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Goiter is a swelling of the neck due to enlargement of the thyroid gland. The thyroid gland produces hormones like thyroxine (T4) as well a triiodothyronine (T3).  These hormones are necessary for maintaining body temperature, digestion, mood, growth and development, puberty, etc.

Goiter is a painless swelling in the neck. However, when it becomes very large, it causes difficulty swallowing, breathing as well as causes chronic cough. The treatment usually depends on the size, symptoms and underlying cause of the goiter.

What are the Symptoms of Goiter?

Goiter is usually detected when the affected person or the doctor sees and feels a swelling in the neck. Common symptoms of goiter include:

  • Swelling that can be as small as a nodule or a big lump. It is felt just below the Adam’s apple
  • The voice turns hoarse
  • Distention of neck veins
  • Feeling dizzy when arms are raised above the head
  • Rapid heartbeat
  • Sweating, even under normal temperature or without doing any vigorous task
  • Trembling
  • Agitated behavior
  • Fatigue
  • Constipation
  • Dry skin
  • Weight gain
  • Menstrual problems

Some of the symptoms are common with hyperthyroidism and hypothyroidism. This indicates that the goiter is either associated with overactive or underactive thyroid.

What Are the Causes of Goiter?

Goiters can be caused by various health issues. The most common reason in history was a deficiency of iodine in the diet. With the introduction of iodized salt, has significantly reduced the number of people suffering from goiter due to iodine deficiency.

In some cases, the cause is idiopathic in nature, that is, has no known cause. This is considered as a case of sporadic goiter. Drugs such as lithium, used for treatment of bipolar disorder and other mental conditions as well as aminoglutethimide can cause goiter.

Other conditions that lead to goiter include:

  • Hashimoto’s disease
  • Graves’ disease
  • Thyroid cancer
  • Thyroiditis
  • Pregnancy
  • Nodular goiter
  • Solitary thyroid nodule
  • Radiation exposure
  • Inflammation
  • Hydatidiform mole
  • Congenital hypothyroidism
  • Pituitary disease
  • Acromegaly
  • Cysts
  • Amyloidosis
  • Sarcoidosis

How is Goiter Diagnosed?

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Goiter is discovered after one feels a swelling in the neck. Other diagnostic tests and procedures a doctor may follow to discover goiter includes:

  • Blood tests to check for levels of thyroid hormones as well as thyroid-stimulation hormone (TSH)
  • Blood tests to check for abnormal antibodies
  • Ultrasonography
  • Thyroid scan
  • Fine needle biopsy

How is Goiter Treated?

Goiter is managed according to its size, symptoms and the underlying cause. Treatments include:

  • A wait and watch approach in cases where the goiter is very small and does not cause any health problems. One may have to visit the doctor frequently to make sure the goiter does not grow and there are no changes in the hormone level.
  • Medications prescribed such as levothyroxine. This medication is a part of thyroid hormone replacement therapy for hypothyroidism.
  • Methimazole is prescribed for overactive thyroid treatment.
  • Radioactive iodine treatment for treating overactive thyroid gland by killing thyroid cells that shrink the gland in turn.
  • Surgery in case the goiter is very large and causes breathing and swallowing problems.

Goiter is a painless swelling that indicates there is some problem with the thyroid gland. In some cases, iodine deficiency leads to this abnormal swelling. One should speak to their doctor and get their goiter treated.

Written by: Saptakee sengupta
Date last updated: April 05, 2015

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