Goiter

Have you noticed a lump or swelling in the front of your neck? It could be a goiter, an enlarged thyroid gland. While some goiters don’t cause symptoms, others can make it harder to swallow, breathe, or speak.

At Diabetes & Glandular Disease Clinic, we diagnose and treat this condition for patients throughout San Antonio and create personalized treatment plans based on the cause.

A goiter refers to an enlarged thyroid gland. The thyroid is a small gland at the front of your neck, just below your voice box. It makes hormones that help control how your body uses energy. These hormones affect many body functions, including:

• Metabolism
• Body temperature
• Heart rate
• Digestion

A goiter is an enlarged thyroid gland. It may cause swelling or fullness at the front of your neck. Some goiters don’t cause symptoms, while others can make it harder to swallow, breathe, or speak.

Your brain helps control how much thyroid hormone your body makes. When the thyroid has to work harder, becomes inflamed, develops nodules, or is affected by an autoimmune disease, it can become enlarged.

A goiter can develop for several reasons.

Around the world, iodine deficiency is a common cause of goiter. However, it isn’t common in the United States. Your thyroid needs iodine to make thyroid hormone. When you don’t get enough iodine, the thyroid may grow larger as it tries to make enough hormones.

Autoimmune thyroid disease is another common cause. In Hashimoto’s disease, the immune system attacks the thyroid. This often leads to low thyroid hormone levels. In Graves’ disease, the immune system causes the thyroid to make too much thyroid hormone. Both conditions can cause this condition.

Thyroid nodules can also cause a goiter. A thyroid nodule is a lump that forms in the thyroid. Some people have one nodule, while others have several. This is called a multinodular goiter. Most thyroid nodules aren’t cancerous, but some need more testing.

Other possible causes include:

• Thyroiditis (inflammation of the thyroid)
• Hormone changes during pregnancy
• Certain medications
• Thyroid cancer

Many people with a goiter notice only a small swelling in the front of the neck. If the goiter becomes larger, it may cause:

• Tightness or pressure in the neck
• A feeling that there’s a lump in your throat
• Trouble swallowing
• Trouble breathing, especially when lying flat
• Hoarseness or other voice changes

Your symptoms may also depend on whether your thyroid is making too little or too much hormone.

If your thyroid is underactive (hypothyroidism), you may have:

• Fatigue
• Weight gain
• Constipation
• Dry skin
• Thinning hair
• Feeling cold more often
• A slower heart rate
• Heavy or irregular menstrual periods

If your thyroid is overactive (hyperthyroidism), you may have:

• Weight loss
• A fast or irregular heartbeat
• Anxiety
• Shakiness
• Sweating
• Heat intolerance
• Trouble sleeping
• Frequent bowel movements

A doctor can often find a goiter during a physical exam. They may feel your neck while you swallow to check the size and shape of your thyroid.

A goiter can have many causes. Your doctor may order tests to find the cause and see how well your thyroid is working.

Blood tests often check TSH and free T4. Your doctor may also check T3. The results show whether your thyroid is making too much or too little hormone. Your doctor may order antibody tests if they think you have an autoimmune thyroid disease.

A thyroid ultrasound gives your doctor a closer look at the gland. It can measure the size of the thyroid and show whether you have any nodules. If a nodule is large enough or has certain features, your doctor may recommend a fine-needle aspiration biopsy to check the cells.

Sometimes, your doctor may also order a radioactive iodine uptake test or thyroid scan to learn more about how your thyroid is working.

Treatment depends on:

• The cause of the goiter
• The size of the goiter
• Your thyroid hormone levels
• Whether the goiter is causing symptoms

A small goiter that isn’t causing symptoms may not need treatment right away. Your doctor may check it over time with exams, blood tests, or ultrasounds.

If an underactive thyroid is causing the goiter, your doctor may prescribe thyroid hormone replacement medicine.

If an overactive thyroid is causing the condition, treatment may include:

• Antithyroid medicine
• Radioactive iodine treatment
• Surgery in some cases

If thyroiditis is causing pain or swelling, treatment focuses on reducing inflammation and managing your symptoms while the thyroid heals.

If the goiter is large enough to make swallowing or breathing difficult, surgery may be recommended. Surgery may also be needed if thyroid cancer is suspected or confirmed.

If you’ve noticed swelling in the front of your neck, trouble swallowing, or voice changes, don’t ignore them. The endocrinology team at Diabetes & Glandular Disease Clinic helps patients throughout San Antonio find the cause of this condition and get the care they need. Contact us today to schedule an evaluation.

1. Is a goiter dangerous?

This condition isn’t always dangerous. However, it can affect your thyroid hormone levels or make it hard to swallow or breathe. It may also be caused by a thyroid condition that needs treatment. Your doctor can find the cause and decide whether you need care.

2. Can a goiter go away on its own?

Sometimes. A goiter caused by short-term thyroid swelling may get smaller as the swelling goes down. Other goiters may stay the same size or slowly grow. Your doctor may recommend treatment or check it over time.

3. Is a goiter cancer?

Most goiters aren’t caused by cancer. They’re more often linked to thyroid nodules, autoimmune thyroid disease, or other noncancerous conditions. Your doctor may order an ultrasound or biopsy if a thyroid nodule needs more testing.