Follow-up without treatment
Hot nodules (see also: What are hot and cold nodules?) are “overactive”. Hot nodules are first treated with medicines, called “thyroid blockers”. These reduce the formation of thyroid hormone or block it completely. Unfortunately, this can also cause reduced function of the thyroid.
Medicine called thyrostatics can ease the symptoms. However, the autonomous regions are not removed by this treatment, which is why medicines are generally used only as a bridging treatment until a definitive procedure is undertaken.
If the nodules are small and cold (see also: What are hot and cold nodules?), and are therefore benign, thyroid hormone is given. This should prevent the growth of the gland tissues.
In many patients treated for toxics nodules, the thyroid functions return to normal after the radioiodine therapy. Sometimes, however, the treatment can lead to reduced function. In that case, the missing thyroid hormone must be replaced for the rest of the patient’s life by means of tablets.
Risks during a thyroid operation include bleeding, injury of the parathyroid glands (small glands located close to the thyroid) and damage to the vocal cord nerves, which could lead to vocal cord paralysis. However, these all occur relatively rarely. Usually, too much tissue is removed, which means sufficient hormones are no longer produced. These missing hormones must then be replaced for the rest of the patient’s life by ingesting thyroid hormones every day. In order to avoid weight gain, this should be taken relatively quickly and necessary adjustment should always be followed up.
Thermoablation is not suitable for malignant tumours, but offers a gentler alternative to surgery when dealing with benign nodules.