Goiter Health Article

Definition

A goiter is an enlargement of the thyroid gland. It is not cancer.

Causes, incidence, and risk factors

There are different kinds of goiters. A simple goiter can occur for no known reason, or when the thyroid gland is not able to produce enough thyroid hormone to meet the body's needs. The thyroid gland makes up for this by becoming larger.

There are two types of simple goiter:

• Endemic (colloid) goiter
• Sporadic (nontoxic) goiter

Goiters occur in groups of people who live in areas with iodine-poor soil. These regions are usually away from the sea coast. People in these communities might not get enough iodine in their diet (iodine is needed to produce thyroid hormone).

The use of iodized table salt in the United States today prevents iodine deficiency. However, a lack of enough iodine is still common in central Asia, the Andes region of South America, and central Africa.

In most cases of sporadic goiter the cause is unknown. Occasionally, certain medications such as lithium or aminoglutethimide can cause a nontoxic goiter.

Inherited factors may cause goiters. Risk factors include:

• Age over 40 years
• Family history of goiter
• Female gender
• Living in an area where people do not get enough iodine
• Not getting enough iodine in the diet

Symptoms

The main symptom is a swollen thyroid gland. The size may range from a single small nodule to large neck lump.

The swollen thyroid can put pressure on the windpipe and esophagus, which can lead to:

• Breathing difficulties
• Cough
• Swallowing difficulties
• Wheezing

There may be neck vein swelling and dizziness when the arms are raised above the head.

Signs and tests

The doctor will feel your neck as you swallow. The doctor may be able to feel swelling in the area.

Tests that may be done include:

• Free thyroxine (T4)
• Thyroid scan and uptake
• Thyroid stimulating hormone (TSH)
• Ultrasound of thyroid

If nodules are found on ultrasound, a biopsy should be done to check for thyroid cancer.