Goitre

A goiter (GOI-tur) is an abnormal enlargement of your thyroid gland. Your thyroid is a butterfly-shaped gland located at the base of your neck just below your Adam's apple. Although goiters are usually painless, a large goiter can cause a cough and make it difficult for you to swallow or breathe.

The most common cause of goiters worldwide is a lack of iodine in the diet. In the United States, where the use of iodized salt is common, a goiter is more often due to the over- or underproduction of thyroid hormones or to nodules in the gland itself.

Treatment depends on the size of the goiter, your symptoms and the cause. Small goiters that aren't noticeable and don't cause problems usually don't need treatment.

Goitre
Symptoms

 

Not all goiters cause signs and symptoms. When signs and symptoms do occur they may include:

  • A swelling at the base of your neck that may be particularly obvious when you shave or put on makeup
  • A tight feeling in your throat
  • Coughing
  • Hoarseness
  • Difficulty swallowing
  • Difficulty breathing
Causes

Iodine deficiency is the main cause of goiters. Iodine is essential to helping your thyroid produce thyroid hormones. When you don’t have enough iodine, the thyroid works extra hard to make thyroid hormone, causing the gland to grow larger.

Other causes include the following:

Graves’ disease:

Graves’ disease occurs when your thyroid produces more thyroid hormone than normal, which is known as hyperthyroidism. The excessive production of hormones makes the thyroid increase in size.

 

Hashimoto’s thyroiditis:

When you have Hashimoto’s thyroiditis, also known as Hashimoto’s disease, it predisposes thyroid to not being able to produce enough thyroid hormone, causing hypothyroidism.

The low thyroid hormone causes the pituitary gland to make more thyroid-stimulating hormone (TSH), which causes the thyroid to enlarge.

 

Inflammation:

Some people develop thyroiditis, an inflammation of the thyroid that can cause a goiter. This is different than Hashimoto’s thyroiditis. One example is viral thyroiditis.

 

Nodules:

Solid or fluid-containing cysts may appear on the thyroid and cause it to swell. These nodules are often noncancerous.

 

Thyroid cancer:

Cancer may affect the thyroid, which causes swelling on one side of the gland. Thyroid cancer isn’t as common as the formation of benign nodules.

 

Pregnancy:

Being pregnant can sometimes cause the thyroid to become larger.

 

Diagnosis

Your doctor will check for neck for swelling. They’ll also order a number of diagnostic tests that include these below:

  • Blood tests: Blood tests can detect changes in hormone levels and an increased production of antibodies, which are produced in response to an infection or injury or overactivity of immune system.
  • Thyroid scan: our doctor may order scans of your thyroid. This is usually done when your thyroid level is elevated. These scans show the size and condition of your goiter, overactivity of some parts or whole thyroid.
  • Ultrasound: An ultrasound produces images of your neck, the size of your goiter, and whether there are nodules. Over time, an ultrasound can track changes in those nodules and the goiter.
  • Biopsy:  A biopsy is a procedure that involves taking small samples of your thyroid nodules if present. The samples are sent to a laboratory for examination.
Treatment

Your doctor will decide on a course of treatment based on the size and condition of your goiter, and symptoms associated with it. Treatment is also based on health problems that contribute to the goiter.

  • Medications:

If you have hypothyroidism or hyperthyroidism, medications to treat these conditions may be enough to shrink a goiter. Medications (corticosteroids) to reduce your inflammation may be used if you have thyroiditis.

 

  • Surgeries:

Surgical removal of your thyroid, known as thyroidectomy, is an option if yours grows too large or doesn’t respond to medication therapy.

 

  • Radioactive iodine:

In people with toxic multinodular goiters, radioactive iodine (RAI) may be necessary. The RAI is ingested orally, and then travels to your thyroid through your blood, where it destroys the overactive thyroid tissue.