The proper evaluation of these nodules is very routine. Much of the thyroid assessment is based on the size of the nodule. Once nodules measure about 15 mm, size criteria are met for recommending an ultrasound guided biopsy.
If there are some concerning features seen on ultrasound in a smaller nodule, a biopsy can be performed even if the size criteria are not met. Additionally, a nodule which is enlarging over a short time period should be sampled under ultrasound guidance. Very small nodules under 6 mm do not require a biopsy under most conditions.
Many patients inquire if the presence of a nodule alters thyroid function. Generally, nodules do not alter normal thyroid function. Routine blood testing are performed to assess thyroid function. Hypothyroidism is not caused by thyroid nodules. If a patient has hypothyroidism, they should be thoroughly evaluated by their primary physician or an endocrinologist.
Hyperthyroidism is rarely caused by toxic thyroid nodules. These nodules hyper-function and drive the hormone levels to an abnormal range. These over-functioning nodules cause symptoms of fatigue, insomnia, increased heart rate, and heat intolerance. If these symptoms exists an endocrinologist is needed to regulate and suppress the thyroid function to normal levels. Further interventions can then be considered to restore normal thyroid function.