What Is a Goiter?
It may be a temporary problem that will get better without treatment. Or it can be a symptom of another, possibly serious, thyroid condition that requires medical attention.
Types of Goiters
Since many things can make your thyroid swell, there are lots of types of goiters. A few of them are:
Simple goiters, which happen when your thyroid gland doesn't make enough hormones. The thyroid grows larger to make up for this.
Endemic goiters. Sometimes called colloid goiters, these are caused by a lack of iodine in your diet. Your thyroid uses iodine to make its hormones. Few people get this kind of goiter in countries where iodine is added to table salt, like the United States.
Sporadic or nontoxic goiters, which usually have no known cause. Certain drugs and medical conditions can trigger them.
Multinodular goiters, which happen when lumps called nodules grow in your thyroid.
A goiter is described as "toxic" when it's linked to hyperthyroidism. That means your thyroid makes too much thyroid hormone. A "nontoxic" goiter doesn't cause ether hyperthyroidism or hypothyroidism (not enough thyroid hormone).
Along with a lump or swelling in your neck, the symptoms of a goiter include:
- A hoarse voice
- Tightness in your throat
- Dizziness when you raise your arms
- Swollen neck veins
- Trouble breathing or swallowing
If you have a toxic goiter with hyperthyroidism, you might have:
If you have hypothyroidism, you could notice:
Goiter Causes and Risk Factors
Goiters don't represent any one disease. They can form quickly or very slowly over years.
Before iodized salt was introduced in 1920, iodine deficiency was the main cause of goiters in the U.S. It still is worldwide.
Risk factors for goiters include:
- Age. You're at higher risk if you're over 40.
- Gender. Women are more likely to have goiters and thyroid disorders overall.
- Pregnancy or menopause, both of which are linked to thyroid issues
- History of autoimmune disease
- Some medications, including lithium (used for mood disorders) and amiodarone (for irregular heartbeat)
- Exposure to radiation, such as cancer treatments
- Living in an area where iodine deficiencies are common
Often, your doctor will diagnose your goiter simply by examining your neck. You may then have tests to find out what caused it and how it affects you. They include:
- An ultrasound to see how large your thyroid is and whether you have nodules
- Blood tests to measure your thyroid hormone levels and see whether you have the antibodies that some goiters cause. Antibodies are proteins your body makes to fight infection.
- A biopsy, where your doctor uses a thin needle to take a sample of tissue or fluid for testing. This is used to rule out cancer.
- A thyroid scan, in which your doctor injects a little radioactive material to create an image of your thyroid on a computer screen. This shows your doctor the size of your thyroid and how well it's working.
- A CT scan or MRI if your goiter is large or has spread to your chest
Depending on what caused your goiter and how serious it is, your doctor can treat it with:
Surgery. The surgeon may remove all or part of your thyroid. Afterward, you may need to take thyroid hormone medicine for the rest of your life.
Radioactive iodine. You take this in a pill to treat an overactive thyroid. It kills cells to shrink the thyroid. After this treatment, you'll probably need to take hormone drugs from then on.