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Goiter is the medical term for an enlarged thyroid gland. Sometimes this occurs because the thyroid is not producing enough hormones, so it increases in size to try and counter this.
Sometimes it occurs because the person is deficient in iodine, a nutrient needed to produce thyroid hormones. Thankfully this is no longer common in many industrialized countries due to the introduction of iodized salt.
There are currently 54 countries in the world that still have problems with iodine deficiency, particularly in communities that live inland and don’t consume much seafood. This type of goiter is called a colloid goiter.
Goiter may occur as a side-effect to a medication such as lithium. This is called non-toxic goiter. Often, the cause of a goiter is not known.
Symptoms
Symptoms include:
• Swollen thyroid gland (presenting as a large mass in the neck or as a smaller nodule).
• Cough
• Hoarse voice
• Dizziness
• Difficulties with swallowing food
Many goiters remain small and disappear on their own, however, breathing difficulties can occur if your goiter becomes large, although this is a very rare complication. You should seek urgent medical attention if you are having any problems with eating or breathing.
Diagnosis
Your doctor will give you a physical examination to see if your thyroid is enlarged. He will take blood to determine your levels of thyroid hormones to see if you are producing too much or too little hormone.
Your doctor may also do a thyroid scan to find out how well your thyroid is functioning and an ultrasound to see if there are any nodules. If nodules are found, a fine needle aspiration will be done to check for cancer.
Treatment
For simple goiter, with no symptoms and no cancer, treatment is not usually offered. If you do have symptoms, your treatment plan will vary according to the cause. If you are iodine deficient you may be given an iodine solution.
Hypothyroidism (underactive thyroid) can be treated with hormone replacement tablets. Overactive thyroid or cancer can be treated by surgically removing part or all of the thyroid gland or destroying it with radioactive iodine.
If this is done you will need to take hormone replacement pills for the rest of your life to do the job your thyroid would have done.
Sources:
Goiter, Simple. Medline Plus. Web. 23 January 2012. http://www.nlm.nih.gov/medlineplus/ency/article/001178.htm
Current global iodine status and progress over the last decade towards the elimination of iodine deficiency. Bull World Health Organ. 2005 July; 83(7): 518–525.
Abstract: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2626287/?tool=pmcentrez
Joanna is a freelance health writer for The Mother magazine and Suite 101 with a column on infertility, http://infertility.suite101.com/. She is author of the book, 'Breast Milk: A Natural Immunisation,' and co-author of an educational resource on disabled parenting.
Reviewed January 23, 2012
by Michele Blacksberg RN
Edited by Jody Smith
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