and remove food sensitivities – Removing common food sensitivities is often very helpful for those with Hashimoto’s. According to my 2015 survey of over 2200 people with Hashimoto’s, 88 percent felt better when they removed gluten from their diet, while 79 percent who removed dairy felt better. Removing common food sensitivities like gluten and dairy can also help reduce the size of your nodules. Check out my article on food sensitivities for more information on how to identify them.
Additionally, I would recommend balancing your blood sugar, as most people with Hashimoto’s have dysregulated blood sugar levels. Research has shown that up to 50 percent of those with Hashimoto’s have a carbohydrate intolerance. [28] This means that when a high-carbohydrate meal is consumed, our blood sugar levels are more likely to spike quickly, leading to low blood sugar levels (reactive hypoglycemia), as well as feelings of nervousness, lightheadedness, anxiety, and fatigue. Blood sugar imbalances have been described as adding “fuel to the fire” in autoimmune thyroid disease, by many practitioners who focus on reversing Hashimoto’s. A review paper published in 2010 that discussed the relationship between thyroid dysfunction and metabolic disorders, highlighted the fact that patients with diabetes were up to three times more likely to develop a thyroid disorder. [29] Balancing your blood sugar can also be helpful for shrinking thyroid nodules. Check out my full article on blood sugar and Hashimoto’s for strategies to support balanced blood sugar.
- Address estrogen dominance – Excess estrogen can be a trigger for thyroid nodules, and for Hashimoto’s. In the case of excess estrogen due to pregnancy or using birth control pills, the estrogen will likely rebalance on its own with time after you have your baby or stop the pill. If a year has passed since you had a baby or stopped the pill, or if your estrogen dominance is due to other reasons, there are many ways to support hormone balance through dietary changes, supplements, and potentially the use of liver support and/or progesterone, to help bring estrogen into balance. I’ve written an article on how to recognize the symptoms of estrogen dominance and how to treat it, and another on the birth control pill which can sometimes be implicated.
- Consider smart supplementation – Over the years, I’ve learned about some key supplements that can be helpful for reducing and eliminating thyroid nodules. Here are a few that I’ve seen the most positive results from:
- Turmeric – Some of my readers have reported an elimination of nodules by using turmeric. Curcumin, the active component of turmeric, is best known for its anti-inflammatory properties, and can also support gut and immune health. [30] In a 2019 study examining the effects of natural extracts on thyroid nodules, euthyroid patients with benign thyroid nodules were given a supplement containing spirulina, curcumin, and boswellia (more on the other two in a moment). [31] The study found that after three months, 29 of the 34 patients had a decrease in size of their thyroid nodules by 5 percent or more, and 22 of the 34 patients had a decrease in size of 10 percent or more. You can add more turmeric to your everyday cooking (don’t forget to add a pinch of black pepper to increase absorption!), or you can use a supplement like Curcumin Absorb.
- Boswellia – This herb reduces inflammation and improves pain in a similar way as turmeric. [32] I’ve also had patients report a reduction in thyroid nodules by using boswellia, and it was one of the main ingredients in the supplement used in the study I referenced above. I recommend a high-quality supplement like Pure Encapsulations Boswellia.
- Systemic Enzymes – Some of my readers have reported an elimination of thyroid nodules by using systemic enzymes. Systemic enzymes act as natural immune modulators, helping to bring our immune system into balance. [33] Systemic enzymes can reduce antibodies to both foods and the thyroid by breaking down circulating immune complexes that are formed in autoimmune diseases. They can also aid in tissue repair by reducing inflammation. I recommend Rootcology Systemic Enzymes, which not only contains systemic enzymes, but is a comprehensive formula that also contains turmeric, boswellia, and other nutrients that have been shown to support modulation of the immune system. This is a great formula for those who want a multi-tasking supplement to support the reduction of thyroid nodules. Another blend of systemic enzymes, Wobenzym, was the subject of a study that found that when given with levothyroxine, Wobenzym resulted in a greater reduction of thyroid antibodies than in those patients only given levothyroxine. [34] Those patients taking Wobenzym also had a reduction of thyroid symptoms, a normalization of their thyroid ultrasound, and a reduction in inflammatory cells found in the thyroid. For more info on the above research utilizing Wobenzym, please review the article here.
- Butyrate – Butyrate is a short-chain fatty acid produced in the gut that has many health benefits. [35] I’ve seen low butyrate levels in many of my Hashimoto’s clients over the years. I was fascinated to come across research that has shown that people with thyroid nodules have low levels of butyrate-producing gut microbiota. [36] Based on these findings, supporting and healing the gut may help reduce thyroid nodules, as well as boosting levels of butyrate with a supplement like Rootcology Butyrate Balance.
- Berberine – Insulin resistance has been found to increase thyroid nodule formation and volume. [37] As I mentioned earlier, many people with Hashimoto’s have dysregulated blood sugar and carbohydrate intolerance, so balancing blood sugar could be helpful for reducing thyroid nodules. Those with thyroid nodules have also been found to have levels of Streptococcus on their gut tests. Streptococcus, among other strains of bacteria, can increase circulating branch-chained amino acids (BCAAs), which have been linked to obesity and insulin resistance. [38] Berberine is a natural plant compound that has blood-sugar balancing properties, and also contains alkaloids that have broad-spectrum antimicrobial and antiparasitic properties, making it effective in helping to clear gut infections and overgrowths of pathogenic bacteria. [39] This makes berberine wonderfully helpful in the case of thyroid nodules, as it targets two potential causative factors. Metformin, a popular diabetes drug, has also been studied for its ability to reduce thyroid nodules through its blood-sugar regulating properties, but I prefer to use berberine, as it has fewer potential side effects. [40] I developed a Berberine formulation as part of my Rootcology supplement line, which contains 400 mg of berberine in a formulation that improves its absorption and delivery.
- Prunella – A traditional Chinese medical herb, Prunella vulgaris, is considered beneficial for thyroid nodules, and thyroid health in general. A 2021 review found that when combined with thyroid medications, Prunella can help reduce the diameter of thyroid nodules, while also improving the clinical efficiency and reducing the risk of adverse reactions of the thyroid medications. [41] I have not used this before, but if you’re looking to try this, I recommend working with an herbalist trained in traditional Chinese medicine if you would like to consider this option.
- Spirulina – Spirulina is a seaweed that is often touted in the health community for its anti-inflammatory and antioxidant properties. [42] The study I referenced about natural extracts reducing the size of thyroid nodules used a supplement that contained spirulina, turmeric, and boswellia. While it may be beneficial for some, if you have Hashimoto’s, I generally don’t recommend using spirulina. It contains high levels of iodine (which, as we discussed earlier, can exacerbate Hashimoto’s), and because of its effects on the immune system, can perpetuate or potentially worsen Hashimoto’s, and may even be associated with new-onset autoimmune conditions. I personally experienced this when I tried to do a “spirulina detox” in my early Hashimoto’s days, and ended up giving myself a new autoimmune condition that consisted of pimples on the inside of my eyelids. Not fun!
