Thyroid goiter is a condition characterized by increase in volume of the thyroid gland. The thyroid gland is small, butterfly-shaped and is located in the front of the neck.
The thyroid produces hormones that control a number of body functions. Thyroid hormones regulate body temperature, heart rate and growth.
The amount of thyroid hormone in the body can increase, decrease or even can be seen simultaneously both situations when a person has thyroid goiter. In some cases, the levels of these hormones may be normal. Treating thyroid goiter can reduce the size of it and can keep the symptoms under control.
Very low levels of iodine in the diet is the most common cause of thyroid goiter, but this condition can be caused by autoimmune disorders, thyroid disorders, drugs or it could be genetics.
- Autoimmune diseases: include Graves and Hashimoto diseases which are triggered when the immune system attacks the thyroid gland. The immune system defends the body against infections and disease. Problems occur when the immune system attacks its own cells including those of the thyroid gland. When this happens, the growth cells of thyroid gland multiply excessively and do not work.
- Other diseases: These may include other thyroid disorders such as cancer, Plummer’s disease, subacute thyroiditis and Riedel thyroiditis. A thyroid goiter can be caused including the presence of one or more thyroid nodules or cysts.
- Genetic inheritance: thyroid goiter can be transmitted from parents to children through genes.
- Medications: Medications that cause this condition include those used to treat mental illness.
The following situations can increase a person’s risk of developing thyroid goiter, especially if it lives in a geographic area where there is little or no iodine:
- Consumption of certain foods
- Family history of thyroid goiter
Signs and symptoms
It is possible that the signs and symptoms of thyroid goiter not to manifest from the very beginning. As thyroid goiter grows in size, it can be observed more easily. A thyroid goiter is not usually painful. When will expand and thyroid can put pressure on the airways or the veins of the neck, and this can cause the following signs and symptoms:
- Cough or shortness of breath
- Flushing and inflammation of veins in the neck
- Hoarse voice
- Pain or discomfort during swallowing food or liquids
- Breathing problems in certain positions of the body.
- Signs and symptoms of hyperthyroidism or hypothyroidism.
The patient may be asked if he had surgery on thyroid or if he suffers from any other medical conditions. The specialist will want to know what kind of medication is used by the patient or if he followed hormone treatment, but also information about family health.
Endocrinologist will touch and analyze patient’s neck and may require any of the following tests:
- Blood tests – with their help can detect which is the thyroid hormone level in the blood.
- Fine-needle biopsy for this test will yield a small portion of the thyroid gland. Biopsy is to check if there are problems such as thyroid cancer. Your doctor may use an anesthetic to numb the front of the neck, and then insert a small needle with which he will obtain a tissue sample from the thyroid gland. After the sample is taken, the biopsy will be covered with a bandage and the sample will be sent to the laboratory for analysis.
- Imaging tests – in some of these tests will be used contrast substance for the results (obtained images) to be as relevant as possible.
- Chest X-ray – this is necessary if the patient suspected thyroid goiter accuse the airway obstruction or enlarged thyroid when pressing on nerves or blood vessels.
- Computerized tomography – also known as CT scan, this investigation will be done by using X-rays, resulting images of the neck and chest. Computerized tomography is necessary to investigate tissues, bones, muscles and blood vessels. For this test, the doctor will use contrast substances.
- Thyroid ultrasound (scanning) – reveals how thyroid works.
- Ultrasound – with this test that uses sound waves, the doctor can analyze your throat.
Minor cases of thyroid goiter can be treated with thyroid hormone in pill form. By providing thyroid hormones, the pituitary will release fewer hormones TSH and the result would be stabilization gland size. By using this strategy, often the goiter will not decrease, but will not increase in size.
If patients do not respond to therapy with thyroid hormone, alternative treatment is surgery, if the gland continues to grow. Surgery is recommended especially if the thyroid gland is so big that cause compression on other structures in the neck such as the trachea and esophagus. In these situations occur: cough, slight change of voice or choking episodes at night.
Another situation in which is recommended surgical removal of the thyroid gland is suspicion of malignancy.
Other reason for surgical removal of the thyroid goiter is cosmetic. Often a goiter becomes large enough that it is unsightly. If thyroid goiter is large enough to be seen, it may be necessary taking drugs or surgery, because it is possible for it to grow even more in size.