Goiter

What Is a Goiter?

A goiter is an enlargement or swelling of the thyroid, a gland in the throat that secretes a hormone which regulates body growth and metabolism. Goiters vary in size and, though sometimes unsightly, are generally painless. Rarely, a goiter may press against the trachea or esophagus, causing difficulty in breathing or swallowing. The disorder affects women four times more often than men.

What Causes Goiter?

• A goiter is a common manifestation of Graves' disease (hyperthyroidism) and Hashimoto’s thyroiditis, two serious thyroid disorders.
• Benign or malignant tumors of the thyroid gland may result in a goiter.
• Certain drugs designed to slow thyroid hormone production may cause goiters.
• Goiters may appear in women because of hormonal changes that occur with pregnancy.
• Goiters can be caused by insufficient amounts of iodine in the diet. This is now rare in the United States since the advent of iodized salt.

Symptoms of Goiter

• A swelling in the neck, ranging from a barely noticeable lump to a large growth
• Difficulty in breathing or swallowing, or unexplained hoarseness (although these symptoms are rare)
• Feeling of tightness in the throat
• Dizziness when the arms are raised above the head

Prevention of Goiter

• There is no known way to prevent goiter except in cases caused by a dietary insufficiency of iodine.

Diagnosis of Goiter

• Patient history and physical examination are performed.
• Blood tests, taken to evaluate the functional status of the thyroid gland, may also help to determine the underlying cause of the goiter.
• Antibody test may be performed to look for certain antibodies that are produced in some forms of goiter.
• Thyroid scan with radioactive iodine or an ultrasound exam may be done.
• To evaluate the size and extent of the goiter, CT scan or MRI (magnetic resonance imaging) scan of the thyroid may be used
• Fine-needle biopsy may be performed to rule out malignancy.

How to Treat Goiter

• Thyroid-hormone-replacement therapy may ease the demand on the gland to produce thyroid hormone, which may cause it to decrease in size.
• Surgical removal of all or part of the thyroid may be necessary if the goiter is large, causes difficulty in breathing or swallowing, or is due to a malignant tumor.
• Your doctor may alter your prescription if the goiter is due to a medication.
• A diet that includes iodized salt and fish is advised in the unlikely event of iodine deficiency.

When to Call a Doctor

• Call a doctor for any swelling in the neck.

Source:

Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference

Simeon Margolis, M.D., Ph.D., Medical Editor

Prepared by the Editors of The Johns Hopkins Medical Letter: Health After 50

Updated by Remedy Health Media