What About Thyroidectomy for Thyroid Nodules?
I have had a lot of people consult with me regarding their nodules, often after a thyroidectomy was recommended. A thyroidectomy is a surgical procedure that removes all, or a part of your thyroid gland. It may be recommended for thyroid cancer and autoimmune conditions (read more in my articles, Is Hashimoto’s a Surgical Disease? and Graves’ remission). Often, it’s recommended without presenting other options, and so I hope this article provides you with more options to consider.
If a nodule is benign, people may wish to try non-invasive protocols that can shrink the nodules with time, but some individuals that I consulted with wanted to “just get it over with” and get a thyroidectomy.
While I support every choice and option, I do often warn about the consequences of having a thyroidectomy (such as scarring, bleeding infection, hypoparathyroidism, and hoarse voice).
I also want to share that many people post thyroidectomy require lifelong thyroid medications, and in my experience, have trouble regulating thyroid function, so I always want to educate about less invasive, root cause options. 🙂
In the case that less invasive options aren’t the right fit, one may wish to consider echotherapy (HIFU ablation) instead of thyroidectomy.
New research suggests that a single session of high-intensity focused ultrasound (HIFU) ablation, which uses focused ultrasound energy to induce thermal ablation (removal), may be more beneficial (and safer) than a thyroidectomy for symptomatic but benign thyroid nodules.
In one study, patients who underwent HIFU ablation did not scar, had a shorter hospital stay, and were less likely to have voice pitch issues a month after their treatment. Furthermore, those in the study saw a greater improvement in symptoms and a lower prevalence of subclinical hypothyroidism compared to those who had surgery. While this treatment is currently only available in a few clinics in Europe, further studies may be conducted in the future to explore its efficacy as a possible thyroidectomy alternative. [43]
The Takeaway
Nodules are often present in those with Hashimoto’s and may be detected with a thyroid panel and ultrasound tests, but most nodules are benign. While thyroid medication can help address thyroid hormone imbalances, they may not always get to the root cause of the nodules alone.
Fortunately, benign nodules may be reduced or even eliminated with dietary changes, strategic supplements, and other innovative lifestyle changes that address the underlying root causes of Hashimoto’s, as discussed in my book Hashimoto’s Protocol. This comprehensive plan has helped many patients feel better and get their thyroid disease into remission, and I hope these changes help you as well!
P.S. You can download a free Thyroid Diet Guide, 10 thyroid-friendly recipes, and the Nutrient Depletions and Digestion chapter of my first book for free by signing up for my newsletter. You will also receive occasional updates about new research, resources, giveaways, and helpful information.
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References
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[2] Ibid
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[7] Thyroid nodules: Causes, symptoms & treatment. Cleveland Clinic. June 21, 2022. Accessed August 21, 2023. https://my.clevelandclinic.org/health/diseases/13121-thyroid-nodule.
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[19] Delgado BJ, Lopez-Ojeda W. Estrogen. In: StatPearls. Treasure Island (FL): StatPearls Publishing; June 26, 2023.; 1. Estrogen-Dependent Cancers. Cleveland Clinic. September 10, 2021. Accessed August 22, 2023. https://my.clevelandclinic.org/health/diseases/10312-estrogen-dependent-cancers.; Derwahl M, Nicula D. Estrogen and its role in thyroid cancer. Endocr Relat Cancer. 2014;21(5):T273-T283. doi:10.1530/ERC-14-0053
[20] Aghili R, Jafarzadeh F, Bhorbani R, et al. The association of Helicobacter pylori infection with Hashimoto’s thyroiditis. Acta Med Iran. 2013;51(5):293-6.
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[22] Di J, Ge Z, Xie Q, et al. Helicobacter pylori infection increases the risk of thyroid nodules in adults of Northwest China. Front Cell Infect Microbiol. 2023;13:1134520. Published 2023 Mar 31. doi:10.3389/fcimb.2023.1134520
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[25] Nordio M, Basciani S. Evaluation of thyroid nodule characteristics in subclinical hypothyroid patients under a myo-inositol plus selenium treatment. Eur Rev Med Pharmacol Sci. 2018;22(7):2153-2159. doi:10.26355/eurrev_201804_14749; Nordio M, Pajalich R. Combined Treatment with Myo-Inositol and Selenium Ensures Euthyroidism in Subclinical Hypothyroidism Patients with Autoimmune Thyroiditis. Journal of Thyroid Research. 2013;2013:424163. doi:10.1155/2013/424163.; Nordio M, Basciani S. Treatment with Myo-Inositol and Selenium Ensures Euthyroidism in Patients with Autoimmune Thyroiditis. International Journal of Endocrinology. 2017;2017:2549491. doi:10.1155/2017/2549491.; Ferrari SM, Fallahi P, Di Bari F, Vita R, Benvenga S, Antonelli A. Myo-inositol and selenium reduce the risk of developing overt hypothyroidism in patients with autoimmune thyroiditis. Eur Rev Med Pharmacol Sci. 2017;21(2 Suppl):36-42.; Ferrari, SM et al. Precision Medicine in Autoimmune Thyroiditis and Hypothyroidism. Front. Pharmacol., 17 November 2021 | https://doi.org/10.3389/fphar.2021.750380
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Note: Originally published in October 2018, this article has been revised and updated for accuracy and thoroughness.
Marlyn Seidman says
How about a thyroid nodule caused by radium treatments as a child?
Dr. Izabella says
Marlyn – thank you for reaching out. Nodules and goiters are often the result of toxicity and/or the autoimmune process. So, doing interventions to reduce the autoimmune attack on the thyroid, and toxicity, can be helpful to reduce them. Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target. We need to rebalance the immune system to prevent this. Sometimes the autoimmunity can be reversed as well! The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research and journey for overcoming my autoimmune thyroid condition. Here are the links to my books:
Hashimoto’s Root Cause
http://amzn.to/2DoeC80
Hashimoto’s Protocol
http://amzn.to/2B5J1mq
Susan says
Please check out RFA (radio frequency ablation) for nodules. Just had the procedure as have many people and it shrunk my 6cm nodule significantly. Fairly new in the US. Dr Kao in NYC and Dr Randolph in Boston are wonderful. It’s been a lifesaver!
Dr. Izabella says
Susan – thank you so much for sharing what has worked for you! I’m so happy to hear you have found some practitioners to help.
Sarah says
Yes! Radiofrequency ablation is common in the US. Everyone with benign thyroid nodules needs to know about it! Research who does it in your area. One of the ENT’s in my area does it. He said I’m a good candidate. It’s thrilling to have an option other than surgery since natural treatments have not worked for me.
Dr. Izabella Wentz says
Sarah – thank you so much for sharing.
Anne Parkinson says
Can I buy your books in any bookstores?
Dr. Izabella says
Anne – thank you for your interest in my books! Yes you should be able to find my books in most books stores. You can also purchase here:
Hashimoto’s Root Cause
http://amzn.to/2DoeC80
Hashimoto’s Protocol
http://amzn.to/2B5J1mq
Davin Casely says
Dr. Wentz,
What is your position in respect to the Broda Barnes Basal Temperature Test Method vs comprehensive blood testing for thyroid function?
Thanks in advance
Dr. Izabella says
Davin – thank you for reaching out. <3 That's a great question and unfortunately I don't have any information to share with you at this time but, I will add this to my list of future article possibilities.
Hudson2006 says
Dear Izabella,
I would like to ask the function of NAC(N-Acetyl Cysteine) supplement and recommended daily allowance of NAC. Can this NAC be useful to reduce thyroid anti-body(TPO & TgAB)?
Thank you for your reply.
Dr. Izabella says
Hudson – thank you for reaching out. N-Acetyl-Cysteine is an amino acid that is a precursor to glutathione, the body’s most powerful antioxidant, and helps promote optimal detoxification. NAC is heavily researched for its role in optimizing lung health and is also used for rapid recovery after workouts. It is also beneficial for protection against normal exposure to heavy metals. NAC is a sulfur-based amino acid and should be avoided if you have a sulfur sensitivity. I have created my own supplements brand, which is named Rootcology. Rootcology’s mission is to provide safe and effective supplement solutions for people struggling with autoimmune thyroid conditions. These supplements are composed of high-quality pesticide-free ingredients, do not contain soy protein, dairy, or gluten ingredients, and undergo third-party testing to ensure that the ingredients on the label match the ingredients inside each bottle. Here is a link
N-Acetyl-Cysteine (NAC)
https://www.rootcology.com/collections/supplements/products/nac-n-acetyl-cysteine
ava says
Hi, I remember a while back you had mentioned low level red light therapy and some successful in some small scale studies in reducing nodule size. Any new updates on that therapy?
Dr. Izabella says
Ava – thank you for reaching out. Here is an article you may find interesting:
LASERS FOR THYROID TISSUE REGENERATION
https://thyroidpharmacist.com/articles/lasers-thyroid-tissue-regeneration/
Tommy says
Hi!I had Grave’s Disease before. After treating my grave’s disease, my TSH was back to normal level. My Thyroid anti-bodies in that time were TPO(58>5(Reference valve))and TGab(89>4(Reference Value)). Then, I tried eat a lot of Seaweed and Seafood everyday. My body gained tones of energy in that time. However, I had a lot of problem after taking lots of seaweed and seafood. I had constipation and my skin become very dry. On the other hand, My skin had another problem, Vitiligo. My Thyroid antibodies now is at a high level(TPO>150 and TGab>136). Is Vitiligo relative with Thyroid antibodies?
Dr. Izabella says
Tommy – thank you for reaching out. The root cause treatments that I recommend for Hashimoto’s may also potentially be helpful for Vitiligo. Any infection or toxin can produce these symptoms of autoimmune disease. Also, with Vitiligo, antibodies may cross-react with the thyroid.
I’ve had a few clients who have been able to reduce or eliminate their Vitiligo through my Hashimoto’s Self-Management Program. Specifically, I had one client who had Vitiligo because of an infection. Another client’s Vitiligo patches stopped growing after doing the program. My 12-week program addresses all of the strategies that I go over with my one-on-one clients. This program gives clients access to all of the things I learned about Hashimoto’s without having to schedule costly consults with me or another practitioner. It was designed to empower clients with the strategies they need so that they can start improving faster, be in charge of their own health, and be less dependent on health care providers. The 12-week Hashimoto’s Self-Management Program walks you through the steps to identify and address the common root causes of autoimmune thyroid disease, like diet, dental, adrenal and blood sugar imbalances, infections, toxins and much more. It is a self-paced self-management program and offers the added benefit of having others with whom to discuss the material each week. If interested in signing up for the program, it is available through this link:
Hashimoto’s Self-Management Program
https://thyroidpharmacist.com/enroll-in-hashimotos-self-management/
Susan Kiernan says
Hi. Thanks so much for your book and the wealth of information you share with us. According to thyroid tests my thyroid is normal, and yet a have many symptoms, IBS, Hives, Depression,Hair loss, Brain fog, and many more. Last year i developed a thyriod nodule and had 3 fine needle biopsies and was discharged from the hospital as it was beneign. Four weeks later developed a barking irritating cough and high temperature that stayed for 4 months, (any connection??)…..I have been trying to cut out of my deit gluten,sugar,soy,caffeine, alcohol and dairy,(struggling with last one as i take kefir made from goats milk which does improve my gut). Must say, although only small changes so far, my nodule is shrinking and seen a difference in my digestion, and mood swings. ….. what are your comments on ‘Bioresonance treatment ‘?? Warm regards
Dr. Izabella says
Susan – thank you so much for reaching out and sharing your journey with me. I am so proud of you for taking charge of your health and I am happy to hear you are feeling better. Unfortunately I don’t have any information to share with you at this time on Bioresonance but, I will add this to my list of future article possibilities. I would love to hear more about your experiences here on this page!
Jane says
I have 2 thyroid nodules, discovered in the beginning of 2018. The first fine needle aspiration and pathology was inconclusive, so we waited 6 months and did another biopsy. My endocrinologist ordered a genetic test on the specimens and I’m happy to say, they were found benign. As little as 6 years ago I would probably have had surgery. I am working on some of your protocols to shrink them and have also had some acupuncture. It was very strange. 3 fine needles on the side of my neck that had the nodules and one on the other side, connected by wire and alligator clips. Three quick shocks were applied. I had read about a clinical trial that was done using such a procedure and it was very successful. Time will tell. Thank you for all your work!!
Dr. Izabella says
Jane – thank you so much for sharing what has worked for you! Please keep me posted on your progress. <3
Sara Flyte says
Hello,
I am 31 years old. I found a nodule on my thyroid 2 weeks after my son was born. It was biopsied and came back benign. We just checked it again 6 months later and it has grown and now the biopsy came back abnormal. All of my blood work and TS levels have been normal and I have no symptoms. If it wasn’t for the lump, I wouldn’t even have known. The doctor is recommending removing the thyroid because my mom had thyroid cancer when I was younger. I am concerned that I am jumping straight to surgery before considering all of my options. I am just scared that if it is cancer, I don’t want to wait to take action. I am looking for any options and steps I should take. Do you have any thoughts?
