Goiter

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Goiter is the increase in the size of the thyroid gland, located in the neck and caused primarily by a deficiency of iodine. The obvious symptoms are abnormal swelling on the neck. There are various types and one is the toxic multinodular goiter. Two main hormones circulate in the bloodstream and help regulate body metabolism. […] Read More

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Goiter

Goiter is the increase in the size of the thyroid gland, located in the neck and caused primarily by a deficiency of iodine. The obvious symptoms are abnormal swelling on the neck. There are various types and one is the toxic multinodular goiter. Two main hormones circulate in the bloodstream and help regulate body metabolism. They are triiodothyronine (T-3) and thyroxine (T-4). These two hormones are produced in the thyroid gland, a butterfly-shaped organ that lies in a person’s neck, just below the Adam Apple. They maintain metabolism- that is the rate at which the body uses fats and carbohydrates, help regulate body temperature, influence heart rate, and help to regulate protein production. In the body, it is the pituitary gland and hypothalamus that control the production and release of T-3 and T-4 while the thyroid gland regulates the production of hormones based on the amount of TSH it receives from the pituitary gland. An overproduction of  T-3 and T-4  hormones could lead to the direct enlargement of the thyroid gland while an underproduction may lead to the prompting of the TSH to overproduce the hormones, in turn resulting in the enlargement of the thyroid gland. This enlargement is called a goiter. WHAT IS GOITER?  A goiter is an abnormal increase in the size of a person’s thyroid, a butterfly-shaped gland located at the neck. TYPES OF GOITER There are different kinds of goiter, majorly due to their underlying causes. They include the following:
  • Colloid Goiter (Endemic)
This type of goiter results from a lack of iodine. Most people with colloid goiter live in areas where iodine is in short supply, for instance, in inland and highland regions of the world.
  • Nontoxic Goiter (Sporadic)
Nontoxic goiters may be caused by medications like lithium, which is often used to treat mood disorders such as bipolar disorder. They do not affect the production of thyroid hormone, and the thyroid still functions normally. The exact cause of nontoxic goiter is unknown.
  • Toxic Multinodular Goiter
These goiters emerge when one or more small nodules are formed in the thyroid gland and produce their thyroid hormone, thus, resulting in hyperthyroidism. The result is usually an extension of simple goiter.

RISK FACTORS

Although goiters may affect anyone and may be present from birth, some people are more prone to the disorder than others. They include:
  • Those living in areas where iodine-containing foods or supplements are in short supply 
  • Female gender: Statistics have shown that more women have a goiter than men.
  • People above 40 years of age.
  • Those with goiter in their family history
  • Pregnant women and women in menopause
  • People who have been treated for heart or psychiatric conditions with certain medications containing amiodarone and lithium 
  • Persons who have been exposed to radiation around the neck or chest either through radiation treatments or via a nuclear facility, test, or accident.
DIAGNOSIS  Patients with swelling on the thyroid region of the neck are often suspected to have a goiter. Doctors check the swelling and run diagnostic tests to confirm the situation. Such diagnostics include :
    1. Blood Tests; used to identify alterations in hormone levels and antibody production. These changes can significantly affect the thyroid hormones and hence the swelling of the glands.
    2. Thyroid Scan; this scan reveals if the level of elevation of the thyroid and shows the size and condition of the goiter. It also reveals parts of the thyroid that are overactive.
  • Ultrasound; usually ordered to produce images of your neck which can reveal goiter and thyroid nodules present.
TREATMENT Based on the size and condition of goiter, doctors determine the type of treatment to be administered to goiter patients. Treatment usually includes one or more of the following.
  • Medications
Medications can be used to treat hypothyroidism or hyperthyroidism, enabling to shrink of a goiter. They are also widely used to reduce thyroiditis inflammation.
  • Surgeries
A surgery known as thyroidectomy can be used to remove the thyroid, where the thyroid is resistant to medication or grows excessively.
  • Radioactive Iodine (RAI)

Thus is used to treat toxic multinodular goiters. The patient ingests RAI orally to allow it to travel through the blood to the thyroid, to destroys the overactive thyroid tissue.

