What is a goiter, its symptoms and treatment?Goiter is an enlargement of the thyroid gland. The thyroid gland is a small gland located in the neck, below your Adam鈥檚 apple. The thyroid can be enlarged due to generalized enlargement of the thyroid or nodules (tissue growths) within the thyroid. The thyroid gland produces the hormones thyroxine (also called T4) and a small amount of triiodothyronine (also called T3). Most of the T4 is converted to T3 outside of the thyroid. These thyroid hormones influence such bodily functions as a person鈥檚 body temperature, mood and excitability, pulse rate, digestive functions, and other processes necessary for life. It is important to understand that goiter is not cancer and that most goiters are, in fact, benign.
Main symptoms include:
1. A swelling, ranging in size from a small nodule to a massive lump, in the front of the neck just below your Adam鈥檚 apple.
2. A feeling of tightness in the throat area.
3. Difficulty breathing (shortness of breath), coughing, wheezing (due to compression of the windpipe).
4. Difficulty swallowing (due to compression of the esophagus).
5. Hoarseness.
6. Neck vein distention.
7. Dizziness when the arms are raised above the head.
Other symptoms can include:
8. An increased resting pulse rate.
9. Rapid heartbeat.
10. Diarrhea, nausea, vomiting.
11. Sweating without exercise or increased room temperature.
12. Shaking.
13. Agitation.
(The above group of symptoms are signs of hyperthyroidism -- a condition in which the thyroid is overstimulated. Some people with goiter may also have hyperthyroidism.)
14. Fatigue, constipation, dry skin
15. Weight gain
16. Menstrual irregularities
(The above group of symptoms are signs of hypothyroidism -- a condition in which the thyroid is underactive. Some people with goiter may also have hypothyroidism
Treatment options depend on the size of the enlargement, your symptoms, and the underlying cause. Treatments typically considered by your doctor include:
1. No treatment/"watchful waiting." If the goiter is small and not bothering you, your doctor may decide that no treatment is necessary at this time, but will continue to watch your condition for changes.
2. Medications. Levothyroxine (Levothroid, Synthroid) is a thyroid hormone replacement therapy that can be prescribed if your doctor determines that the cause of your goiter is an underactive thyroid (a condition called hypothyroidism). Other medications can be prescribed if tests indicate your thyroid is overactive (hyperthyroidism). Aspirin or a corticosteroid mediation might be prescribed if the underlying cause of your goiter is inflammation. Small does of iodine (in the form of Lugol鈥檚 or potassium iodine solution) can be prescribed if the goiter is due to iodine deficiency.
3. Radioactive iodine treatment. This treatment, used in cases of an overactive thyroid gland, involves injecting radioactive iodine into your bloodstream. The iodine is delivered to the thyroid gland, killing thyroid cells, which shrinks the gland. Radioactive iodine treatment is usually followed by the use of hormone replacement therapy for life.
4. Biopsy. This may be required if you have large nodules in the thyroid to exclude cancer.
5. Surgery. Surgery, to remove all or part of the thyroid gland, may be necessary if the goiter is large and causing difficulty with breathing and swallowing or sometimes to remove nodules and certainly if cancer is present. Depending on the amount of thyroid gland removed, lifelong thyroid hormone replacement therapy may be necessary. I'm not familar with it, but you can find answers i'm sure at MD.COM
or do a google search for Goiter.You should be able to find your answers. A goitre (or goiter), also called a bronchocele, is a swelling in the neck (just below adam's apple or larynx) due to an enlarged thyroid gland. They are classified in different ways:
A "diffuse goitre" is a goitre that has spread through all of the thyroid (and is contrasted with a "simple goitre", "single thyroid nodule" and "multinodular goitre").
"Toxic goitre" refers to goitre with hyperthyroidism. These are derived from inflammation, neoplasm, and some kinds of activating autoimmune disease (Grave's disease). "Nontoxic goitre" (associated with normal or low thyroid levels) refers to all other types (such as that caused by lithium or certain other autoimmune diseases).
Symptoms
Often a goitre is a cosmetic problem only. Although large swellings may press on the windpipe, causing some difficulty in breathing. A goitre may also compress the gullet (oesophagus), causing difficulty in swallowing.