Dr. Izabella says
Sara – thank you for reaching out and sharing your journey. I am so sorry you are dealing with all of this. My heart goes out to you. <3 Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically, is ‘dead’, or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target.
We need to re-balance the immune system to prevent this (sometimes the autoimmunity can be reversed as well). The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my books focus on balancing the immune system. The information is based on my own research in my journey whilst overcoming my own autoimmune thyroid condition. Here are some articles which might help:
IS HASHIMOTO’S A SURGICAL DISEASE
https://thyroidpharmacist.com/articles/is-hashimotos-a-surgical-disease
HASHIMOTOS AND THYROID CANCER
https://thyroidpharmacist.com/articles/hashimotos-and-thyroid-cancer/
HORMONE REPLACEMENT THERAPY AND CANCER
https://thyroidpharmacist.com/articles/hormone-replacement-therapy-and-cancer
THE CONVENTIONAL, COMPLEMENTARY AND ALTERNATIVE APPROACH TO HASHIMOTO’S AND THYROID CANCER
https://thyroidpharmacist.com/articles/the-conventional-complementary-and-alternative-approach-to-hashimotos-and-thyroid-cancer
Iwona says
Hello,
i had an ultrasound done in years:
– 2012 – 4 thyroid nodules (some calcified/partly calcified biggest over 1 cm)
– 2015 – 8 thyroid nodules (biggest 1,6 cm)
-2018- 8 thyroid nodules (biggest 1,6 cm)
TSH is ok
My question is, is it possible to heal it naturally? is’nt it to late? I do not know exacly when they appeared.
Dr. Izabella Wentz says
Iwona – thank you for reaching out. I am so sorry you are struggling with this. Nodules and goiters are often the result of toxicity and/or the autoimmune process. So, doing interventions to reduce the autoimmune attack on the thyroid, and toxicity, can be helpful to reduce them. Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target.
We need to rebalance the immune system to prevent this. Sometimes the autoimmunity can be reversed as well! The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research and journey for overcoming my autoimmune thyroid condition.Have you read my books?
Hashimoto’s Root Cause
http://amzn.to/2DoeC80
Hashimoto’s Protocol
http://amzn.to/2B5J1mq
Iwona says
I have not read your books yet, i watched your movies on youtube, but will try, i struggle since over 10 years, but just do not “inside” feel that this is a good solutions. I have never believed in medicaments, its syntetic, but didn’t have any better idea of what to do. I’ll try to get this book.
Dr. Izabella Wentz says
Iwona – thank you for reaching out and sharing your journey. I understand how overwhelming and hard this can be. <3 Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target.
We need to rebalance the immune system to prevent this. Sometimes the autoimmunity can be reversed as well! The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research and journey for overcoming my autoimmune thyroid condition. Here are the links to my books:
Hashimoto’s Root Cause
http://amzn.to/2DoeC80
Hashimoto’s Protocol
http://amzn.to/2B5J1mq
Melinda W. says
Hello! I am a 32 year old woman. I have a Toxic Multi-nodular Goiter or Plummer’s Disease. I found out about my goiter over 10 years ago. It did not grow at all during that time. 3 years ago I developed a cough and visited my doctor. With my previous thyroid history she ran some bloodwork and we discovered I was hyperthyroid. I had a thyroid uptake scan which confirmed the Plummer’s Disease. I wanted to get pregnant so my endocrinologist and I decided to go on thyroid meds before surgery. I was able to get pregnant and have a healthy pregnancy while on anti thyroid medication, under the care of my endocrinologist and OB. I am currently on a low dose of PTU and we are holding off on surgery until my baby is done breastfeeding. I have been gluten free for 3 years. I do occasionally consume dairy. I take a prenatal multivitamin, cod liver oil, and magnesium daily. I would like to shrink my goiter so I do not need surgery. There is very little information about Plummer’s disease available and most information I have found says the only cure is surgery. Is there any protocol for shrinking a toxic multi nodular goiter? Thank you!
Dr. Izabella Wentz says
Melinda – thank you so much for sharing your journey. Congratulations on you new baby! <3 I understand how hard this can all be. Nodules and goiters are often the result of toxicity and/or the autoimmune process. So, doing interventions to reduce the autoimmune attack on the thyroid, and toxicity, can be helpful to reduce them. Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target.
We need to rebalance the immune system to prevent this. Sometimes the autoimmunity can be reversed as well! The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research and journey for overcoming my autoimmune thyroid condition. Have you read my books?
Hashimoto’s Root Cause
http://amzn.to/2DoeC80
Hashimoto’s Protocol
http://amzn.to/2B5J1mq
Tracy Chandler says
Hello, I have been borderline hyperthyroidism since a teenager and because of this, I am tested every year. I am 53 and Karlie this year was diagnosis hypothyroidism/hashimoto’s. Dr had me do an ultrasound and I had multiple nodules, radiologists said they didn’t not look concerning so watched, by doing another 6 months later and one nodule had grown, so did a fna. Came back papillary cancer. I am post surgery 1 week and doing great, dr plan on doing RAI when my levels are 50, I go do bloodwork this Wednesday. My pathology report shows right lobe 1.6 cm, left lobe 2.0 cm and .06cm. Papillary carcinomas, right lobe papillary carcinoma tall cell variant, left lobe papillary carcinoma classic, papillary carcinoma follicular variant, encapsulated/well demarcated, with tumor capsular invasion. Margins uninvolved and 2 lymphs nodes attached no cancer. My question is about the RAI, I’m concerned about the chance of secondary cancers and trying to weigh the risk. Please help.
Thanks, Tracy
Dr. Izabella says
Tracy – thank you for sharing your journey wit me. I am so sorry you are going through all of this. <3 My heart goes out to you. Most nodules are benign (non-cancerous); however, thyroid cancers generally begin with a nodule and 1 to 2 percent of nodules may be cancerous, so if you have a thyroid nodule, it’s important to get an accurate diagnosis. Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically, is ‘dead’, or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target.
