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The thyroid gland is located in the lower middle neck. It is small and straddles the windpipe. It moves with swallowing.

It secretes a hormone, thyroxine or T4, that circulates in the blood and gives feedback to the pituitary, which in turn secretes TSH that acts on the thyroid to limit production of T4.

An imbalance in these levels may lead to a thyroid enlargement and a multinodular goiter or solitary nodule. 

Nodules may be single or multiple and must be followed in order to try to ascertain whether to biopsy them.

A single nodule is more likely to be a problem. An ultrasound is ordered and then a needle biopsy or FNA is usually in order.

In order to evaluate the nodule, a fine needle biopsy (FNA) is in order. If able to do this in our office, we can do this easily. At times, these are difficult to palpate and an ultrasound-guided FNA is required.

Once evaluated by ultrasound, FNA and labs, we can decide on need for further treatment such as an open biopsy under anesthesia.

We often co-manage these nodules and other thyroid dysfunctions such as hyperthyroidism, hypothyroidism, Graves Disease with our endocrine colleagues.