Slideshow: Thyroid Symptoms and Solutions

Swallow another mouthful of water and watch your neck, taking note of anything that seems unusual.

How to Do a Thyroid Neck Check

Dr. Danielle Weiss is the founder of the Center for Hormonal Health and Well-Being, a personalized, proactive, patient-centered medical practice with a unique focus on integrative endocrinology. She enjoys giving lectures and writing articles for both the lay public and medical audiences.

A thyroid swallowing test is a self-exam of your thyroid gland. It’s also called a neck check. You can do the thyroid swallowing test at home to check for lumps or enlargements on your own thyroid gland.

What Is Your Thyroid?

The thyroid gland is a small, butterfly-shaped organ located in the lower front of the neck. It’s just above your clavicle (collarbone) and below your larynx (voice box).

Growths on the thyroid can be nodules and goiters or thyroid cancer. Lumps in the neck can be caused by thyroid disease or other conditions such as:

• Lymph node enlargement
• Lymphoma
• An infectious abscess
• A traumatic injury

However, you should know that a neck check is not considered the most accurate or reliable way to identify thyroid disease. You can have serious thyroid disease and have a completely normal neck check.

Americans see their primary care doctors less often than they did a decade ago. Adults under 65 made nearly 25% fewer visits to primary care providers in 2016 than they did in 2018, according to National Public Radio. In the same time period, the number of adults who went at least a year without visiting a primary care provider increased from 38% to 46%.

On the other hand, finding a major growth on your thyroid is likely not a serious problem; often, it’s a sign of an easily treatable condition, such as an iodine deficiency.

Is a Thyroid Neck Check Accurate?

A 2017 report from the U.S. Preventive Services Task Force concluded that feeling the neck for lumps detected thyroid nodules in only 11.6% of cases. Ultrasound, an imaging procedure using sound waves, was five times more accurate at finding abnormal thyroid growths.

This article will go over how to do a thyroid swallowing test at home to check your thyroid. It will also help you decide when to see a provider about something you find on a thyroid neck check.

Preparing to Do a Thyroid Neck Check

To prepare for a thyroid swallowing test at home, stand in front of a mirror so that you can see your neck.

Remove any items, such as a scarf, necktie, jewelry, or turtleneck, that could block your view of your neck.

If you’re going to use a hand-held mirror, make sure it’s focused on the lower-front part of your neck.

Position Your Neck

Your neck needs to be in the right position for a thyroid swallowing test.

Gently extend your neck back and slightly point your chin toward the ceiling so that you can get a longer view of your neck.

Sip Water

The actual “swallowing” part of a thyroid swallowing test comes next.

With your neck slightly extended back, take a sip of water. When you swallow, it moves your voice box ( larynx ) forward.

Swallowing will help you see the shape of your thyroid gland better. It will also make it easier to see any abnormal shapes.

Watch as You Swallow

Here’s what to look for as you’re doing a thyroid swallowing test:

• Bigger than normal areas (enlargements)
• Lumps
• Parts sticking out (protrusions)
• Parts that look or feel off-center

Doing a thyroid check just one time probably won’t be enough to get a proper look at your thyroid, so you can repeat the steps again.

Swallow another mouthful of water and watch your neck, taking note of anything that seems unusual.

Nodules vs. Goiters

When you do a thyroid swallowing test you might see nodules or goiters. Here is how to tell which is which:

• Thyroid nodules are bumps that usually look round. You may feel a thyroid nodule rolling beneath your fingertips or see it move with your thyroid gland when you swallow.
• A goiter (swelling) is often on one side of the thyroid but sometimes it can be on both sides.

Feel Your Neck

Once you’ve completed the looking part of a thyroid swallowing test, move on to the feeling part.

Gently touch the area around your thyroid gland to feel for any parts that are bigger than normal, have bumps, or are sticking out.

Here’s how to tell the difference between your thyroid and the other structures of your neck:

1. Slide your finger down the midline of your neck. The first hard structure you will hit is the thyroid cartilage that goes to your Adam’s apple.
2. As you continue to move your finger down, you will feel another bit of cartilage called the cricoid ring. It goes around your windpipe (trachea).
3. About two fingers-width below the ring is the thyroid isthmus . This is the tissue that connects the two sides of the thyroid gland. The lobes of the gland are on either side of the thyroid isthmus.

Talk to Your Provider

After you’ve done a thyroid swallowing test at home, talk to your healthcare provider about what you saw and felt.

If you have a thyroid that is bigger than normal or any bumps, your provider might want to do some tests like:

• A thyroid ultrasound
• Thyroid hormone blood tests
• A​ computerized tomography (CT) scan

Is It Cancer?

