Goiter: Symptoms, Causes, Diagnosis & Treatment

Goiter is a swelling of the neck due to the enlargement of the thyroid gland. The thyroid gland produces the hormones thyroxine (T4) and triiodothyronine (T3).  

These hormones are necessary to maintain body temperature, digestion, mood, growth, puberty, etc.

Goiter is a painless swelling in the neck. However, when it becomes large, it causes difficulty swallowing, difficulty breathing, and 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 with 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 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 an overactive or underactive thyroid.

What Are the Causes of Goiter?

Various health issues can cause goiters. The most common reason is a deficiency of iodine in the diet. With the use of iodized salt, we can significantly reduce goiter due to iodine deficiency.

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

Goiter is discovered with the 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 treated 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.
  • Levothyroxine: This medication is a part of thyroid hormone replacement therapy for hypothyroidism.
  • Methimazole: It 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.

If you see any swelling in the thyroid gland, consult your doctor for goiter treatment.