Goiter

Information on enlarged goiter symptoms and the causes of goiter.

Select a Topic

  1. What is Goiter?
  2. Symptoms of a Goiter
  3. Goiters in Babies and Children
  4. What are the Causes of Goiter?
  5. Help for Goiter
  6. Tips for Coping with Goiter

What is Goiter?

A goiter is an abnormal enlargement of the thyroid gland and can occur for a number of different reasons. The thyroid is a small, butterfly- shaped gland inside the neck, just below your Adam’s apple. The thyroid gland produces hormones which control the body’s metabolism and regulate the rate at which the body carries out its functions.

The presence of an enlarged goiter usually means that the thyroid gland is not functioning normally. Causes of a goiter include an imbalance in the thyroid gland and Goiter symptoms generally occur in a gland that is overactive, producing too much hormone (hyperthyroidism), or that is underactive, producing too little hormone (hypothyroidism).

Goiter puts pressure on other parts of the neck such as the trachea and esophagus - making it difficult to breathe and swallow. Often, goiters are also removed for cosmetic reasons. They are more common in women and the elderly.

Diagnosing Goiter

The presence of an enlarged goiter indicates that there is a problem with the thyroid gland, even if the patient does not have any clinical signs of a thyroid problem.

Tests to Diagnose Goiter
  • Hormone Test - Blood tests measuring all the various thyroid hormones will able to determine how your thyroid is functioning. If your thyroid is overactive, the level of thyroid hormone in the blood will be high and the level of thyroid stimulating hormone (TSH) will be low. If your thyroid is underactive the level of thyroid hormone will be low while the level of TSH will be high.
  • Antibody Test - A blood test may confirm the presence of auto-immune antibodies, such as in Graves Disease, that are causing the goiter to develop.
  • Ultrasonography - An ultrasound scan is an imaging test will be able to reveal the size of the thyroid gland and the presence of any nodules.
  • Thyroid Scan - This scan will help evaluate the structure and function of the thyroid and involves the administration of radioactive substance.

Symptoms of Goiter

Symptoms and signs of goiter may include:

  • Symptoms of hyperthyroidism or hypothyroidism (e.g. High Blood Pressure, Hair Loss, and Digestive Problems)
  • Neck and Ear Pain
  • Stress & Anxiety
  • Sore Throat
  • Difficulty swallowing
  • Headaches
  • Snoring
  • Coughing
  • Swelling or disfigurement of the neck
  • A feeling of tightness in your throat
  • Difficulty breathing

Goiters in Babies and Children

Some babies are born with an enlarged thyroid, referred to as a congenital goiter. Unlike a goiter in an adult, which can occur due to an unsuitable diet, a congenital goiter is associated with increased or decreased thyroid function. When a newborn baby has a congenital goiter, oftentimes it is hard for them to breathe due to the goiter pressing against their windpipe. This is why it is so important to make sure infants born with congenital goiters are diagnosed quickly to ensure proper treatment.

Children can also acquire a goiter without having been born with one. The reasons for a childhood goiter are more in line with those of an adult. Children develop goiters due to the lack of iodine in their diet. Be sure your child is getting enough nutrients by eating well-balanced meals that include foods rich in iodine.

What are the Causes of Goiter?

There are various different causes of a goiter:

  • Iodine Deficiency - Iodine found in fish products, drinking water and table salt, is essential for the production of thyroid hormone. If there is a lack of it, an individual will suffer from hypothyroidism. In an effort to produce more thyroid hormone the thyroid gland is over stimulated and enlarges to form an endemic goiter. An iodine deficiency is very common in underdeveloped countries.

  • Graves’ Disease - This is an autoimmune disorder which causes the thyroid gland to be overactive (hyperthyroidism). In Graves’ disease, antibodies produced by the immune system stimulate the thyroid gland which then enlarges, resulting in an enlarged goiter, and produces excess thyroid hormone.

  • Hashimoto's Thyroiditis - Hashimoto’s disease is also an autoimmune disorder. The immune system destroys the thyroid gland which results in less thyroid hormone being produced. The pituitary gland then stimulates the thyroid gland to produce more thyroid hormones, causing it to enlarge and a goiter can then develop.

  • Solitary Thyroid Nodules - A single nodule develops inside the thyroid which causes an enlarged thyroid.

  • Multinodular Goiter - In this disorder, many nodules develop inside the thyroid which causes an enlarged thyroid. These nodules are usually not harmful.

  • Thyroid Cancer - The cancer may be detected as a lump or nodule in the thyroid gland and may result in goiter formation.

  • Inflammation - Inflammation of the thyroid is also referred to as thyroiditis, and it is usually associated with hypothyroidism (underactive thyroid). There are many causes of thyroiditis that can result in an enlarged thyroid or goiter. Some common symptoms of thyroiditis include mild fever and neck pain that is worse with swallowing.

  • Pregnancy - During the first tri-mester of pregnancy, a hormone called human chorionic gonadotrophin (HCG) can result in an enlarged thyroid gland. The thyroid gland mistakenly registers HCG for TSH (the thyroid stimulating hormone produced by the pituitary gland) and enlarges in response to it.

Help for Goiter

Treatment for goiter depends on a number of factors such as the size of the enlargement, symptoms and the underlying cause. Once these are determined, a plan for treatment can begin.

A conventional goiter remedy often involves observation. Another commonly used goiter remedy is prescription medication. Radioactive iodine treatment and surgery are usually used as a last resort.

Tips for Coping with Goiter

Here are some useful tips that you can use to help maintain thyroid health and relieve goiter symptoms:

  • Eat a diet high in protein to replace muscle tissue that is lost from an overactive thyroid
  • Eat a low fat diet if you are overweight
  • Drink bottled water. Fluoride and a product known as perchlorate, are substances in tap water that may trigger or worsen the risk of thyroid problems
  • Good dietary sources of iodine are seaweed, salt water fish and shellfish. These foods are recommended for people with underactive thyroids. In general, iodine is well tolerated by the body. Although some sources will caution against high doses, there are many populations in the world which consume large amounts of iodine daily without any ill effects.
  • Excessive soy isoflavones may trigger or worsen hypothyroidism, goiter or nodules
  • Avoid feeding babies soy-based formulas – there is evidence that this can contribute to later risk of thyroid disease
  • Try to give up smoking as it damages the thyroid
  • Try to reduce your stress. Using mind-body techniques can help to prevent thyroid disease.
 
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