Your thyroid produces the hormones that help your metabolism run smoothly. When issues occur, you may need medical treatment to get back to full wellness.

What is a goiter?

A goiter is an abnormal enlargement of your thyroid gland. Goiters are common and are not necessarily indications that your thyroid is malfunctioning. It can, however, be a sign that your thyroid is producing either too much or too little thyroid hormone.

Types of goiter

A couple of types of goiters can occur.

A diffuse goiter involves the enlargement of the entire thyroid.

Multinodular goiters are among the most common. These goiters occur when there are one or more nodules within your thyroid that are causing thyroid enlargement. In some cases, a single nodule is the issue. In others, a number of smaller nodules will be detected.

Goiters are divided into multiple classes. Class I goiters cannot be seen and are detected with ultrasound or palpation of the area. Class II goiters can be easily seen. Class III goiters are very large' pressure on the goiter leaves behind compression marks.

Causes of goiter

Worldwide, the most common cause of goiter is iodine deficiencies. However, because of widespread fortification of foods in the US, iodine deficiency is uncommon here.

Goiter can be caused by an autoimmune condition called Graves' disease. Graves' causes an individual's immune system to create a protein that overstimulates the thyroid. A goiter can result.

Hashimoto's thyroiditis is another common cause of goiters. Hashimoto's is an autoimmune condition that causes destruction of the thyroid gland. The damaged gland supplies more thyroid stimulating hormone (TSH) to stimulate the thyroid, which can produce a goiter.

Symptoms of goiter

Some small goiters are not detected by the patient. The individual may not become aware of the goiter until it is discovered during a physical exam.

Larger goiters may be visible. You may notice that shirt collars, necklaces or ties feel tight against your throat. You may feel like you have a lump in your throat or pressure against your windpipe.

Diagnosing Goiters

An ultrasound exam can allow your doctor to get a look at a goiter and see whether the enlargement is solid or caused by fluid-filled nodules. You will probably also have thyroid function tests performed that show whether your thyroid is under or over active. If you have a diffusely enlarged goiter and you have hyperthyroidism, your doctor will also perform tests to see if you have Graves'. Testing for Hashimoto's will be performed if your thyroid is underactive. A fine needle biopsy can also give more information about the cause of your goiter.

Goiter treatment

The treatment for your goiter will depend on its cause and size. Iodine supplements are given if the cause is iodine deficiency. Medication that either suppresses your thyroid or that provides additional thyroid hormones will be prescribed if a thyroid disorder is the cause.

If the cause of the goiter is hyperthyroidism, treatment may cause the goiter to disappear. For instance, Graves' is sometimes treated with radioactive iodine, which can shrink the thyroid.

Some goiters may be treated with surgical thyroid removal.

Multinodular goiters that are associated with normal levels of thyroid hormone may need no treatment. However, if the goiter gets large or becomes associated with a thyroid hormone issue, further tests may be necessary to determine a future course of treatment.