Goiter

What is a Goiter?
A goiter is an abnormal enlargement of the thyroid gland, the butterfly-shaped organ at the base of your neck.

Key Point: Having a goiter doesn't necessarily mean your thyroid isn't working. It can happen if your thyroid is overactive, underactive, or even functioning normally.

Symptoms

Small goiters often have no symptoms. As they grow larger, signs include:

• Visible Swelling: A bulge at the base of the neck, often noticeable when shaving or applying makeup.
• Tightness: A feeling of pressure or tightness in the throat.
• Hoarseness: Or coughing.
• Difficulty Swallowing: A feeling like food is getting stuck.
• Difficulty Breathing: In severe cases where the gland compresses the windpipe.

Causes

The thyroid swells for different reasons. Common causes include:

1. Iodine Deficiency

The most common cause worldwide. The thyroid needs iodine to make hormones. If you don't eat enough (e.g., in countries without iodized salt), the gland swells in an effort to trap more iodine.

2. Autoimmune Diseases

• Hashimoto's Disease (Hypothyroidism): The immune system damages the thyroid so it produces too little hormone. The pituitary gland then sends signals to "work harder," causing the thyroid to swell.
• Graves' Disease (Hyperthyroidism): Antibodies mistakenly attack the thyroid, causing it to produce excess hormone and swell.

3. Nodules

• Multinodular Goiter: Several solid or fluid-filled lumps develop on both sides of the gland.
• Solitary Nodule: A single lump develops. Most are benign (non-cancerous).

4. Pregnancy

A hormone called HCG, produced during pregnancy, may cause the thyroid to enlarge slightly.

Diagnosis

Doctors can often feel a goiter during a physical exam. To find the cause, they use:

• Blood Tests: To measure levels of TSH (Thyroid-Stimulating Hormone) and T4. This tells if the gland is overactive or underactive.
• Ultrasound: Uses sound waves to reveal the size of the gland and if there are any nodules.
• Biopsy: A fine needle is used to take a tissue sample if cancer is suspected.

Treatment

Treatment depends on the size of the goiter and how the thyroid is functioning.

1. Observation ("Wait and See")

If the goiter is small, not cancerous, and your thyroid levels are normal, no treatment may be needed.

2. Medications

• For Hypothyroidism: Levothyroxine (Synthroid) replaces the missing hormone and tells the pituitary to stop stimulating the gland, which may shrink the goiter.
• For Hyperthyroidism: Medications to slow down hormone production.
• For Inflammation: Aspirin or corticosteroids to reduce swelling.

3. Radioactive Iodine

Used for overactive thyroids. You take a pill containing radioactive iodine, which destroys thyroid cells, causing the goiter to shrink. You will likely need to take synthetic hormone replacement for life afterward.

4. Surgery

Removing all or part of the thyroid (Thyroidectomy) is an option if:

• The goiter is so large it makes breathing or swallowing difficult.
• Thyroid cancer is present.

Disclaimer: The content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician regarding any medical condition.