We need to re-balance the immune system to prevent this (sometimes the autoimmunity can be reversed as well). The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my books focus on balancing the immune system. The information is based on my own research in my journey whilst overcoming my own autoimmune thyroid condition. Here are some articles which might help:
HASHIMOTOS AND THYROID CANCER
https://thyroidpharmacist.com/articles/hashimotos-and-thyroid-cancer/
HORMONE REPLACEMENT THERAPY AND CANCER
https://thyroidpharmacist.com/articles/hormone-replacement-therapy-and-cancer
THE CONVENTIONAL, COMPLEMENTARY AND ALTERNATIVE APPROACH TO HASHIMOTO’S AND THYROID CANCER
https://thyroidpharmacist.com/articles/the-conventional-complementary-and-alternative-approach-to-hashimotos-and-thyroid-cancer
Tara Hayghe says
HELP – I have all you books. I have changed my way of living drastically (NO Gluten and NO Dairy and now eat ALL Organic foods) this caused my sodium to dropped to 121 and I’m trying to balance my eating with you supplements, but its very difficult. I have a nodule on my right thyroid thats growing. My thyroid is not over active or under producing according to the doctors testing. I’m scheduled to have surgery Dec 2019 and really don’t want to but my nodule is not shrinking. I don’t think I’m balancing your supplements appropriately. Please HELP
Dr. Izabella says
Tara – thank you so much for reaching out and sharing your journey. I am so sorry to hear you are struggling with all of this. I understand how hard it is. My heart goes out to you. <3 Hashimoto’s is often a combination of food sensitivities, nutrient deficiencies, adrenal issues, gut issues as well as an impaired ability to get rid of toxins. Any of those things would prevent a person from getting better. Hashimoto's is very much an individual condition. While there are root cause commonalities, each person will have their own or in some cases, more than one root cause. You will have to start with the simplest modifications, by removing triggers, followed by repairing the other broken systems to restore equilibrium, allowing the body to rebuild itself. You will need to dig down to why the immune system is imbalanced in the first place and this will tell you how you begin to finally feel better, reduce your thyroid antibodies and even take your condition into remission. You will have to create your own health timeline. Look back at your overall history as far back as you can remember. Look for infections, periods of severe stress, the use of medications (especially antibiotics, antacids, and oral contraceptives), accidents, and exposure to toxins. These are events that may have contributed to Hashimoto's. Once you do, you will know what types of changes you need to implement to make yourself feel better.
If you need further support, please check out the list of lab tests inside the “Testing” chapter of my book, Hashimoto’s Root Cause. I also offer a 12-week program, Hashimoto's Self Management Program. Here are some resources I hope you find helpful as well.
BUILDING YOUR OWN HEALTH TIMELINE
https://thyroidpharmacist.com/sample-health-timeline/
IS HASHIMOTO’S A SURGICAL DISEASE
https://thyroidpharmacist.com/articles/is-hashimotos-a-surgical-disease
S.M. Geiger says
In 2011, a benign nodule on my left thyroid measuring 3.3 cm was found. Biopsy revealed colloid nodule. Yearly ultra sounds were taken with little change until recently. A CT scan revealed the nodule is now 4.4 cm and causing a 1.3 cm deviation on my trachea. Now they want another biopsy. Of course, surgery is the only option I’ve been given, but at 75 years old, female, in good health, I am seeking a way to shrink the nodule. Blood tests on thyroid are normal. I’ve been told over the years that there is nothing that can shrink the nodule and surgery is the only option. I would appreciate your advice. Thank you.
Dr. Izabella says
S.M. – thank you for reaching out and sharing your journey. <3 I am so sorry you are struggling with this. Nodules and goiters are often the result of toxicity and/or the autoimmune process. So, doing interventions to reduce the autoimmune attack on the thyroid, and toxicity, can be helpful to reduce them. Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically, is ‘dead’, or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target.
We need to re-balance the immune system to prevent this (sometimes the autoimmunity can be reversed as well). The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my books focus on balancing the immune system. The information is based on my own research in my journey whilst overcoming my own autoimmune thyroid condition. Here are some resources that might be helpful:
IS HASHIMOTO’S A SURGICAL DISEASE
https://thyroidpharmacist.com/articles/is-hashimotos-a-surgical-disease
Hashimoto’s Root Cause
http://amzn.to/2DoeC80
Hashimoto’s Protocol
http://amzn.to/2B5J1mq
Rob Scarr says
Dear Dr. Wentz, fascinating to read your article and your suggestions and recommendations to address the autoimmune imbalance. I have been diagnosed with multinodular goiter. One side is putting pressure on my trachea (which is now not straight as seen from x-rays) but so far have had no issues with breathing or swallowing food. My endocrinologist has recommended i have a thyroidectomy within next 2 months. Thyroid function is normal according to blood test. Reading your article, I am now even more wary of having the thyroidectomy, and have started treatment from with a Chinese (herbal medicine) doctor (in a well known Traditional Chinese Medicine Hospital in Asia) as well as acupuncture, as an alternative to see if the nodules can reduce in size. I plan after 3 months to go back for a further ultrasound to see if any improvements, before I would reconsider having a thyroidectormy. Appreciate your thoughts and any feedback/experience of treatments using Traditional Chinese Medicine.
Dr. Izabella Wentz says
Rob – thank you so much for sharing your journey! I’m so happy to hear you are taking charge of your health and have found a practitioner! <3 Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Hashimoto’s is a complicated condition with many layers that need to be unraveled. While conventional medicine only looks at each body system as a separate category and is only concerned with the thyroid’s ability to produce thyroid hormone, Hashimoto’s is more than just hypothyroidism, it's an autoimmune disease that needs to be managed. Whether you have all, part or no thyroid, the autoimmunity still persists in most cases. We need to re-balance the immune system which begins in the gut. With the exception of discussing proper thyroid medication dosing, the majority of my website and book's focuses on balancing the immune system. The info I present is based on my own research and journey overcoming my autoimmune thyroid condition. You may find these resources helpful as well.
Hashimoto’s Root Cause
http://amzn.to/2DoeC80
Hashimoto’s Protocol
http://amzn.to/2B5J1mq
Kim says
Thank you very much doc!
Dr. Izabella Wentz says
Kim – you are very welcome! <3 I hope you will keep me posted on your progress.
Susan Carmony says
Hi, I’ve been diagnosed with a suspicious nodule that is only 1.3. My thyroid blood tests are normal. I’ve had the FNA and molecular testing done and still 50% possibility of cancer. I am very healthy. Very rarely am sick. 69 yrs old. Just stopped eating dairy which I ate a lot of it. Doctors are suggesting surgery to remove 1/2 thyroid. Isn’t it wise to wait and watch in case it’s not cancer? I take no meds.
Thank you,
Susan
Dr. Izabella Wentz says
Susan – thank you so much for reaching out and sharing your journey. I am so sorry you are struggling with all of this. <3 The thyroid can break down until it’s almost gone from Hashimoto’s disease. Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically, is ‘dead’, or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target.