Finding a nodule when you do a thyroid swallowing test does not mean that you have thyroid cancer. In fact, a 2018 study found that only around 8% of thyroid nodules are cancerous.

Summary

A thyroid swallowing test is a way to check your thyroid gland at home. Doing an at-home thyroid neck check can help you find lumps or growths on your thyroid gland.

All you need to do a thyroid self-check is a mirror and a glass of water. You take a sip of water and watch your neck as you swallow. If you notice any areas that look or feel bigger or bumpier than normal, let your provider know.

A Word From Verywell

A thyroid swallowing test can help you spot potential problems with your thyroid, but it’s not perfect.

You could have a thyroid condition and have a normal self-check and finding something abnormal does not mean you have a serious condition.

The best way to catch thyroid problems, including thyroid cancer, is to see your provider regularly for check-ups.

If you do notice something unusual in your neck or are concerned, make sure you let your provider know. They can do tests that are more accurate than a thyroid swallowing test.

Thyroid Disease Healthcare Provider Discussion Guide

Get our printable guide for your next healthcare provider’s appointment to help you ask the right questions.

Slideshow: Thyroid Symptoms and Solutions

Does fatigue drag you down day after day? Do you have brain fog, weight gain, chills, or hair loss? Or is the opposite true for you: Are you often revved up, sweaty, or anxious? Your thyroid gland could be to blame. This great regulator of body and mind sometimes goes haywire, particularly in women. Getting the right treatment is critical to feel your best and avoid serious health problems.

What Is the Thyroid Gland?

2/23

The thyroid is a butterfly-shaped gland in the front of the neck. It produces hormones that control the speed of your metabolism — the system that helps the body use energy. Thyroid disorders can slow down or rev up metabolism by disrupting the production of thyroid hormones. When hormone levels become too low or too high, you may experience a wide range of symptoms.

Symptom: Weight Gain or Loss

3/23

An unexplained change in weight is one of the most common signs of a thyroid disorder. Weight gain may signal low levels of thyroid hormones, a condition called hypothyroidism. In contrast, if the thyroid produces more hormones than the body needs, you may lose weight unexpectedly. This is known as hyperthyroidism. Hypothyroidism is far more common.

Symptom: Swelling in the Neck

4/23

A swelling or enlargement in the neck is a visible clue that something may be wrong with the thyroid. A goiter may occur with either hypothyroidism or hyperthyroidism. Sometimes swelling in the neck can result from thyroid cancer or nodules, lumps that grow inside the thyroid. It can also be due to a cause unrelated to the thyroid.

Symptom: Changes in Heart Rate

5/23

Thyroid hormones affect nearly every organ in the body and can influence how quickly the heart beats. People with hypothyroidism may notice their heart rate is slower than usual. Hyperthyroidism may cause the heart to speed up. It can also trigger increased blood pressure and the sensation of a pounding heart, or other types of heart palpitations.

Symptom: Changes in Energy or Mood

6/23

Thyroid disorders can have a noticeable impact on your energy level and mood. Hypothyroidism tends to make people feel tired, sluggish, and depressed. Hyperthyroidism can cause anxiety, problems sleeping, restlessness, and irritability.

Symptom: Hair Loss

7/23

Hair loss is another sign that thyroid hormones may be out of balance. Both hypothyroidism and hyperthyroidism can cause hair to fall out. In most cases, the hair will grow back once the thyroid disorder is treated.

Symptom: Feeling Too Cold or Hot

8/23

Thyroid disorders can disrupt the ability to regulate body temperature. People with hypothyroidism may feel cold more often than usual. Hyperthyroidism tends to have the opposite effect, causing excessive sweating and an aversion to heat.

Other Symptoms of Hypothyroidism

9/23

Hypothyroidism can cause many other symptoms, including:

• Dry skin and brittle nails
• Numbness or tingling in the hands
• Constipation
• Abnormal menstrual periods

Other Symptoms of Hyperthyroidism

10/23

Hyperthyroidism can also cause additional symptoms, such as:

• Muscle weakness or trembling hands
• Vision problems
• Diarrhea
• Irregular menstrual periods

Thyroid Disorder or Menopause?

11/23

Because thyroid disorders can cause changes in menstrual cycle and mood, the symptoms are sometimes mistaken for menopause. If a thyroid problem is suspected, a simple blood test can determine whether the true culprit is menopause or a thyroid disorder — or a combination of the two.

Who Should Be Tested?

12/23

If you think you have symptoms of a thyroid problem, ask your doctor if you should be tested. People with symptoms or risk factors may need tests more often. Hypothyroidism more frequently affects women over age 60. Hyperthyroidism is also more common in women. A family history raises your risk of either disorder.

