A goiter is an enlarged thyroid gland. It can range from an enlargement that is slight and unnoticeable to a lump that is visible and pronounced. In some cases a goiter is not associated with thyroid disease, and in other cases the presence of a goiter can be a sign of hypothyroidism. If you have a goiter, your healthcare provider can use tests to determine what may be causing it.
Thyroid nodules and thyroid cancer
Thyroid nodules are lumps that may develop on the thyroid. They can range in size, and they can appear as a single nodule or as many nodules. If you have many, it causes a goiter—this is called a multinodular goiter.
Most thyroid nodules are benign, which means they are harmless. But in about 5% of cases, these nodules can be cancerous.1 This risk might be higher for you if you have a family history of thyroid cancer, or if you have a history of radiation exposure, particularly to the head or neck.2 Because thyroid cancer is a possibility, it is important to share with your healthcare provider if you think you see or feel nodules on your thyroid.
Signs and symptoms of a goiter or thyroid nodule
In addition to seeing or feeling lumps on your throat, other signs and symptoms of a goiter or thyroid nodule can include 3
• Hoarse voice
• Difficulty swallowing
• Feeling of fullness in the throat
• Pain in the neck or ear
If you are experiencing any of these symptoms, see your doctor right away for a proper diagnosis.goiter, thyroid nodules and thyroid cancer
Diagnosing thyroid conditions
Your doctor will evaluate your symptoms, perform a physical examination, and use tests to determine if you have a goiter, thyroid nodules or thyroid cancer. And since these conditions can be associated with hypothyroidism, your doctor may use a thyroid-stimulating hormone (TSH) test to determine if you have hypothyroidism, too.
TSH is produced by the pituitary, a small gland in your brain. TSH is a hormone your body naturally produces if it senses that your thyroid is not releasing enough of its main hormone, thyroxine. A healthy thyroid receives the message and responds by producing more thyroxine. This helps to keep your hormone levels within a normal range.
If you have hypothyroidism, your TSH levels will often be elevated because your thyroid is not able to produce enough thyroxine. This overproduction of TSH can enlarge the thyroid, causing a goiter.3
A TSH test can help determine if your thyroid is underperforming, and if you may have hypothyroidism. It is recognized as the most reliable test of its kind.3
Your healthcare provider may also use other tests to determine the nature of a goiter or thyroid nodule. These may include other thyroid function tests or scans, an ultrasound or a biopsy. A specific biopsy called fine needle aspiration is often used to determine the nature of a goiter or thyroid nodule.3 This procedure can be done in a doctor’s office under local anesthetic and can determine if a thyroid nodule is cancerous or benign.
Treatment for thyroid conditions
If hypothyroidism is causing your goiter or thyroid nodules, your healthcare provider will probably prescribe a medication that replaces the thyroid hormone your body needs but is not producing.
If you are prescribed a thyroid replacement treatment, it is important to keep taking your medication, even if your goiter or thyroid nodules disappear. Your healthcare provider will carefully monitor your TSH levels regularly. Over time, your treatment strength may need to be adjusted.3 Generally, thyroid replacement therapy is to be taken for life.
It is also possible that a goiter or small thyroid nodule will not require any immediate treatment.
Your healthcare provider may just monitor your thyroid levels over time to make sure no further action is needed.
Sometimes thyroid nodules can be shrunk with thyroid hormone treatment. However, if a nodule is cancerous or if…