Some goitres are smooth and even. Some contain firm nodules that can be felt.
Treatment
Treatment may not be necessary if the goitre is not caused by disease and is small. Removal of the goitre may be necessary if it is causing difficulty with breathing or swallowing.
Treatment depends on the cause. Thyroid overactivity or underactivity will usually require treatment for those conditions. A goiter is an enlarged thyroid gland, and the symptoms are largely those of its physical presence, that is, a lump in the front of the neck, that can press on the nearby structures; and it may, depending on cause, be associated with abnormalities of function, either hyper- or hypo-thyroidism ( over or under), both of which are easy enough to Google. Medical Encyclopedia: Goiter
URL of this page: http://www.nlm.nih.gov/medlineplus/ency/...
Definition
A goiter is an enlargement of the thyroid gland. It is not cancer.
Causes, incidence, and risk factors
There are different kinds of goiters. A simple goiter usually occurs when the thyroid gland is not able to produce enough thyroid hormone to meet the body's needs. The thyroid gland makes up for this lack by enlarging, which usually overcomes mild deficiencies of thyroid hormone.
A simple goiter may be classified as either an endemic (colloid) goiter or a sporadic (nontoxic) goiter.
Endemic goiters occur within groups of people living in geographical areas with iodine-depleted soil, usually regions away from the sea coast. People in these communities might not get enough iodine in their diet (iodine is vital to the formation of thyroid hormone). The modern use of iodized table salt in the U.S. prevents this deficiency. However, inadequate iodine is still common in central Asia and central Africa.
In most cases of sporadic goiter the cause is unknown. Occasionally, certain medications such as lithium or aminoglutethimide can cause a nontoxic goiter.
Hereditary factors may cause goiters. Risk factors for the development of a goiter include female sex, age over 40 years, inadequate dietary intake of iodine, residence in an endemic area, and a family history of goiter.
Symptoms
Thyroid enlargement varying from a single small nodule to massive enlargement (neck lump)
Breathing difficulties, cough, or wheezing due to compression of the windpipe
Swallowing difficulties due to compression of the esophagus
Neck vein distention and dizziness when the arms are raised above the head
Signs and tests
Measurement of thyroid stimulating hormone (TSH) and free thyroxine (T4) in the blood
Thyroid scan and uptake
Ultrasound of thyroid -- if nodules are present, a biopsy should be done to check for thyroid cancer
Treatment
A goiter only needs to be treated if it is causing symptoms. The enlarged thyroid can be treated with radioactive iodine to shrink the gland or with surgical removal of part or all of the gland (thyroidectomy). Small doses of iodine (Lugol's or potassium iodine solution) may help when the goiter is due to iodine deficiency.
Expectations (prognosis)
A goiter is a benign (harmless) process. A simple goiter may disappear on its own, or may become large. Over time, hypothyroidism (not enough thyroid hormone) may develop due to destruction of the normal thyroid tissue. This can be treated with medications to replace the thyroid hormone.
Occasionally, a goiter may progress to a toxic nodular goiter when a nodule is making thyroid hormone on its own. This can cause hyperthyroidism (too much thyroid hormone) and can be treated with radioactive iodine to destroy the nodule.
Complications
Progressive thyroid enlargement or the development of hardened nodules may mean thyroid malignancy. All thyroid nodules should be biopsied to check for cancer.
A simple goiter may progress to a toxic nodular goiter.
Hypothyroidism may occur after treatment of a large goiter with radioactive iodine or surgery.
Calling your health care provider
Call your health care provider if you experience any swelling or enlargement in the front of your neck, increased resting pulse rate, or rapid heartbeats. Also call if you have diarrhea, nausea, vomiting, sweating without exercise or increased room temperature, shaking, agitation, shortness of breath, or signs of hypothyroidism such as fatigue, constipation, or dry skin.
Prevention
The use of iodized table salt prevents endemic goiter.
Update Date: 8/1/2005
Updated by: Nikheel S. Kolatkar, MD, Clinical and Research Fellow, Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. Review provided by VeriMed Healthcare Network.
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