A goiter is an abnormal enlargement of the thyroid gland. The thyroid is a butterfly-shaped gland found in your neck, just below the Adam’s apple. While some goiters are painless, they can become big enough to cause a cough, sore throat, and/or breathing problems. A variety of underlying conditions can cause goiters to develop. There are many treatment options that are recommended to treat goiters depending on their cause and severity.
Diagnosing a Goiter
Learn about goiters. To diagnose and then treat a goiter, you must first learn what a goiter is. A goiter is an abnormal, but usually benign, growth in the thyroid gland. This may be associated with normal, decreased, or increased thyroid production.
- Goiters are usually painless, but they can cause coughs, breathing problems, difficulty swallowing, diaphragm paralysis, or superior vena cava (SVC) syndrome.
- Treatment depends on the size of your goiter and symptoms, as well as the reasons the goiter developed
Know the symptoms of a goiter. To figure out if you may have a goiter, know the symptoms. If you’re experiencing any of the following, you should make a visit to your primary care doctor for an official diagnosis:
- A visible swelling the base of your neck, which may be very obvious when you shave or put on makeup
- A tight feeling in your throat
- Difficulty swallowing
- Difficulty breathing
Prepare for your appointment. As goiters are somewhat nebulous medical conditions — they can be caused by a number of conditions and there are a variety of options for treatment —come in with a list of questions. Questions should include:
- What is causing this goiter?
- Is it serious?
- How should I treat its underlying causes?
- Are there any alternative treatments I can try?
- Can I use a watch and wait approach?
- Will the goiter get bigger?
- Will I have to take medication? If so, for how long?
Visit your physician. Your doctor will perform a variety of tests to diagnose a goiter. These tests depend on your medical history and what the doctor suspects is causing the goiter.
- Your doctor may perform a hormone test to see the amounts of hormones produced by your thyroid and pituitary gland. If the levels are too low or too high, this is likely the cause of the goiter. Blood will be drawn and sent to a lab.
- An antibody test might be performed, as abnormal antibodies can cause goiters. This is done through blood tests.
- In ultrasonography, a device is held over your neck and sound waves from your neck and back form images on the computer screen. Abnormalities that cause goiters can be identified.
- A thyroid scan might also be performed. A radioactive isotope is injected into the vein in your elbow and you then lie on the table. A camera produces images of your thyroid on a computer screen, providing information about what’s causing the goiter.
- A biopsy may be performed, usually used to rule out cancer, in which tissues is drawn from your thyroid for testing.
Seeking Medical Treatments
Use radioactive iodine to shrink the enlarged thyroid gland. In some cases, radioactive iodine can be used to treat an enlarged thyroid gland.
- The iodine is taken orally and reaches the thyroid gland through your bloodstream, destroying thyroid cells. This treatment option is common in Europe, and its usage dates back to the 1990’s.
- The treatment is effective in that 90% of patients have a 50 – 60% reduction in goiter size and volume after 12 to 18 months.
- This treatment can result in an underactive thyroid gland, but such an issue is rare and usually shows up in the first two weeks after treatment. If you’re concerned about the risk, talk this option over with your doctor beforehand.
Use medications. If you’re diagnosed with hypothyroidism, that is an underactive thyroid, medications will be prescribed to treat the condition.
- Thyroid hormone replacements, such as Synthroid and Levothroid, help with symptoms of hypothyroidism. This also slows the release of hormones from your pituitary gland, a compensatory response of your body, which may decrease goiter size.
- If your goiter does not decrease with hormone replacements, you will still stay on the medication to treat other symptoms. However, your doctor might suggest aspirin or a corticosteroid cream.
- Thyroid replacement hormones are usually well tolerated in patients, but some side effects can occur. Side effects may include chest pain, increased heart rate, sweating, headaches, insomnia, diarrhea, nausea, and irregular menstrual cycles.
Consider surgery. The goiter can be removed surgically. A 3 to 4 inch cut will be made in the middle of your neck, on top of the thyroid gland, and all or part of the thyroid is removed. The surgery takes about four hours and most people go home the day of the surgery.
- If your goiter is large enough to cause compression of the neck and esophagus, resulting in difficulty breathing and nighttime choking episodes, surgery is usually recommended.
- Although rare, a goiter can be caused by thyroid cancer. If malignancy is suspected, your doctor will likely want to remove the goiter surgically.
- A less common reason for surgery is cosmetic concerns. Sometimes, a large goiter is simply a cosmetic concern and patients may opt for surgery in this case. However, if it’s a cosmetic concern insurance may not cover the cost of the operation.
- The same kind of hormone replacement therapy used for an underactive thyroid usually becomes necessary for life after the removal of the thyroid.
Trying At Home Care
Watch and wait. If your doctor finds your thyroid to be functioning normally, and your goiter isn’t big enough to cause health problems, she might recommend simply watching and waiting. Medical intervention can cause side effects, and if there’s no problem other than a small amount of irritation you should wait and see if the problem clears up with time. Down the road, if the goiter increases in size or begins to cause problems, you can make other decisions.
Get more iodine. Sometimes, goiters can be caused by problems in your diet. Iodine deficiencies have been linked to goiters, so getting more iodine in your diet can reduce their size.
- Everyone needs at least 150 micrograms of iodine a day.
- Shrimp and other shellfish are high in iodine, as are sea vegetables such as kelp, hiziki, and kombu.
- Organic yogurt and raw cheese are high in iodine. One cup of yogurt contains 90 micrograms, and an ounce of raw cheddar contains 10 to 15 micrograms.
- Cranberries are extremely high in iodine. There are 400 micrograms in 4 ounces of cranberries. Strawberries are another great berry choice. One cup has 13 micrograms.
- Navy beans and potatoes also contain high amounts of iodine.
- Make sure you get iodized salt.