Goiter Causes, Symptoms, and Treatment

  • Medical Author:
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

What is a goiter?

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).

What conditions cause a goiter?

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
Illustration of the Thyroid Gland

Medically reviewed by John A. Seibel, MD; Board Certified Internal Medicine with a subspecialty in Endocrinology & Metabolism

REFERENCES:

American Thyroid Association. What is a goiter?

MedscapeReference.com. Goiter Differential Diagnosis.

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