What is goiter?
Goiter refers to an enlargement of the thyroid gland. This condition usually occurs when the thyroid gland is not making enough thyroid hormone, so it tries to compensate by growing in size. There are two varieties of simple goiter: endemic goiter, which occurs because of iodine deficiency in the diet, and sporadic goiter, which often develops for no known reason. In both cases, the primary symptom is an enlargement of the thyroid gland, a small gland in the front of the neck. While this article focuses on simple goiter, other causes of an enlarged thyroid gland are inflammatory conditions and nodules or tumors.
Endemic goiter is very rare in the United States because of the use of iodized table salt; however, it occurs more frequently in other areas of the world. While the specific causes of sporadic goiter are often not known, they may include genetics and medication side effects.
In addition to the characteristic lump that occurs with goiter, you may experience difficulty breathing or trouble swallowing, or you may have a cough or sore throat. In mild cases of goiter, you may have a small lump, which may not be accompanied by any other symptoms and therefore may not require treatment. In moderate cases due to iodine deficiency, iodine may be sufficient to treat the problem. In more severe cases, thyroid hormones, radioactive iodine, or surgery may be necessary to treat the goiter.
Simple goiters may resolve spontaneously or with the addition of dietary iodine. If a serious goiter goes untreated, however, it may enlarge and begin to interfere with the normal production of thyroid hormones. Both hypothyroidism and hyperthyroidism can result.
Seek immediate medical care (call 911) for serious symptoms of goiter, such as difficulty breathing.
Seek prompt medical care for persistent or uncomfortable goiter, as leaving goiter untreated may lead to either hypothyroidism or hyperthyroidism.
What are the symptoms of goiter?
The primary symptom of goiter is a swelling or lump on the front of the neck, which is due to an enlarged thyroid. In mild cases, goiter causes no other symptoms and thyroid function may be normal. In more serious cases, pressure from the goiter can interfere with swallowing, chewing or speaking. Other symptoms of goiter are related to dysfunction of the thyroid and hormone imbalance.
Common symptoms of goiter
You may experience goiter symptoms daily or just once in a while. At times any of these symptoms can be severe:
Small nodule or lump on the front of the neck
Vein swelling in the neck
Symptoms that might indicate a serious condition
In some cases, goiter can be a serious condition that should be evaluated immediately in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these serious symptoms including:
What causes goiter?
A goiter is an increase in the amount of thyroid gland tissue in the neck. It is part of the body’s compensation mechanism for inadequate production of thyroid hormones, which include thyroxine and triiodothyronine. The two types of simple goiter arise from different causes.
Causes of endemic goiter
Endemic goiter, also called colloidal goiter, occurs due to iodine deficiency. Iodine is used in the production of thyroid hormones. When there is not enough iodine available to make these hormones, the thyroid gland enlarges.
Causes of sporadic goiter
Sporadic goiter, or nontoxic goiter, may also occur because the thyroid does not produce enough hormones to meet the body’s requirements. In some cases of sporadic goiter, the more precise cause is not known, but it may be linked to:
- Medication side effects (such as side effects from lithium)
- Other diseases or disorders of the thyroid
Other causes of enlarged thyroid
An enlarged thyroid gland can also result from inflammatory conditions of the thyroid gland and tumors that develop in the gland. This article focuses on simple goiter, a noncancerous enlargement of the gland.
A number of factors increase the risk of developing goiter. Not all people with risk factors will develop goiter. Risk factors for goiter include:
- Age greater than 40 years
- Diet low in iodine (diet does not include iodized salt)
- Family history of goiter
- Female gender
- History of head and neck irradiation or radiation exposure
- Residence in an area poor in soil iodine, such as Central Asia, the Andes, or Central Africa
Reducing your risk of goiter
While it may not be possible to reduce the risk of sporadic goiter, you may be able to lower your risk of endemic goiter by:
- Eating a balanced diet with sufficient iodine
- Using iodized table salt
How is goiter treated?
In many cases, simple goiters will resolve spontaneously. Unless goiter symptoms are problematic, goiter generally does not require treatment. In cases of goiter caused by iodine deficiency, iodine supplements may provide adequate treatment. If goiter symptoms are more serious, however, medical treatment may be required.
Treatment for problematic simple goiter
- Iodine supplements (Lugol’s iodine or potassium iodine)
- Radioactive iodine to decrease thyroid hormone production
- Surgery to remove excess thyroid tissue
- Thyroid hormone therapy
Complications of simple goiter are generally not life threatening, though in rare cases goiter may press on the windpipe, preventing breathing. As goiter affects the production of thyroid hormones, which are important to many aspects of metabolism, serious complications can develop if the disease goes untreated for long periods of time. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of goiter include: