A goiter is an enlargement of the thyroid gland that is not due to cancer. The thyroid gland is located in the neck just below the Adam's apple.
What is going on in the body?
Thyroid hormone is important for the body's metabolism. Hypothyroidism is a condition caused by low levels of thyroid hormone in the body. The thyroid gland responds by getting larger and forming a goiter. This may allow it to make enough thyroid hormone.
What are the causes and risks of the condition?
Goiter is seen most often in people who:
- have too little iodine in their diet
- take certain medicines, such as lithium, iodides, and cobalt
- have a family history of goiter
- are female
- eat large amounts of certain foods such as cabbage, peanuts, peaches, and spinach
What can be done to prevent the condition?
Getting enough iodine in the diet can prevent an individual from getting one form of goiter. Avoiding foods and medicines that can cause a goiter may also help prevent the condition. Some cases cannot be prevented.
How is the condition diagnosed?
The healthcare professional will take a medical history and perform a physical exam. A lump in the throat may indicate a goiter. It can also signal a more serious problem such as cancer of the neck or thyroid cancer.
Blood tests and special X-rays or imaging tests are also used to help with the diagnosis.
Long Term Effects
What are the long-term effects of the condition?
Untreated, goiter may lead to the compression of the trachea and esophagus. Most goiters are small and do not cause serious long-term effects.
What are the risks to others?
Goiter is not contagious and poses no risk to others.
What are the treatments for the condition?
The goal of treatment is to reduce the size of the thyroid gland. Thyroid hormone replacement pills are the treatment of choice. These medicines will supply some of the body's requirement for thyroid hormone in a person who has hypothyroidism and will allow the gland to rest.
If goiter is due to inadequate intake of iodine, taking small doses of iodide will relieve the condition. In some cases of goiter, a person may need to avoid certain foods and medicines. Rarely, surgery is necessary when the goiter does not respond to other treatment.
What are the side effects of the treatments?
Too much thyroid hormone can cause toxic levels to build up in the body. This can lead to symptoms of hyperthyroidism such as fast heartbeat, diarrhea, and insomnia.
If the goiter was brought on by a particular medicine, the condition being treated could worsen or return if the medicine is discontinued. Surgery carries the risks of bleeding, infection, and allergic reaction to anesthesia.
What happens after treatment for the condition?
The thyroid gland should decrease in size after treatment. This will improve symptoms.
How is the condition monitored?
A person with goiter should be seen regularly by the healthcare professional to monitor the status of the thyroid gland. Any new or worsening symptoms should be reported to the professional.
Professional Guide to Diseases, Sixth Edition. Springhouse: Springhouse Corporation, 1998
Conn's Current Therapy. Philadelphia: W.B. Saunders Company, 1999