The term thyroid goiter refers to an enlargement of the thyroid gland. This gland is found in the front of the neck and its main job is to regulate the body’s metabolic processes. Weight, blood pressure, heart rate and growth are just some of the processes that rely upon the hormones produced by the thyroid. When the thyroid becomes enlarged due to growths or disease, the gland is then referred to as a thyroid goiter.
Thyroid Goiter Causes
A thyroid goiter can develop as a result of many different conditions. Hyperthyroidism, a condition in which too much thyroid hormone is released and hypothyroidism, a condition in which severely low amounts of the thyroid hormones are released, can also cause the thyroid to become enlarged. Tumors and inflammation of the thyroid can also cause a goiter.
When the goiter becomes too large it can cause additional symptoms because it puts pressure on nearby structures, such as the trachea. Symptoms caused by an enlarged goiter can include shortness of breath, difficulty swallowing, wheezing, or hoarseness.
A common cause of a thyroid goiter is an iodine deficiency. The thyroid will take iodine from the blood in order to create thyroid hormones. If there is not enough iodine in the blood the thyroid cannot produce the right amount of hormones, resulting in hypothyroidism. When the pituitary gland in the brain senses that these hormone levels are too low it will send a signal to the thyroid. This signal is known as TSH, or thyroid stimulating hormone. This hormone works to stimulate the thyroid to boost the production of hormones and to grow larger in size. In countries where iodine deficiency is common, thyroid goiters will also be common.
In America, one of the most common causes of the thyroid goiter is Hashimoto’s Thyroiditis. This is an autoimmune condition in which a person’s immune system will attack the thyroid. As the thyroid becomes more damaged, it will lose the ability to create a supply of thyroid hormones. Once this happens the pituitary gland will secrete more thyroid stimulating hormones, which in turn will cause a thyroid goiter.
Another cause of the thyroid goiter is Grave’s disease. Grave’s disease causes a person’s immune system to produce thyroid stimulating immunoglobulin protein. This protein will stimulate the thyroid gland, causing enlargement of the gland. The TSI protein can also stimulate the gland to make too much hormones, causing hyperthyroidism. If the pituitary gland senses too much thyroid hormones it will stop secreting the TSH. However, the thyroid will continue to grow and produce thyroid hormones.
Multinodular goiters is another condition that causes the formation of a thyroid goiter. A person with this condition will have one or more nodules within the thyroid, causing it to become enlarged. A doctor can usually detect this condition during a physical exam. A patient may have only a single large nodule, or they can have several, smaller nodules in the thyroid when the condition is first detected. The cause of this condition is not well understood.
How is Thyroid Enlargement Detected and Diagnosed?
The diagnosis of a thyroid goiter will usually occur during an annual physical exam. The presence of a goiter indicates that the gland suffers an abnormality and because of this it’s important to diagnose the root cause. When a doctor identifies an enlarged thyroid gland they will proceed with tests for such conditions as Grave’s disease.
If you have previously been diagnosed with hypothyroidism and the gland has become enlarged, your physician will test for Hashimoto’s Thyroiditis. Other diagnostic tests used to determine the cause of a thyroid goiter include a radioactive iodine scan, blood tests, ultrasounds or a needle aspiration biopsy.
Treatment for an Enlarged Thyroid
Treatment of a thyroid goiter will be dependent upon the cause. If gland enlargement is due to an iodine deficiency, your physician will prescribe an iodine supplement. This will cause the thyroid to shrink.
If the goiter is caused by Hashimoto’s Thyroiditis and you have hypothyroidism, your physician will prescribe a daily thyroid hormone supplement. This type of treatment will restore the hormone levels to normal, but will not usually completely resolve the goiter. While it will shrink in size, there may be too much scar tissue inside the gland to allow it to return to its normal size. Ongoing treatment will prevent the goiter from becoming larger. For more severe cases, surgery may be necessary.
If a goiter has developed due to hypothyroidism, your treatment will be based on the cause of the hypothyroidism. For certain causes, treatment will completely shrink the gland.
Whatever the cause of the thyroid goiter, it’s crucial that you continue to have regular monitoring, based on your physician’s recommendations and the cause of the enlargement. Typically, most physicians will require their patients to come in every three to six months until hormone levels have been regulated and the goiter has shrunk in size.