What's in this article?
What Are Goiters?
Goiters can be any one of several types of growths in the thyroid gland, located at the base of the front side of the neck just below the Adam’s apple.
In the case of Graves’ disease, the entire thyroid gland becomes enlarged.
Another type, called toxic nodular goiter, results when one or more nodules, or adenomas, develop in the thyroid and trigger excess production of thyroid hormone.
In short, a goiter is any enlargement of the thyroid gland. A goiter may be a temporary problem that will remedy itself over time without medical intervention, or a symptom of another, possibly severe, thyroid condition that requires medical attention.
Causes of Goiter
There are different kinds of goiters:
- A simple goiter can occur without a known reason. It can occur when the thyroid gland is not able to make enough thyroid hormone to meet the body’s needs. This can be due to a lack of iodine in a person’s diet. To make up for the shortage of thyroid hormone, the thyroid gland grows larger.
- Toxic nodular goiter is an enlarged thyroid gland that has a small, rounded growth or many growths called nodules. One or more of these nodules produce too much thyroid hormone.
The body needs iodine to produce thyroid hormone:
- Simple goiters may occur in people who live in areas where the soil and water do not have enough iodine. People in these areas might not get enough iodine in their diet.
- The use of iodized salt in many food products in the United States prevents a lack of iodine in the diet.
In many cases of simple goiter, the cause is unknown. Other than a lack of iodine, other factors that may lead to the condition include:
- Certain medicines (lithium, amiodarone)
- Cigarette smoking
- Certain foods (soy, peanuts, vegetables in the broccoli and cabbage family)
Simple goiters are also more common in:
- Persons over age 40
- People with a family history of goiter
Symptoms of Goiter
Not all goiters cause signs and symptoms. When signs and symptoms do occur they may include:
- A visible 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
- Difficulty swallowing
- Difficulty breathing
Fast facts on goiter
- Here are some key points about goiter. More detail and supporting information is in the body of this article.
- Goiter is an enlarged thyroid gland, which is located in the neck.
- Iodine deficiency is the world’s leading cause of goiter – but this is rare in North America.
- In developed countries, goiter is usually caused by an autoimmune disease.
- Autoimmunity, in which the body attacks itself, causes over- or underactive thyroid, both of which lead to swelling.
- Goiter is usually diagnosed by physical examination, but thyroid function blood tests and scans may be used.
- Treatment is not necessary unless the goiter is large and causes symptoms (there are often no symptoms).
- Synthetic thyroid hormone is a treatment for underactive thyroid, while anti-thyroid drugs are options for an overactive gland.
- Surgery is rarely used as a treatment, reserved for cases that cause difficulty swallowing or breathing.
Who Is at Risk for a Goiter?
You may be at risk for a goiter if you:
- Have a family history of thyroid cancer, nodules, and other problems that affect the thyroid.
- Do not get enough iodine in your diet.
- Have a condition that decreases the iodine in your body.
- Are female. Women have a higher risk for goiter than men.
- Are over the age of 40. Aging may affect the health of your thyroid.
- Are pregnant or experiencing menopause. These risk factors are not easily understood, but pregnancy and menopause may trigger problems in the thyroid.
- Have radiation therapy in the neck or chest area. Radiation may change the way your thyroid functions.
Treatment of Goiter
Treatments for an enlarged thyroid include:
- Thyroid hormone replacement pills, if the goiter is due to an underactive thyroid
- Small doses of Lugol’s iodine or potassium iodine solution if the goiter is due to a lack of iodine
- Radioactive iodine to shrink the gland, especially if the thyroid is producing too much thyroid hormone
- Surgery (thyroidectomy) to remove all or part of the gland