We need to re-balance the immune system to prevent this (sometimes the autoimmunity can be reversed as well). The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my books focus on balancing the immune system. The information is based on my own research in my journey whilst overcoming my own autoimmune thyroid condition. Here are some articles which might help:
HASHIMOTOS AND THYROID CANCER
https://thyroidpharmacist.com/articles/hashimotos-and-thyroid-cancer/
HORMONE REPLACEMENT THERAPY AND CANCER
https://thyroidpharmacist.com/articles/hormone-replacement-therapy-and-cancer
THE CONVENTIONAL, COMPLEMENTARY AND ALTERNATIVE APPROACH TO HASHIMOTO’S AND THYROID CANCER
https://thyroidpharmacist.com/articles/the-conventional-complementary-and-alternative-approach-to-hashimotos-and-thyroid-cancer
Hanna Hondzo says
Hello! I have recently been diagnosed with Hashimotos and am still swimming in a world of confusion about what particularly is wrong with my body. I am a researcher and a pre-med, so just like you I get frustrated when I don’t understand exactly WHY things are happening! Your books and websites have given me clarity in a very isolating time. Thank you for that. Unfortunately like most, I haven’t had much luck with doctors (I’ve gone to 3 so far. One told me the thyroid and the gut weren’t related and that if I test positive for antibodies once, there is no reason to ever test for them again) and the soonest endo appointment under my insurance isn’t until June. Holistic practitioners are just too expensive for me at this time, so I am trying to take matters into my own hands. Here is my question- I recently had a thyroid ultrasound done and it showed a 1.1 cm nodule (TR-3) that is “hypervascular”. They recommend no dedicated follow-up. Here is my question- what does this mean?! Should I be concerned that the impression indicates a hypervascular thyroid gland? Does hypervascular mean my thyroid gland is under extra stress, or will I always have a hypervascular gland, as a Hashimotos patient?
Dr. Izabella Wentz says
Hanna – thank you for reaching out. I’m so sorry you are struggling with all of this. My heart goes out to you. Nodules and goiters are often the result of toxicity and/or the autoimmune process. So, doing interventions to reduce the autoimmune attack on the thyroid, and toxicity, can be helpful to reduce them. Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target. We need to rebalance the immune system to prevent this. Sometimes the autoimmunity can be reversed as well! The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research and journey for overcoming my autoimmune thyroid condition.
Here are the links to my books:
Hashimoto’s Root Cause
http://amzn.to/2DoeC80
Hashimoto’s Protocol
http://amzn.to/2B5J1mq
I also suggest that you join one of the Hashimoto’s groups that are out there. Being able to share ideas of what has worked with one another and offer support for each other can be very helpful. A couple of years after my diagnosis, I found Hashimoto’s 411, a closed Facebook group run by Alice Berry McDonnell. This group is amazing! It is comprised of an army of highly motivated, smart, supportive women and men (now 45,000+ strong), and each of them sharing ideas of what worked for them, things they were planning to try, and offering support to one another. The comfort I received from knowing that there were others going through the same challenges as I, was enormous. Ask questions. Post your thoughts. Scan the files. It is an absolutely amazing resource. Best of all it’s kept private from spammers.
https://www.facebook.com/groups/hashimotos411/
Brady says
Hi, My thyroid surgeon has suggested RFA to shrink a 6.5 cm nodule that was was first detected in 2018 and has not grown in size since then. However, there is some difficulty with swallowing and so thinking of shrinking it using RFA. You suggest HIFA in your article as a treatment option. Is HIFA another name for RFA?
Thanks,
Brady
Dr. Izabella Wentz says
Brady – thank you for reaching out. <3 Those are two different treatments. High-intensity focused ultrasound (HIFU) ablation, uses focused ultrasound energy to induce thermal ablation (removal). It is a new treatment but, you may want to look into this more and discuss with your practitioner the pros and cons of the different treatments. I do hope you will keep me posted on your progress. <3
Wissem says
Hi doctor , hope youre doing good ,
Should i worry about a Eu-tirads 3 , 7.5 mm nodule?
Dr. Izabella Wentz says
Wissem – thank you for reaching out. ❤️ Nodules and goiters are often the result of toxicity and/or the autoimmune process. So, doing interventions to reduce the autoimmune attack on the thyroid, and toxicity, can be helpful to reduce them. Here is an article you may find helpful.
THYROID NODULES
https://thyroidpharmacist.com/articles/hashimotos-and-thyroid-nodules/
Naomi says
I have an inlarged thyroid I have had A biopsy done and was benign. I have started on a Keto diet
And I was wondering would that help reduce my thyroid size
Dr. Izabella Wentz says
Naomi – thank you so much for sharing. ❤️ Nodules and goiters are often the result of toxicity and/or the autoimmune process. So, doing interventions to reduce the autoimmune attack on the thyroid, and toxicity, can be helpful to reduce them. Here is an article you may find helpful.
THYROID NODULES
https://thyroidpharmacist.com/articles/hashimotos-and-thyroid-nodules/
USING A KETOGENIC DIET WITH HASHIMOTO’S
https://thyroidpharmacist.com/articles/using-ketogenic-diet-hashimotos/
Mahir says
Hi dear Dr Izabella
I am from Afghanistan my neck was hurt someone hold my neck hard after that while i swallowed a pill it’s banned in throat for 2hours in this time my heart beats so increase. After 10 years l loss my weight and never got weight. The lines around neck was hurt that time and now it’s fine. I don’t have any problems but i don’t get weight i loss weight very slowly. I tested TSH, T4 it’s normal. What can i do for getting weight i will strong again. I am so sad 😔 from 10 years
Dr. Izabella Wentz says
Mahir – thank you for reaching out. ❤️ I am so sorry you are struggling with all of this. When it comes to weight gain these are a couple of things to think about.
1) What was your recent TSH, Free T3 and Free T4? Sometimes when those numbers are on the outskirts of normal, your metabolic rate may still be impaired making it more difficult for you to burn calories. Most people report feeling well with a TSH between 0.5-2.
2) What type of medication are you on? Some report more weight loss with T4/T3 combinations (Armour, Nature-Throid, compounded medications) versus T4 medications (Synthroid, Levoxyl, Tirosint) alone. T4 is a precursor to T3, but some individuals do not convert T4 to T3 properly, and the T3 component is the metabolically active one.
3) What type of diet are you eating? Some report more weight loss with T4/T3 combination vs T4 alone. Some do not convert T4 properly.The Standard American Diet (S.A.D.) full of sugar and simple carbohydrates is perfectly designed to cause us to gain weight year after year. Even yogurts that are marketed as “healthy” contain the equivalent of 16 teaspoons of sugar. Divorcing the S.A.D. is often a step that many of us must take to not just lose weight, but to also feel better. Some diets that have been helpful include the Body Ecology Diet, the Paleo Diet, the Virgin Diet, Autoimmune Paleo Diet, GAPS diet, SCD diet, Weston A. Price Diet, or the Mediterranean Diet. You may need to modify these diets to your own individuality.
BEST DIET FOR HASHIMOTO’S AND HYPOTHYROIDISM
https://thyroidpharmacist.com/articles/best-diet-for-hashimotos-hypothyroidism
HOW TO LOSE WEIGHT WITH HASHIMOTO’S AND HYPOTHYROIDISM
https://thyroidpharmacist.com/articles/how-to-lose-weight-with-hashimotos
Savannah says
My 8 year old daughter has a 1 inch mostly solid thyroid nodule that the endocrinologist is recommending to be biopsied. At least 3 doctors have said solid nodules don’t shrink. Is this true? I am worried to jump to biopsy and potential surgical removal when she’s so young.
