Understanding Goiter -- Treatment

Medically Reviewed by Sabrina Felson, MD on April 21, 2021

How Do I Know if I Have a Goiter?

A goiter may be large enough for you to see or to feel with your hand, or it may remain unnoticed until a doctor discovers it, perhaps during a routine exam.

In any case, the first step is to determine why you have a goiter.

An ultrasound of the thyroid gland may help to determine the size of the gland and the presence of nodules.

Blood tests also can measure levels of thyroid hormone.

Depending on the results of your initial blood work and ultrasound, additional tests may be ordered to clarify your diagnosis. These might include additional blood work looking at specific thyroid antibodies. If you are hyperthyroid (and are not pregnant or breastfeeding) a radioactive iodine uptake test can help determine the size of your goiter and whether it is functioning (making hormone). The pattern of radioactive iodine uptake also can tell your doctor if a biopsy might be needed.

What Are the Treatments for a Goiter?

A goiter may require no treatment, especially if it is small and thyroid hormone levels are normal. However, if your thyroid hormone levels are affected--either too high or too low-- you will need treatment.

Treatment involves getting the thyroid hormone levels back to normal, usually with medication. When the medication takes effect, the thyroid may begin to return to its normal size. However, a large nodular goiter with a lot of internal scar tissue will not shrink with treatment. If the goiter is uncomfortable, causes overproduction of thyroid hormone unresponsive to medications, is large enough that it causes symptoms because of its size, or becomes cancerous, the entire thyroid gland may have to be surgically removed.

If you have a goiter, your doctor may want to reevaluate it on a periodic basis with ultrasound to be sure that it is not growing larger or developing suspicious looking nodules that might require a fine-needle biopsy.