Thyroid Nodules
Thoughtful evaluation, clear answers, and a personalized plan for monitoring or treatment.
Clinically reviewed by Dr. Chhaya Makhija, MD, Triple Board-Certified Endocrinologist, in 2026.
Thyroid nodules are common and are a frequent reason people see an endocrinologist. Most are benign, but a newly discovered nodule deserves a careful evaluation. At Unified Endocrine and Diabetes Care, I take time to understand your symptoms, review your thyroid function, and examine the nodule so we can decide together what comes next.
How Thyroid Nodules Are Discovered
Many thyroid nodules cause no symptoms. They may be found unexpectedly on a carotid ultrasound, CT scan, or MRI performed for another reason.
Other people notice a lump or swelling at the front of the neck. A large nodule may cause neck discomfort, difficulty swallowing, or a choking sensation. Nodules can also be discovered during an evaluation for an overactive thyroid.
Some nodules produce excess thyroid hormone. These are called functioning or toxic nodules and require a different evaluation and treatment approach.
Your Thyroid Nodule Evaluation
You do not need a referral to schedule a consultation at our office. I welcome patients with a newly discovered nodule, a history of thyroid nodules, neck symptoms, or concerns following a diagnosis of hyperthyroidism.
Before and during your visit, I review any prior thyroid imaging and blood work. Depending on your history and findings, I may recommend updated thyroid function tests and other laboratory testing.
Your consultation includes a discussion of your symptoms and family history, along with an examination of your neck and thyroid. I also perform an ultrasound during the initial consultation to assess the thyroid and the nodule’s size and features, and to look for any concerning lymph nodes. If your results suggest that a nodule may be producing excess thyroid hormone, additional testing may be appropriate.
Monitoring and Treatment
A nodule does not always need a biopsy. I review its ultrasound features with you and use established guidance, including ACR TI-RADS and American Thyroid Association recommendations, to help determine whether fine-needle aspiration biopsy or ultrasound monitoring is appropriate. The timing of any follow-up ultrasound depends on the nodule’s features, your history, and the overall clinical picture.
If you also have an underactive or overactive thyroid, we will discuss the appropriate treatment for that condition. If a biopsy is needed, my office helps arrange a referral. When a thyroid surgeon’s assessment is appropriate, we help coordinate that care as well.
Time to Understand Your Results
Your initial evaluation, including preparation, consultation, ultrasound, and care planning, may involve two to three hours in total. Unified Endocrine and Diabetes Care was founded on time, trust, and transformation: time to listen, examine, explain your findings, and help you navigate the next steps with confidence.
Frequently Asked Questions
Will I need medication if I have a thyroid nodule?
Not necessarily. Thyroid function tests can be normal even when a nodule is present. Thyroid hormone replacement or antithyroid medication may be used when there is a thyroid hormone problem, but medication is generally not prescribed simply to shrink a nonfunctioning nodule. Your treatment depends on the nodule and your thyroid function.
Are there natural remedies for thyroid nodules?
Thyroid nodules vary widely. Some are small, fluid-filled cysts; others are solid or contain both fluid and solid tissue. A cyst may shrink over time, remain stable, or grow. There is no established supplement that reliably shrinks thyroid nodules, and evidence does not support taking selenium for that purpose. We can discuss any supplements you use as part of your evaluation.
How do I know whether my thyroid nodule is cancerous?
Ultrasound helps us assess a nodule’s features and decide whether it needs a fine-needle aspiration biopsy. A pathologist examines the cells collected during the biopsy. In some cases, additional molecular testing may help clarify an indeterminate result. I will explain what your findings mean and recommend the next step based on your results.
Patient Education and Resources
A Note on Insurance:
Unified Endocrine Care is an out-of-network practice. Practicing outside of insurance networks allows us to give each patient the time and attention their care deserves, and to build treatment plans around clinical need and personal health goals rather than around the limitations insurance coverage places on them.
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Request an Appointment
Tell us a little about you and your goals. Our team will reach out to confirm your appointment and next steps.
PLEASE NOTE:
Unified Endocrine Care is a direct pay, concierge style practice that does not participate with any insurance plans, which allows Dr. Makhija to provide longer visits and highly personalized care without the constraints of insurance.
Complex Hormones Require Specialist-Level Care
Conditions We Treat:
Where we Provide Thyroid Nodules Care:
In person at our Fresno office (serving Clovis, Visalia, Madera, Hanford, and Tulare) and our Lafayette office (serving Walnut Creek, Orinda, Danville, Berkeley, Oakland, and San Francisco) — plus telehealth for patients anywhere in California.