Thyroid Goitre

Causes

• • Iodine deficiency: The most common cause worldwide, but less frequent in developed countries due to iodized salt.
  • Autoimmune diseases: Graves’ disease and Hashimoto’s thyroiditis can cause goiter.
  • Inflammation (thyroiditis)
  • Pregnancy (temporary)
  • Genetics
  • Certain medications

Symptoms

• • Visible lump or swelling in the neck (most common)
  • Tightness in the throat
  • Difficulty swallowing (dysphagia)
  • Difficulty breathing (dyspnea), especially when lying down
  • Hoarseness
  • Cough

Diagnosis

• • Physical examination by a doctor
  • Blood tests to check thyroid hormone levels
  • Thyroid ultrasound to examine the gland’s size and structure
  • Radioactive iodine uptake test (rarely)

Treatment

• • Watch and wait: Small goiters without symptoms often don’t require treatment.
  • Medication:
    • Levothyroxine (Synthroid) for an underactive thyroid (hypothyroidism).
    • Antithyroid medications for an overactive thyroid (hyperthyroidism).
    • Medications to shrink the goiter (rarely used).
  • Radioiodine therapy: A radioactive iodine capsule is taken to destroy some thyroid tissue.
  • Minimally Invasive Procedure: Radiofrequency ablation can be used to treat benign thyroid goitres wihout surgery (Click here to read more on Radio frequency ablation of benign thyroid nodules/ goitre).
  • Surgery: To remove part or all of the thyroid gland in severe cases or if there’s concern about a nodule being cancerous.

Complications

• Large goiters can compress nearby structures in the neck, leading to breathing and swallowing difficulties.
• Goiter can be associated with an underactive or overactive thyroid gland.