  • Home Care

This involves the patient taking recommended iodine supplements or iodine-containing food to either increase or decrease their iodine level. However, a small-sized goiter may require no treatment at all.

Symptoms

SYMPTOMS 

A person suffering from goiter may experience or exhibit the following symptoms:

  • Swelling at the base neck, just below the Adam Apple.
  • Discomfort in the throat
  • Difficulty swallowing
  • Coughing
  • Difficulty breathing
  • Causes

    CAUSES OF GOITER

    Goiter mainly results from iodine insufficiency in the body. Iodine helps in the production of thyroid hormones. When the body lacks a sufficient amount of iodine, the pressure is mounted on the thyroid to make thyroid hormones, which causes the gland to enlarge.

    Other causes of goiter may include hyperthyroidism, hypothyroidism, thyroiditis, thyroid cysts, thyroid cancer, and pregnancy.

    • Iodine deficiency: Iodine is a vital element needed for the production of thyroid hormones. It is often present in seawater and coastal soils. People living in inland or highland areas of the world are often deficient in iodine due to its limited supply in those regions, and as a result, commonly develop goiters. Those who often take foods such as broccoli, cabbage, and cauliflower are also more prone to goiter because these foods are hormone inhibiting foods that can affect the thyroid.

    In countries where iodine is added to table salt and other foods, goiters may result from other causes other than lack of iodine.

    • Hyperthyroidism: This is when the thyroid gland produces too much thyroid hormone resulting in the production of antibodies that blindly attack the thyroid gland, leading to the excess production of thyroxine.  Hyperthyroidism can lead to the swelling of the thyroid, causing goiter.
    • Hashimoto's disease: This is also known as Graves' disease, hypothyroidism is a medical condition resulting from an underactive thyroid, where the thyroid produces insufficient hormone. This often triggers the pituitary gland to produce more thyroid-stimulating hormone, causes the enlargement of the thyroid gland as well as goiter.
    • Multinodular goiter. This is a situation where both sides of the thyroid are enlarged, as a result, multiple nodules (solid or fluid-filled lumps) develop on them.
    • Solitary thyroid nodules. This causes the enlargement of one side of the thyroid gland as a result of the development of a single nodule.
    • Thyroid cancer.  This is a cancerous growth on the thyroid that can cause swelling of the gland or otherwise goiter. A biopsy can be used to check for thyroid cancer. However, thyroid cancers are rare.
    • Pregnancy. The thyroid gland in pregnant women could slightly enlarge due to the production of human chorionic gonadotropin (HCG) during pregnancy. This often causes goiter.
    • Thyroiditis: Thyroiditis is a condition where the body produces excess or too little thyroxine. It often causes painful inflammation of the thyroid or painful goiter.
    • FAQ

      What causes Goiter?

      Goiters are mostly caused by the over or under the production of thyroid hormones, resulting from lack of iodine in diets. However, they can also be due to other thyroidism, hypothyroidism, thyroiditis, thyroid cancer, etc 

      What are the symptoms of goiter?

      Goiter symptoms include swelling at the base neck, discomfort in the throat, difficulty swallowing, coughing, and sometimes, difficulty breathing

      How can goiter be treated?

      Goiter can be treated with the use of prescribed medication. Large and complex goiters can be cured through the removal of part or all of the thyroid gland. Surgery is used to treat goiter resulting from thyroid cancer.

      Can goiters go away on their own?

      Simple goiters sometimes go away on their own. In such cases, the thyroid hormone may eventually be regulated on their own. However, some others will persist and increase in size over time.

      Is goiter painful?

      Most goiters are painless. However, goiters due to thyroiditis and thyroid cancer can be painful.

      What happens if a goiter is left untreated?

      A goiter resulting from a condition such as hypothyroidism can lead to more complex health problems, such as obesity, joint pain, heart diseases, and infertility.