Comprehensive thyroid care requires accurate diagnosis, thoughtful decision-making, and a personalized treatment plan. Out team is ready to support you.
At Saint John’s Health Center, we provide expert evaluation and treatment for thyroid nodules, thyroid cancer, hyperthyroidism, and hypothyroidism. Our approach combines advanced imaging, biopsy techniques, molecular diagnostics, and expert surgical care to deliver tailored treatment plans for each patient.
Thyroid Conditions We Treat
The thyroid plays an important role in regulating metabolism, energy, and overall hormonal balance. Conditions affecting the thyroid can vary widely in severity, from benign nodules to thyroid cancer and hormone imbalances. Our team evaluates each condition carefully to determine the most appropriate course of care.
- Thyroid nodules
- Thyroid cancer (papillary, follicular, and other types)
- Hyperthyroidism (including Graves’ disease)
- Hypothyroidism (underactive thyroid)
- Thyroid enlargement (goiter)
- Multinodular goiter
Thyroid Ultrasound
Thyroid ultrasound is a foundational tool in thyroid care, allowing physicians to evaluate the structure and characteristics of the gland in real time. It helps guide decisions about whether additional testing—such as biopsy—is needed.
What Is a Thyroid Ultrasound?
Thyroid ultrasound is a safe, non-invasive imaging test that uses sound waves to create detailed images of the thyroid gland and surrounding structures. It is often the first step in evaluating thyroid nodules and detecting early signs of thyroid cancer.
When Is It Recommended?
Because many thyroid conditions do not cause symptoms early on, ultrasound is often used proactively to investigate subtle findings or risk factors. It provides critical information that cannot be obtained through physical examination alone.
- Thyroid nodule or lump
- Neck swelling or visible enlargement
- Abnormal thyroid blood tests
- Symptoms of thyroid disease
- History of thyroid cancer or radiation exposure
What Can It Detect?
In addition to identifying nodules, ultrasound helps classify their appearance and risk level. These findings play a key role in determining whether monitoring or further intervention is necessary.
- Size and structure of thyroid nodules
- Features suggesting cancer risk
- Inflammation (Hashimoto’s or Graves’ disease)
- Abnormal lymph nodes
Thyroid Biopsy and Molecular Testing
When imaging identifies a thyroid nodule that requires further evaluation, biopsy is the next step in determining its nature. This process allows physicians to distinguish between benign conditions and those requiring treatment.
What Is a Thyroid Biopsy?
A thyroid biopsy is a minimally invasive procedure used to determine whether a thyroid nodule is benign or cancerous. It is typically performed using fine needle aspiration (FNA) under ultrasound guidance.
When Is a Biopsy Needed?
- Nodules larger than 1–1.5 cm
- Suspicious ultrasound findings
- Abnormal lymph nodes
What to Expect
The procedure is designed to be efficient and convenient, often performed during the same visit as your ultrasound evaluation. Most patients are able to resume normal activity immediately afterward.
- Performed in-office
- No sedation required
- Takes only a few minutes
- Minimal discomfort
Possible Results
Biopsy results provide essential guidance for next steps, ranging from simple monitoring to surgical intervention. Understanding these categories helps patients feel more confident in their care plan.
- Benign: Monitoring recommended
- Nondiagnostic: May require repeat biopsy
- Indeterminate: Additional testing needed
- Suspicious or malignant: Surgery recommended
Molecular Testing
Molecular testing may be used when biopsy results are indeterminate. It helps estimate cancer risk and guide treatment decisions, potentially avoiding unnecessary surgery. This advanced testing is particularly helpful in avoiding unnecessary surgery while still identifying higher-risk nodules that require treatment. It adds another layer of precision to modern thyroid care.
Thyroid Treatment Options
Not all thyroid conditions require immediate treatment. Many can be safely monitored over time, while others benefit from early intervention to prevent complications or progression. Treatment depends on your diagnosis and may include monitoring, medication, minimally invasive procedures, or surgery.
Radiofrequency Ablation (RFA)
For select patients with benign thyroid nodules, radiofrequency ablation (RFA) offers a minimally invasive alternative to surgery. This outpatient procedure shrinks nodules while preserving thyroid function. This approach is particularly helpful for patients who prefer to avoid surgery or who are not ideal surgical candidates. It can significantly reduce nodule size and associated symptoms over time.