Dr. Izabella Wentz says
Savannah – I’m so sorry. My heart goes out to you and your daughter. ❤️ Nodules and goiters are often the result of toxicity and/or the autoimmune process. So, doing interventions to reduce the autoimmune attack on the thyroid, and toxicity, can be helpful to reduce them. For children, teens, (and adults), I always recommend starting with the diet. Are they gluten, dairy, corn and soy free? Are they eating a nutrient dense diet with fermented foods? Implementing those changes can help many symptoms. For example, some cases of anemia can be helped by eating liver, others may resolve by going gluten free. Acid reflux is often caused by food sensitivities. Most of the interventions recommended in my book can be done with children, with the exception of the dosing of supplements. I do suggest that you work with a functional medicine doctor that is familiar in working with children. Please feel free to email my team at info@thyrodpharmacist.com and they will be happy to share some resouces I have pertaining to children. I do hope you will keep me posted on her progress. Here are some resources I hope are helpful as well.
THYROID NODULES
https://thyroidpharmacist.com/articles/hashimotos-and-thyroid-nodules/
FUNCTIONAL MEDICINE APPROACH TO THE THYROID
https://thyroidpharmacist.com/articles/functional-medicine-approach-to-the-thyroid
CLINICIAN DATABASE
https://thyroidpharmacist.com/database-recommended-clinicians/
FIND A FUNCTIONAL MEDICINE CLINICIAN
https://www.functionalmedicine.org/practitioner_search.aspx?id=117
Esther says
Hi doc!
I don’t have hashimotos yet still developed a nodule. My #s are all normal (I do have low thyroid symptoms though) and I already don’t eat gluten etc. I don’t know what could’ve caused the nodule I’m only 33. My tsh is 2.24. My nodule is TR3. I’m gaining weight continuously even low calorie. Is there anything else that may be contributing to this nodule? Or anything else I can do to help get rid of it? Would metabolic disorders/stress/hpa axis dysfunction contribute?
Dr. Izabella Wentz says
Esther – thank you for reaching out. I’m so sorry you are struggling with this. Nodules are often the result of toxicity and/or the autoimmune process. So, doing interventions to reduce the autoimmune attack on the thyroid, and toxicity, can be helpful to reduce them. Here is an article you may find helpful.
THYROID NODULES
https://thyroidpharmacist.com/articles/hashimotos-and-thyroid-nodules/
Ginger Turner says
Hello Dr. Wentz. Can you provide more information/resources that could help my 16 year old daughter. I tried emailing your team but the email was kicked back. She has seen two doctors who recommended surgery for two nodules on her thyroid (neck). She did have it drained four years ago and they found NO cancerous cells. She has had the thyroid level test and her levels were normal. She took thyroid medication for 90 days to see if it would reduce the size and it did not. We really don’t want to resort to surgery. I do not believe she has Hashimotos.
So…can you please share resources for a teenager? We are willing to change her diet and add supplements. In reading Dr. Wentz’s articles, it appears gluten free, dairy free, toxin free would be a solution + adding in 250 mcg of iodine to diet?? Anything else?
Do you provide consultations or make appointments to complete a diagnosis and provide suggestions for patients??
Anxious to hear back.
Dr. Izabella Wentz says
Ginger – thank you so much for reaching out. My heart goes out to you and your daughter. I checked with my team and they have recently emailed you. I hope the information is helpful.
Betsy Moore says
I have plummers disease. Since diagnosis, I went dairy free and gluten free, and feel so much better! But my TSH levels are still too low. My doctor wants me to take radioiodine pill to treat it. I am so worried it will kill my thyroid and I’ll be on medication for the rest of my life. I’m have gone to several doctors asking for a nature/ diet solution, all said it was not possible. You explain a lot about hypothyroidism. Does the same philosophy work for hyperthyroidism? would love to hear about any additional insight you have for me.
Dr. Izabella Wentz says
Betsy – thank you for reaching out. I’m so glad you are taking charge of your health and doing your research! Graves and Hashimoto’s are both autoimmune conditions that affect the thyroid. They are thought to be closely related. Sometimes one turns into the other. The difference is the site of the antibody attack. In Hashimoto’s, the antibodies are found to thyroglobulin (in 80%) and thyroid peroxidase (TPO) enzyme (in 95% of people) Hashimoto’s results in hypothyroidism and is usually treated with Synthroid and replacement hormone.
The same antibodies may be present in a smaller percentage of people who have Graves, but the main antibody is to the TSH Receptor (TSHR-Ab). Usually, people with Graves have hyperthyroidism, and they are treated conventionally with thyroid suppressing drugs (methimazole) or radioactive iodine to destroy the thyroid. At that point, the thyroid will no longer produce hormones on its own, and these people end up on Synthroid as well.
Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target. We need to rebalance the immune system to prevent this. Sometimes the autoimmunity can be reversed as well! The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research and journey for overcoming my autoimmune thyroid condition. Here is an article I hope you find helpful:
GRAVES AND HASHIMOTO’S
https://thyroidpharmacist.com/articles/graves-vs-hashimotos/
Penny Lee says
Hi! I was diagnosed with Hashimoto’s at 25 after discovering a goiter and having a family history. Through diet and lifestyle changes I was able to get off of thyroid medication and shrink some of the nodules on my thyroid.
Fast forward to the last 2 years – my TSH consistently tests low and I just recently had a thyroid uptake scan done. The results are a hot nodule causing hyperthyroidism. I noticed you mentioned that in your article but didn’t really elaborate. I know conventional treatment is radioiodine or surgery, both of which I’m not thrilled about. My endocrinologist doesn’t really believe diet and lifestyle changes affect the thyroid so she’s not much help in alternative options.
Are radioiodine and surgery really the only options for a nodule that is producing too much hormone?
Thank you so much, I follow so much of what you do!
Dr. Izabella Wentz says
Penny – thank you for following. Nodules are often the result of toxicity and/or the autoimmune process. So, doing interventions to reduce the autoimmune attack on the thyroid, and toxicity, can be helpful. I do recommmend finding a functional minded practitioner if you can. I believe that everyone needs to find a practitioner that will let them be a part of the healthcare team. You want someone that can guide you, that will also listen to you and your concerns. You want someone that’s open to thinking outside of the box and who understands that you may not fit in with the standard of care. It’s a good idea to ask some standard questions when contacting a new doctor for the first time. Something else to consider is you can work with a functional doctor remotely, via Skype. You could also contact your local pharmacist or compounding pharmacy, who may be able to point you to a local doctor who has a natural functional approach. But I encourage you to keep looking for the right one for you! Here are some resources you might find helpful.
