Goiter Causes, Symptoms, and Treatment

A goiter is an enlarged thyroid gland. The thyroid is the gland in front of the neck just below the area of the Adam's apple. This butterfly-shaped gland plays a critical role in regulating the metabolic processes of the body by producing thyroid hormone. Heart rate, blood pressure, growth, and breathing are examples of the many processes that depend upon thyroid hormone from the thyroid gland. When the gland becomes enlarged due to diseases or tumors, the gland is referred to as a goiter.

A goiter can develop as a result of numerous different conditions. It can be associated with over-function of the thyroid gland (hyperthyroidism, or excessive thyroid hormones) or with under-function of the gland (hypothyroidism, or inadequate levels of thyroid hormones). Also, some goiters are associated with normal levels of thyroid hormones. Both inflammation and tumors can cause thyroid enlargement. Sometimes, the entire gland may be enlarged in a symmetrical pattern, while in other goiters, nodules, or enlargement may develop in one part of the gland only.

When a goiter becomes very large, it can sometimes cause symptoms because it presses on adjacent structures such as the esophagus and trachea. Symptoms that can occur related to a large goiter include problems with swallowing, shortness of breath, hoarseness, and stridor (a wheezing sound that results from turbulent air flow in and out of the trachea).

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Some of the conditions that can cause a goiter include:

• Hashimoto's thyroiditis, a common autoimmune condition in which the body's immune response is directed against the thyroid gland, leading to inflammation of the thyroid
• Thyroid cancers and benign tumors (nodules) that may cause a so-called multinodular goiter
• Iodine deficiency, which was formerly a major cause of goiter in the US
• Graves' disease, another autoimmune condition, which stimulates the gland to be overly active

Just as no one disease causes a goiter, there is also no one specific treatment for a goiter. The treatment depends upon the cause of the enlargement. Treatments for goiter can include medications, surgery, treatment with radioactive iodine, and simple observation.

Illustration of the Thyroid Gland