Nodules in the thyroid gland are detected in at least 4-7% of people, and even benign formations sometimes require surgical intervention. In what cases is it necessary to “go under the knife,” explained endocrinologist Olga Derevyanko.
The exact cause of the formation of thyroid nodules is unknown, but there are some risk factors:
- genetic causes — nodules often appear as a consequence of random mutations in genes;
- iodine deficiency — in conditions of a lack of this element, a compensatory increase in the glandular tissue of the organ occurs, which becomes the cause of the development of neoplasms;
- radiation exposure — increased radiation activity for the production of thyroid hormones, the organ absorbs radioactive iodine from the environment, which often leads to the appearance of malignant neoplasms;
- stress and strong experiences can “trigger” a pathological process in the thyroid gland;
- vascular pathologies — atherosclerosis, complications of diabetes;
- smoking.
According to WHO standards, the daily requirement for iodine is 150–250 mcg, and the average person in the Russian Federation receives about 40–80 mcg per day. In conditions of deficiency of this element, the risk of developing not only nodules, but also other diseases of the thyroid gland, including cancer pathologies, increases significantly.
According to Olga Derevyanko, there is often an opinion among patients that it is better to remove the node for preventive purposes before they turn malignant.
Thyroid nodules do not degenerate, so there is no need to remove benign nodules (when this is confirmed by the results of a puncture biopsy).
Derevianko Olga 
doctor
Head Department of Endocrinology, Fomin Clinic 
According to the expert, there are several clear indications for surgical intervention:
The nodules are malignant and highly likely to be malignant.This is determined by the results of a biopsy and/or the level of calcitonin in the blood. p>
When the nodes change the level of hormones and cause thyrotoxicosis. This condition is called “functional autonomy”, but even in this case there is an alternative — radioiodine therapy).
Large size of formation. In this case, the node compresses the surrounding organs and tissues and prevents their normal functioning.
Cosmetic defect. The operation is performed at the request of the patient.
In other cases, thyroid nodules nothing , other than observation is not required. There is no need to delete nodes “just in case.”
Olga Derevianko 
doctor
Head. Department of Endocrinology, Fomin Clinic 
According to the recommendations of the Ministry of Health “Nodular goiter in adults”, which were published in 2016, benign nodes require removal only in special cases. The document states that the likelihood that they will be malignant is from 0% to 4%. If they are detected, patients are recommended to undergo dynamic monitoring.
Follow-up for most patients with nodular colloid goiter in the absence of gland dysfunction, without cosmetic defect or compartment syndrome includes TSH determination and ultrasound examination of the thyroid gland once a year or less often.