Goiter

A goiter can be unsightly and can also signal an underlying health condition. At Atrium Health Floyd and Harbin Clinic, our experts will help you understand your risk factors, diagnose you and share treatment options.

What is a goiter?

A goiter is an abnormal enlargement of the thyroid. The thyroid sits at the front of the neck, above where the collarbones meet. The thyroid is a part of endocrine system, and produces hormones related to growth, development and metabolism. Most goiters are benign, but their swelling may make breathing difficult and may suggest other problems with the thyroid.

What causes goiters?

Goiters are most common in people over 40, those with a family history of goiters and women. Some causes include:

• Autoimmune disorders
• Certain foods (soy, peanuts, vegetables in the broccoli and cabbage family)
• Certain medicines
• Cigarette smoking
• Iodine deficiency
• Infections

What are the symptoms of goiters?

The main symptom is an enlarged thyroid gland. Sizes range from a single small nodule to a large mass at the front of the neck. A simple goiter may have symptoms of an underactive thyroid gland. In rare cases, an enlarged thyroid can put pressure on the windpipe (trachea) and food tube (esophagus).

This can lead to breathing difficulties, coughing, difficult swallowing, hoarseness and pain near the thyroid.

What are the different types of goiters?

Goiters may manifest in three different ways: simple, nodular and multinodular.

• Simple goiter – uniform swelling over the thyroid
• Nodular goiter – a single well-defined lump which can be solid or filled with fluid and may or may not affect thyroid function
• Multinodular goiter – multiple lumps or nodules that may – or may not – release hormones that contribute to hyperthyroidism

How is a goiter diagnosed?

Your health care provider will perform a physical exam. This involves feeling your neck as you swallow. If you have a large goiter, you may feel pressure on your neck veins. As a result, when asked to raise your arms above your head, you may feel dizzy.

Possible goiter tests include:

• Free thyroxine (T4)
• Thyroid scan and uptake
• Thyroid stimulating hormone (TSH)
• Ultrasound of the thyroid

If nodules are found on an ultrasound, a biopsy may be needed to check for thyroid cancer.

What are risk factors for goiters?

Certain things make it more likely someone will develop a goiter:

• Being over 40
• Endocrine-disrupting chemicals
• Family history of goiters
• Being female, as women are more susceptible than men
• Iodine deficiency
• Medications
• Pregnancy and menopause
• Radiation exposure
• Smoking

Goiter prevention, treatment & recovery

For most people, preventing goiters is as simple as using iodized salt or iodine rich foods such as seaweed, dairy, eggs and seafood, especially cod and tuna. For those with underlying thyroid problems, managing these conditions is essential, as are proper lifestyle and diet choices.

Goiter treatment

A goiter only needs to be treated if it is causing symptoms. Goiter treatments include:

• Potassium iodine solution or small doses of Lugol’s iodine
• Radioactive iodine
• Thyroid hormone replacement pills
• Thyroidectomy, surgically removing all or part of the gland