Goiter: An Overview
A goiter is an abnormal enlargement of the thyroid gland. The thyroid is a butterfly-shaped gland located in the neck just below the Adam's apple. Although it is usually painless, a goiter can cause coughing, shortness of breath and difficulty swallowing. The most common cause of goiter is a lack of iodine in the diet.
Treatment depends on the size of the goiter, your symptoms and its cause. Small goiters that go unnoticed and cause no problems usually do not need treatment. Having a goiter does not mean that the thyroid gland is not working properly. It may produce normal, excessive or insufficient amounts of thyroid hormone.
Symptoms of Goiter
- Swelling at the base of the neck, noticed while shaving or applying makeup,
- Coughing,
- Shortness of breath,
- Difficulty swallowing,
- Hoarseness,
- A feeling of tightness in the throat (choking sensation).
Causes of Goiter
Iodine Deficiency: Iodine is essential for the production of thyroid hormones and is found mainly in seawater and in the soil of coastal areas. Iodine deficiency is more pronounced, and the risk of developing goiter is higher, in developing countries and among people living inland and at high altitudes. Frequent consumption of goitrogenic foods such as cabbage, broccoli and cauliflower can accelerate the development of goiter.
Graves' Disease: A goiter can sometimes occur when your thyroid gland produces too much thyroid hormone (hyperthyroidism). In a person with Graves' disease, antibodies produced by the immune system mistakenly attack the thyroid gland (autoimmunity) and cause it to produce excess thyroid hormone. This overstimulation causes the thyroid gland to enlarge.
Hashimoto's Disease: Like Graves' disease, Hashimoto's disease is an autoimmune disorder. Hashimoto's damages your thyroid and lowers your thyroid hormone levels. To raise thyroid hormone levels, the pituitary gland sends more stimulating signals to the thyroid gland. This overstimulation causes the thyroid gland to enlarge.
Multinodular Goiter: In this condition, lumps called nodules develop on both sides of your thyroid. These also cause the thyroid gland to enlarge.
Solitary Thyroid Nodule: In this condition, there is a single lump in one part of the thyroid gland. It presents as enlargement on one side.
Thyroid Cancer: Nodules can sometimes be malignant. As they grow, they can cause a goiter.
Pregnancy: Under the influence of pregnancy hormones, your thyroid gland may enlarge slightly.
Inflammation of the Thyroid Gland (Thyroiditis): Sometimes viruses can cause inflammation of the thyroid gland. In this case, there may be pain and swelling in the thyroid gland, and it appears larger than normal.
Risk Factors for Goiter
- Iodine deficiency,
- Being female,
- Being over 40 years of age,
- A family history of goiter,
- Pregnancy and menopause,
- Certain medications, such as the heart medication amiodarone and the psychiatric medication lithium,
- Radiation exposure.
Complications of Goiter
Small goiters that do not cause physical or cosmetic concerns do not cause problems. However, large goiters can cause shortness of breath, coughing, a choking sensation, difficulty swallowing and hoarseness.
In autoimmune diseases that cause goiter, such as Graves' disease or Hashimoto's disease, symptoms such as fatigue, excessive weight gain, weight loss, irritability and insomnia may occur.
Diagnosis of Goiter
In addition to a medical history and physical examination, diagnosing a goiter may require blood tests, a thyroid ultrasound, thyroid scintigraphy and a biopsy. Your doctor will make a detailed assessment after these tests.
Treatment and Follow-up of Goiter
Treatment varies depending on the underlying cause. Your doctor will inform you about the options of medication, radioactive iodine therapy and surgery.
Surgery is the appropriate treatment in the presence of hyperthyroidism, shortness of breath, difficulty swallowing, hoarseness or nodules that raise suspicion of cancer. Depending on how much of the thyroid gland is removed, you may need to take thyroid hormone after surgery.
The most common cause of goiter is iodine deficiency. Getting enough iodine (150 micrograms/day) is especially important during pregnancy and for growing children.
In goiters caused by autoimmune diseases (Graves' disease, Hashimoto's disease), a low-iodine diet is recommended.
The information on our website is not intended to direct individuals to any treatment. Do not take any diagnostic or treatment steps without consulting your doctor. The content does not contain information about İzmir Can Hastanesi's therapeutic healthcare services.