Thyroid Neck Check

13/23

A careful look in the mirror may help you spot an enlarged thyroid that needs a doctor’s attention. Tip your head back, take a drink of water, and as you swallow, examine your neck below the Adam’s apple and above the collarbone. Look for bulges or protrusions, then repeat the process a few times. See a doctor promptly if you see a bulge or lump.

Diagnosing Thyroid Disorders

14/23

If your doctor suspects a thyroid disorder, a blood test can help provide an answer. This test measures the level of thyroid stimulating hormone (TSH), a kind of master hormone that regulates the work of the thyroid gland. Along with TSH measurements , thyroid hormone levels are also analyzed. If TSH is high, it typically means that your thyroid function is too low (hypothyroid). If TSH is low, then it generally means the thyroid is overactive (hyperthyroid.) Your doctor may also check levels of other thyroid hormones in your blood. In some cases, imaging studies are used and biopsies are taken to evaluate a thyroid abnormality.

Hashimoto’s Disease

15/23

The most common cause of hypothyroidism is Hashimoto’s disease. This is an autoimmune disorder in which the body attacks the thyroid gland. The result is damage to the thyroid, preventing it from producing enough hormones. Hashimoto’s disease tends to run in families.

Other Causes of Hypothyroidism

16/23

In some cases, hypothyroidism results from a problem with the pituitary gland, which is at the base of the brain. This gland produces thyroid-stimulating hormone (TSH), which tells the thyroid to do its job. If your pituitary gland does not produce enough TSH, levels of thyroid hormones will fall. Other causes of hypothyroidism include temporary inflammation of the thyroid or medications that affect thyroid function.

Graves’ Disease

17/23

The most common cause of hyperthyroidism is Graves’ disease. This is an autoimmune disorder that attacks the thyroid gland and triggers the release of high levels of thyroid hormones. One of the hallmarks of Graves’ disease is a visible and uncomfortable swelling behind the eyes wich can trigger thyroid eye disease.

Other Causes of Hyperthyroidism

18/23

Hyperthyroidism can also result from thyroid nodules. These are lumps that develop inside the thyroid and sometimes begin producing thyroid hormones. Large lumps may create a noticeable goiter. Smaller lumps can be detected with ultrasound. A thyroid uptake and scan can tell if the lump is producing too much thyroid hormone.

Thyroid Disorder Complications

19/23

When left untreated, hypothyroidism can raise cholesterol levels and make you more likely to have a stroke or heart attack. In severe cases, very low levels of thyroid hormones can trigger a loss of consciousness and life-threatening drop in body temperature. Untreated hyperthyroidism can cause serious heart problems and brittle bones.

Treating Hypothyroidism

20/23

If you are diagnosed with hypothyroidism, your doctor will most likely prescribe thyroid hormones in the form of a pill. This usually leads to noticeable improvements within a couple of weeks. Long-term treatment can result in more energy, lower cholesterol levels, and gradual weight loss. Most people with hypothyroidism will need to take thyroid hormones for the rest of their lives.

Treating Hyperthyroidism

21/23

The most common option in treating adults is radioactive iodine, which destroys the thyroid gland over the course of 6 to 18 weeks. Once the gland is destroyed, or removed by surgery, most patients must begin taking thyroid hormones in pill form. Another common treatment for hyperthyroidism is antithyroid medication, which aims to lower the amount of hormones produced by the thyroid. The condition may eventually go away, but many people need to remain on medication for the long term. Other drugs may be given to reduce symptoms such as rapid pulse and tremors.

Surgery for Thyroid Disorders

22/23

Removing the thyroid gland can cure hyperthyroidism, but the procedure is only recommended if antithyroid drugs don’t work, or if there is a large goiter. Surgery may also be recommended for patients with thyroid nodules. Once the thyroid is removed, most patients require daily supplements of thyroid hormones to avoid developing hypothyroidism.

What About Thyroid Cancer?

23/23

Thyroid cancer is uncommon and is among the least deadly. The main symptom is a lump or swelling in the neck, and only about 5% of thyroid nodules turn out to be cancerous. When thyroid cancer is diagnosed, it is most often treated with surgery followed by radioactive iodine therapy or, in some cases, external radiation therapy.

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American Academy of Family Physicians.
American Association of Clinical Endocrinologists web site.
American Cancer Society web site.
American Thyroid Association web site.
National Cancer Institute web site.
National Endocrine and Metabolic Diseases Information Service.
National Institutes of Health web site.
The Hormone Foundation web site.