Goiter

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Overview

Goiter is a condition where your thyroid gland grows larger. Your entire thyroid can grow larger or it can develop one or more small lumps called thyroid nodules.

Your thyroid gland is a small, butterfly-shaped endocrine gland located in your neck, below your Adam's apple. It produces the hormones thyroxine (also called T4) and triiodothyronine (also called T3). These hormones play a role in certain bodily functions, including:

Metabolism.

Body temperature.

Mood and excitability.

Pulse and heart rate.

Digestion.

Goiter may be associated with an irregular amount of thyroid hormone in your body (hyperthyroidism or hypothyroidism) or with normal levels of thyroid hormone (euthyroid).

Goiter has several possible causes. Depending on the cause, it may or may not require treatment.


Symptoms

The size of a goiter can range from very small and barely noticeable to very large. Most goiters are painless, but if you have thyroiditis (an inflamed thyroid gland), it can be painful.


The main symptoms of goiter include:


A lump in the front of your neck, just below your Adam's apple.

A feeling of tightness in your throat area.

Hoarseness (scratchy voice).

Neck vein swelling.

Dizziness when you raise your arms above your head.

Other, less common symptoms include:


Difficulty breathing (shortness of breath).

Coughing.

Wheezing (due to squeezing of your windpipe).

Difficulty swallowing (due to squeezing of your esophagus).

Some people who have a goiter may also have hyperthyroidism (overactive thyroid). Symptoms of hyperthyroidism include:


Rapid heart rate (tachycardia).

Unexplained weight loss.

Diarrhea.

Sweating without exercise or increased room temperature.

Shaking.

Agitation.

Some people with goiter may also have hypothyroidism (underactive thyroid). Symptoms of hypothyroidism include:


Fatigue (feeling tired).

Constipation.

Dry skin.

Unexplained weight gain.

Abnormal menstruation (periods).


Causes

Goiter is an adaptive reaction of the cells in your thyroid to any process that blocks thyroid hormone production. While the most common cause of goiter worldwide is iodine deficiency, many conditions can cause it.


Causes of goiter include:


Iodine deficiency: Your thyroid needs iodine to produce thyroid hormone. If you don’t get enough iodine in your diet, your thyroid makes more cells (and grows) to try to make more thyroid hormone. While this is the most common cause of goiter worldwide, it’s not common in the United States. You can get the recommended amount of iodine in your diet by including seafood, dairy products and iodized salt in your diet. Supplementation with iodine is not recommended for most people and may have unintended negative effects on your health.

Graves' disease: Graves' disease is an autoimmune disease in which your immune system attacks your thyroid, causing it to grow larger. Graves’ disease also causes hyperthyroidism, which requires treatment.

Hashimoto's disease: This is an autoimmune disease that causes inflammation of your thyroid gland. Some people with Hashimoto's disease develop a compensatory increase in the thyroid gland's size. This type of goiter usually gets better on its own over time. Some cases of Hashimoto’s disease require treatment with thyroid hormone.

Thyroid cancer: Cancer of the thyroid gland often enlarges your thyroid.

Pregnancy: Human chorionic gonadotropin, a hormone that a person produces during pregnancy, can cause their thyroid to grow.

Thyroiditis: Inflammation of the thyroid gland itself can cause your thyroid gland to grow. This can happen for several reasons.

Sporadic goiters, in most cases, have no known cause. In some cases, certain drugs can cause this type of goiter. For example, the drug lithium, which is used to treat certain mental health conditions, as well as other medical conditions, can cause this type of goiter.


Risk factors

A lack of dietary iodine. Iodine is found primarily in seawater and in the soil in coastal areas. ...

Being female. Women are more likely to develop a goiter or other thyroid disorders.

Pregnancy and menopause. ...

Age. ...

Family medical history. ...

Medications. ...

Radiation exposur

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Complications

A goiter itself usually doesn't cause complications. The appearance may be troublesome or embarrassing for some people. A large goiter may obstruct the airway and voice box.


Changes in the production of thyroid hormones that may be associated with goiters have the potential for causing complications in multiple body systems.

Prevention

A goiter caused by iodine deficiency (simple goiter) is generally the only type of goiter you can prevent. Consuming a diet that includes fish, dairy and a healthy amount of iodized table salt prevents these types of goiters.