Great question, Vanessa — and smart that you’re staying above the nodule rather than putting the head right on it. Short version: I don’t have a big pile of published “US VNS + thyroid nodules” case series to hand you, and I’m not your doctor — so this isn’t medical advice. But here’s the useful framing, plus what I’d do in your shoes. 1. Diagnostic ultrasound over the thyroid is considered very safe Imaging ultrasound of the thyroid/neck is routine for nodules and uses non-ionizing sound waves (no radiation). That’s a different use-case than what we’re doing for vagus work, but it’s why “ultrasound near the thyroid” isn’t automatically a red flag the way heat/radiation would be: https://my.clevelandclinic.org/health/diagnostics/thyroid-ultrasound 2. “Therapeutic ultrasound on purpose for nodules” is a different animal There is a whole clinical world of ultrasound-guided treatments aimed at thyroid nodules (thermal ablation / HIFU, etc.) — those are higher-energy, clinician-delivered procedures meant to shrink tissue. That’s not what low-intensity US VNS is trying to do. So we shouldn’t casually aim stim energy into a known nodule “to treat it,” and we also shouldn’t assume our coaching protocols are the same as ablation settings. 3. Anatomy helps your instinct The cervical vagus you’re targeting sits more in the carotid sheath territory (side of the neck). The thyroid sits more central/anterior. So your approach — left side, short sessions, staying superior to / clear of the nodule — is the right kind of caution. 4. What I’d recommend practically - Keep doing what you’re doing: don’t place the transducer on the nodule itself. Stay above / clear of it. - Keep sessions short (your ~5 min is reasonable), and stay in the low-intensity / non-heating feel — no deep warmth, no pain, no pressure sensations that feel “off.” - Loop in the clinician who already follows your nodule (endo / whoever ordered your imaging). Show them exactly where you’re placing it and for how long. They’re the ones who know your nodule’s size, type, and follow-up plan. - If anything local changes (new neck pain, voice change, swelling, swallowing weirdness, or thyroid labs shifting), pause and get checked.