Healthy Pilipinas:Goiter

The thyroid gland swells as an adaptation in response to underproduction or overproduction of thyroid hormones. Some common causes of goiter include:

Iodine deficiency

Lack of iodine in the diet is the most common cause of goiter since iodine is the material needed by the thyroid gland to produce its hormones

Hypothyroidism

This condition describes an underactive thyroid gland
Since the gland does not produce enough hormones for the body, it is overstimulated to produce more which leads to swelling
This could be caused by Hashimoto’s thyroiditis wherein the immune system attacks its own tissue and causes the gland to swell

Hyperthyroidism

This condition describes an overactive thyroid gland
Goiter can also occur when the body produces too much thyroid hormones
Hyperthyroidism can be caused by Grave’s disease

Less common causes of goiters include the following:

Smoking (interferes with iodine absorption)
Hormonal changes (puberty, pregnancy, menopause)
Thyroiditis (inflammation caused by infection)
Thyroid cancer

Most people with goiter only experience swelling at the base of the neck where the thyroid gland lies. If the goiter is small enough, it may not be noticeable to the naked eye but may only be discovered during a routine medical exam or an imaging test.

Excessive swelling in some cases can cause throat tightness, cough, voice hoarseness, trouble swallowing, and difficulty breathing.

Hyperthyroidism associated with goiter can result to metabolic changes such as:

Heat hypersensitivity
Palpitations
Hyperactivity
Increased sweating
Fatigue
Increased appetite
Hair loss
Weight loss

Hypothyroidism, on the other hand, causes the following:

Intolerance to cold
Constipation
Forgetfulness
Hair loss
Weight gain

Severe cases of goiter can be diagnosed just by looking at the swelling at the patient’s neck but other procedures can be done for milder cases. Doctors can evaluate an enlarged thyroid gland by feeling your neck area for any nodules or tenderness. Thyroid blood tests are done to measure the amount of thyroid hormones your body has to determine if the gland is working properly.

Different imaging modalities can also be done to look at the thyroid gland:

Ultrasounds are done to “see” your thyroid and check for its size and presence of nodules
Thyroid uptake and scan uses radioactive iodine to evaluate the gland’s function and ability to absorb
CT Scan or MRIs are also done if the goiter is very large since it can also check if the goiter has spread to other parts of the body

For treatment, simple cases of goiter can go away on their own without much intervention. In hypothyroidism cases, medications such as levothyroxine are given as replacement to thyroid hormone. In hyperthyroidism cases, methimazole and propylthiouracil are examples of drugs that are usually prescribed by physicians. If the goiter is caused by inflammation, noninflammatory drugs are given.

Other forms of treatment for goiter are radioactive iodine treatment which involves taking a drug orally to kill thyroid cells to shrink the gland. Thyroidectomy is also a surgical option if the goiter is very large.

Since the most common cause of goiter is the lack of iodine in the diet, it would be best to include iodine-rich foods in the diet such as fish, dairy, eggs, or seaweed. Some table salts are also marketed as “iodized salt” which means they have extra iodine and these are actually developed to prevent iodine deficiency.

References

https://www.medicalnewstoday.com/articles/167559#causes

https://my.clevelandclinic.org/health/diseases/12625-goiter

https://www.mayoclinic.org/diseases-conditions/goiter/symptoms-causes/syc-20351829

https://www.hopkinsmedicine.org/health/conditions-and-diseases/goiter

Cause

Signs And Symptoms

Management (Diagnostic, Treatment, Other Care)

What You Can Do (Prevention and Control)