Hypoechoic nodules are fluid-filled cysts that most often occur on the thyroid gland. The nodules are usually non-cancerous, but can still cause problems within the thyroid. Hypoechoic nodules can cause the thyroid to become under-active or overactive. The type of treatment for these cysts depends on how they affect the thyroid.

An under-active thyroid gland is commonly referred to as hypothyroidism. The thyroid becomes hypothyroid when the gland does not produce enough hormones. These hormones are responsible for regulating various body functions, including the heart rate, metabolism, and skin cell turnover. Common symptoms of hypothyroidism can include sudden weight gain, decreased appetite, and excessive fatigue, as well as dry skin and hair loss.

Hypoechoic nodules can sometimes prevent the thyroid from producing hormones. This leads to a hypothyroid effect. The way hypothyroidism is treated is through hormone replacement therapy with prescription synthetic hormones. Blood work is done in advance to determine what dosage of hormones the patient needs. Too much or too little hormone can cause further problems.

An overactive thyroid is the exact opposite of hypothyroidism. Medically referred to as hyperthyroidism, the gland produces too much thyroid hormone. Symptoms of hyperthyroidism might include increased appetite, weight loss, insomnia, and anxiety.

Just as hypoechoic nodules can suppress thyroid hormone production, they can sometimes take on a life of their own and produce excess hormones. The extra hormones in the system lead to hyperthyroidism. An overactive thyroid gland is usually a little more difficult to treat. Radioiodine treatments are used to destroy the part of the thyroid gland in which the nodules reside. This is typically done if hyperthyroidism progresses rapidly.

Some patients might exhibit no symptoms linked to hypoechoic nodules. In many cases, the cysts are not problematic enough to make the thyroid gland overactive or under-active. A doctor might recommend a small dosage of synthetic hormones to prevent further growth of the nodules. This is done with care, since giving a patient too many hormones can lead to hyperthyroidism.

Whether the nodules cause hypo- or hyperthyroidism, an endocrinologist will likely recommend routine ultrasounds to track the progress of the nodules. This is done to see if the nodules are growing. Large nodules can cause a goiter, which is an enlarged thyroid gland that can eventually lead to neck pain and breathing troubles.

Surgery is a last resort treatment method that is necessary for a number of reasons. If hypoechoic nodules aren’t responsive during radioactive iodine treatments for hyperthyroidism, an endocrinologist may recommend removal of that part of the thyroid gland. Surgery can be used for goiters as well as for cancerous nodules.