WHAT IS GOITER

A goiter (GOI-tur) is an enlarged thyroid gland. The thyroid is a butterfly-shaped gland situated at the base of your neck just below your Adam’s apple and is responsible for producing and secreting hormones that regulate growth and metabolism. Although goiters are often painless, a large goiter can cause a cough and make it hard for you to swallow or breathe.

The most major cause of goiters worldwide is a lack of iodine in the diet. In the United States, where iodized salt is commonly used, a goiter is often common due to the over- or underproduction of thyroid hormones or to nodules that develop in the gland itself.

Treatment lies on the size of the goiter, your symptoms and the common cause. Small goiters that aren’t noticeable and don’t cause problems often don’t need treatment.

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Symptoms

Not all goiters cause signs and symptoms. When signs and symptoms do happen they may include:

An apparent swelling at the base of your neck that may be especially obvious when you shave or wear makeup

Coughing

A tight feeling in your throat

Difficulty swallowing

Hoarseness

Difficulty breathing

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Causes

Your thyroid gland produces two major hormones — thyroxine (T-4) and triiodothyronine (T-3). These hormones circulate in your bloodstream and help regulate your metabolism. They keep up the rate at which your body makes use of fats and carbohydrates, help regulate your body temperature, influence your heart rate, and help control the production of proteins.

Your thyroid gland also secretes calcitonin — a hormone that helps to keep in check the amount of calcium in your blood. Your pituitary gland and hypothalamus regulate the rate at which these hormones are produced and released.

The process starts when the hypothalamus a region at the base of your brain that behaves like a thermostat for your whole system, signals your pituitary gland to produce a hormone known as thyroid-stimulating hormone (TSH). Your pituitary gland also situated at the base of your brain secretes a certain amount of TSH, depending on the amount of thyroxine and T-3 is in your blood. Your thyroid gland, in turn, control its production of hormones based on the how much of TSH it receives from the pituitary gland.

Having a goiter doesn’t really mean that your thyroid gland isn’t functioning normally. Even when it’s enlarged, your thyroid may secrete normal amounts of hormones. It might also, however, produce excess or too little thyroxine and T-3.

Underlined factors can make your thyroid gland to enlarge. Among the most common are:

Iodine deficiency: Iodine, which is vital for the production of thyroid hormones, is gotten primarily in seawater and in the soil in coastal region. In the developing world, those who live inland or at high elevations are usually iodine deficient and can develop goiters when the thyroid enlarges in an effort to get more iodine. The initial iodine deficiency may become even worse by a diet high in hormone-inhibiting foods, such as broccoli cabbage, and cauliflower.

Although a lack of dietary iodine is the leading cause of goiters in many parts of the world, this is not often the problem in countries where iodine is routinely added to table salt and other foods.

Graves’ disease: A goiter can sometimes happen when your thyroid gland makes too much thyroid hormone (hyperthyroidism). In Graves’ disease, antibodies produced by your immune system unknowingly attack your thyroid gland, resulting to production of excess thyroxine. This overstimulation causes the thyroid to swell.

Hashimoto’s disease: A goiter can also be caused from an underactive thyroid (hypothyroidism). Like Graves’ disease, Hashimoto’s disease is an autoimmune condition. But instead of causing your thyroid to produce excess hormone, Hashimoto’s damages your thyroid so that it produces very little.

Multinodular goiter: In this condition, several solid or fluid-filled lumps known as nodules occur in both sides of your thyroid, leading to overall enlargement of the gland.

Solitary thyroid nodules: In this condition, a single nodule develops in one part of your thyroid gland. Most nodules are noncancerous (benign) and don’t cause cancer.

Thyroid cancer: Thyroid cancer is far less common than benign thyroid nodules. A biopsy of a thyroid nodule is very accurate in analyzing if it’s cancerous.

Pregnancy: A hormone produced during pregnancy, human chorionic gonadotropin (HCG), may make your thyroid gland to enlarge slightly.

Inflammation: Thyroiditis is an inflammatory problem that can cause pain and swelling in the thyroid. It may also trigger an over- or underproduction of thyroxine.

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Risk factors

Anyone can be affected by goiters. They may be present at birth and happen at any time throughout life. Some common risk factors for goiters may include:

A lack of dietary iodine: Those living in areas where iodine is in short supply and who don’t have access to iodine supplements are at greater risk of goiters.

Being female: Women are more prone to thyroid conditions, they’re also more likely to have goiters.

Your age: Goiters are more common at age 40 and above.

Medical history: A personal or family history of autoimmune condition increases your risk.

Pregnancy and menopause: For reasons that aren’t entirely known, thyroid problems are more likely to happen during pregnancy and menopause.

Certain medications: Some medications, such as the heart drug amiodarone (Cordarone, Pacerone, others) and the psychiatric drug lithium (Lithobid, others), elevates your risk.

Radiation exposure: Your risk rises if you’ve had radiation treatments to your neck or chest region or you exposed yourself to radiation in a nuclear facility, test or accident.

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Complications

Small goiters that don’t cause physical or cosmetic issues aren’t a concern. But large goiters can make it difficult to breathe or swallow and can cause a cough and hoarseness.

Goiters that result from other conditions, including hypothyroidism or hyperthyroidism, can be connected with a number of symptoms, ranging from fatigue and weight gain to unintended weight loss, irritability and difficulty sleeping.

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