Learn more about Thyroid Radiofrequency Ablation
Thyroidectomy (Surgery)
Surgery remains one of the most effective treatments for certain thyroid conditions, particularly when cancer or significant symptoms are present. Surgical decisions are based on a combination of biopsy results, ultrasound findings, and patient-specific factors. The goal is to remove abnormal tissue while preserving normal function whenever possible. Thyroidectomy involves removal of part or all of the thyroid gland and is commonly used to treat thyroid cancer, suspicious thyroid nodules, or hyperthyroidism.
Types of Surgery
- Lobectomy (partial thyroid removal)
- Thyroidectomy (total thyroid removal)
- Thyroidectomy with lymph node removal
When Surgery Is Recommended
- Confirmed or suspected cancer
- Large or symptomatic nodules
- Hyperthyroidism not controlled with medication
Recovery
Recovery experiences vary depending on the extent of surgery, but most patients experience only mild, temporary symptoms. Careful follow-up ensures proper healing and optimal long-term outcomes. Most patients return to normal activities within 1–2 weeks. Some may require thyroid hormone replacement depending on the extent of surgery.
Our team also provides specialized surgical care for other endocrine conditions, including adrenal tumors and hormone-producing adrenal disorders.
Radioactive Iodine (RAI) Therapy
Radioactive iodine (RAI), also known as I-131, is a targeted treatment that destroys overactive or cancerous thyroid tissue by leveraging the thyroid’s natural ability to absorb iodine.
RAI may be used to treat hyperthyroidism, including Graves’ disease, or after thyroid surgery to eliminate remaining thyroid tissue or microscopic cancer cells in selected cases. Treatment is typically given as a single oral dose and completed in one visit.
RAI is not appropriate for all patients, and its use is carefully determined based on diagnosis, cancer risk, and individual treatment goals. In many cases, radioactive iodine leads to reduced thyroid function over time, which is expected and managed with thyroid hormone replacement. Radioactive iodine is a targeted treatment used for hyperthyroidism and certain types of thyroid cancer.
- Typically given as a single oral dose
- Outpatient treatment
- May require temporary precautions afterward
Hormone Therapy for Thyroid
Hormone therapy is essential in maintaining normal body function when thyroid hormone levels are too high or too low. Proper management helps regulate metabolism, energy levels, and overall well-being.Hormone therapy plays an essential role in managing thyroid conditions and maintaining normal metabolic function. It may be used to treat both underactive and overactive thyroid disorders, as well as to replace hormone function after surgery.
Thyroid Hormone Replacement
Patients with hypothyroidism or those who have undergone thyroid surgery may require daily thyroid hormone replacement, most commonly in the form of levothyroxine (T4). This medication restores normal hormone levels and supports metabolism, energy, and overall health. Dosing is carefully monitored and adjusted over time based on blood tests and symptoms.
Medication for Hyperthyroidism
In patients with overactive thyroid function, medications may be used to control hormone production. These treatments are often used as an initial step or to manage symptoms before definitive treatment with surgery or radioactive iodine.
While many patients receive hormone therapy as part of thyroid care, additional medical management may be used in select endocrine conditions. See Hormone Therapy for Endocrine Disorders.
Radiation Therapy
In select cases of advanced thyroid cancer, external beam radiation therapy may be recommended. Learn more about Radiation Therapy and the Vasek Polak Radiation Oncology department at Saint John’s Health Center.
Additional Endocrine Treatments
In addition to condition-specific care, we offer medical management for endocrine disorders, including hormone therapy when appropriate.
Frequently Asked Questions
Patients often have questions about thyroid conditions and their treatment options. The answers below address some of the most common concerns we hear in clinical practice.
Do all thyroid nodules need treatment?
No. Many thyroid nodules are benign and can be safely monitored.
Is a thyroid biopsy painful?
Most patients experience mild discomfort. The procedure is quick and does not require sedation.
Will I need surgery for a thyroid nodule?
Not always. Surgery is recommended only when cancer is suspected or symptoms are significant.
Will I need lifelong medication after thyroid surgery?
Total thyroidectomy requires lifelong hormone replacement. Some patients do not require medication after partial surgery.
What is the best treatment for thyroid cancer?
Treatment may include surgery, radioactive iodine, and sometimes radiation therapy depending on the case.
Getting answers to your thyroid questions
The thyroid and endocrine team at Saint John’s Health Center is ready to support you. Our expertise in these areas and others is providing reassurance and hope to patients each day. From second opinions to multidiciplinary support, we surround each patient with the care they need for the best clinical outcomes.
If you have questions regarding thyroid care, diagnosis, or treatment, please call today. Click here to request an appointment.