CLINICIAN DATABASE
https://thyroidpharmacist.com/database-recommended-clinicians/
FIND A FUNCTIONAL MEDICINE CLINICIAN
https://ifm.org/find-a-practitioner/
COMPOUNDING PHARMACIES
https://thyroidpharmacist.com/database-recommended-compounding-pharmacies/
Elahe says
Hello, I have R/o thyroid colloid cysts and my thyroid tests are normal and I did aspiration 2times but my throat swelling has not gone away
After I read your novel I found that there may be a connection between my PCO and my thyroid nodule so I request you pls help me if there is any diet or recommendation
Dr. Izabella Wentz says
Elahe – thank you for following and sharing your journey. Nodules, goiters and cysts are often the result of toxicity and/or the autoimmune process. So, doing interventions to reduce the autoimmune attack on the thyroid, and toxicity, can be helpful to reduce them. Addressing nutrient deficiencies in iodine, selenium, and vitamin D, clearing out any toxins by opting for natural products to lessen the burden on your liver, changing your diet and removing foods that you are sensitive to, balancing your blood sugar, and addressing estrogen dominance, are all interventions that can help.
Sandy Vaccaro says
Good Morning…
I have a large benign multi-nodule goiter. All of my T-3, etc. numbers are normal as is my antibody level. I’ve had several ultrasound scans and two fine needle biopsies all showing nothing. The Ear, Nose, and Throat group, I’ve recently been referred to, recommends I have the goiter removed, removing half of my thyroid. Any other options I can pursue? I am scheduling an appointment with an endocrinologist to research further. Let me know, thank you .
Dr. Izabella Wentz says
Sandy – thank you for following. Surgical removal may be required as I said in the article above when a benign nodule is large in size and causing difficulty when breathing or swallowing, when there are diagnosed large multinodular goiters, or when goiters constrict airways, the esophagus, or blood vessels. However, keep in mind life is not always roses once your thyroid is removed, as it does not remove the autoimmunity. Nodules and goiters are often the result of toxicity and/or the autoimmune process. Addressing nutrient deficiencies in iodine, selenium, and vitamin D, clear out any toxins by opting for natural products to lessen the burden on your liver, changing your diet and removing foods that you are sensitive to, balancing your blood sugar, and addressing estrogen dominance, are interventions that can help. Check out the article above for more tips to help as well as this link:
https://thyroidpharmacist.com/articles/is-hashimotos-a-surgical-disease/
Meli says
Hi I have a 9cm multi modular goitre which I’m told must be removed as do big. I’m trying to opt for only one side not all thyroid even though they said they other side may need to be done layer. However I’ve never been diagnosed hashimotos and my thyroid tests always come up normal – sometimes slightly keen towards hyper. A lot of advice about thyroid I’ve seen talks about hashimotos – what if you have this (apparently)? What could the cause be and would you recommend the same as above? I’ve tried to resist an operation for years but feel I have no choice. I’ve tried pescatarian type paleo and Mediterranean diets on and off for years too (try to keep principles but a bit off the wagon now though and find weights goes up hugely then). Thanks
Dr. Izabella Wentz says
Meli – thank you for reaching out. I’m so sorry you are struggling. Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target.
We need to rebalance the immune system to prevent this. The gut determines your immune system. Check out the article above on some tips to strink nodules and goitres. Here is another article you might find helpful as well:
https://thyroidpharmacist.com/articles/is-hashimotos-a-surgical-disease/
Katherine Deering says
Hi Dr. Izabella Wentz,
I emailed your team and the email bounced back. I am looking for resources in my area for soneolastography on two suspicious nodules. I am also looking for a recommended functional med doctor in my area. If you can help in any way I would much appreciate it! Thank you so much!
Dr. Izabella Wentz says
Katherine – thank you for reaching out. I’m so sorry that your email did not go through. Please feel free to email them again at info@thyroidpharmacist.com if you need anything. I do not have a resource at this however, I do have a practitioner list I will link here so that you can check it out: https://thyroidpharmacist.com/doc-list/
Colin says
Hi – I just chanced upon your website and it is a wonderful resource – thank you so much for all these articles and insights! I (46M, UK) have recently been told I have a 3cm thyroid nodule which has a 35% chance of malignancy (ultrasound and needle biopsy were uncertain). I was advised to have a partial thyroidectomy this summer which is booked in. My question is – I have had various muscular symptoms in the past year (weakness, possible muscle loss, twitching, fatigue) which I suspect may be thyroid related. My B12 has also been low.
My TSH and T4 are in range but TSH has fallen to 0.54 in April from 0.9 in February (range 0.35 to 5.00) after years of being over 1. My Free T4 is apparently fine at 16.1 (range 9-21) – it was 13.4 in Feb – and my T3 hasn’t been measured. The ENT doctor was certain that my thyroid function was normal based on these numbers and the ultrasound scan – but can they be sure? I know you can’t diagnose anything but I am wondering if it’s possible in theory to have Hashimoto’s or Graves, or some kind of Thyroiditis due to the nodule, even though my numbers appear to be OK – as they are moving around somewhat? Thanks again.
Dr. Izabella Wentz says
Colin – thank you for reaching out and sharing your journey. The presence of thyroid nodules is a common way to diagnose autoimmune thyroid disease. Nodules and goiters are often the result of toxicity and/or the autoimmune process. So, doing interventions to reduce the autoimmune attack on the thyroid, and toxicity, can be helpful to reduce them. I highly recommend that you work with a functional medicine clinician to be a part of your own health care team. It’s an entire medical specialty dedicated to finding and treating underlying root causes and preventing serious chronic disease rather than treating individual disease symptoms. Check out this article:
FUNCTIONAL MEDICINE APPROACH TO THE THYROID
https://thyroidpharmacist.com/articles/functional-medicine-approach-to-the-thyroid
CLINICIAN DATABASE
https://thyroidpharmacist.com/database-recommended-clinicians/
FIND A FUNCTIONAL MEDICINE CLINICIAN
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SUSAN says
Hi Izabella,
A 1 cm thyroid nodule was discovered on me July 2023 by an ultrasound. I just had another ultrasound done 2 days ago and it’s grown to now almost double the size and is described as “solid hypoechoic” and rated as a “TIRADS 4”. They suggested an FNA and a follow up in a year. Is an FNA worth the risk and if it were you, would you go get one in my case?
Thank you so much for all you do! I truly appreciate you and your work! ♥️
Dr. Izabella Wentz says
Susan – thank you for sharing. I recommend discussing your concerns and options with your practitioner who is familiar with your health history and able to help you determine the best option for you. As I shared in the article, a more non-invasive technique is sonoelastography, where ultrasonography imaging is used. You may want to discuss this as well with your practitioner.