Thyroid Goiter

WHAT YOU SHOULD KNOW:

  • A thyroid goiter is a condition where your thyroid gland slowly gets big. The thyroid gland is a small, butterfly-shaped organ found in the front of your neck. It makes thyroid hormones (special chemicals) that help control how your body works. When you have a goiter, the amount of thyroid hormones in your body may be normal, increased or decreased. Your thyroid goiter may be diffuse, nodular, retrosternal or substernal. There is a small chance that your thyroid goiter may be cancer. With thyroid goiter, you may often cough or choke, or have a flushed face and swollen neck veins. You may see a lump in your neck, have trouble breathing and swallowing, or have a hoarse voice.

  • Thyroid goiters are most often caused by having too little or no iodine in your diet. With low iodine in your body, being pregnant, smoking cigarettes or eating certain foods may increase your risk. You are more likely to have a goiter if others in your family have one. A thyroid goiter may also be caused by certain medicines, or other thyroid disorders. You may need an ultrasound, thyroid scan, biopsy, computed tomography (CT) scan, x-ray, and blood tests. A goiter may be treated with iodine, thyroid medicines, ethanol injection, or surgery. Small goiters may not need any treatment. Having your goiter checked by a caregiver will help him know if you need treatment. Treating a thyroid goiter may decrease it's size, and make your symptoms go away. It can also help caregivers learn if you have other medical problems related to or causing your goiter.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • Medicines used to treat your thyroid goiter may cause a fever, skin rash, joint pain, or liver problems. Surgery to remove the thyroid may damage nerves, tissues and other organs. Your larynx (voice box) may stop working. You may also bleed more than expected or get an infection. Even after treatment, your signs and symptoms may continue, or stop and then come back later.

  • If your goiter is not treated, the problems or symptoms you have may worsen. If the amount of thyroid hormones in your body is too high, your temperature and blood pressure increase, and your heart may not work as well. If the amount is too low, this can cause a dangerous condition called myxedema. With this condition, you may have fluid and swelling in your legs, ankles, lungs, or around your heart. Your body temperature decreases, your heart may beat very slowly, and you may have problems thinking clearly. You may even go into a coma or die if you do not get treatment right away. A thyroid goiter may be a sign of thyroid cancer, which can get worse and spread.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

An IV

is a small tube placed in your vein that is used to give you medicine or liquids.

Medicines:

You may be given the following medicines:

  • Radioactive iodine: This medicine damages cells in your thyroid gland, decreasing the amount of thyroid hormone in your blood. This may help your body work better. After taking radioactive iodine, your thyroid gland may still make too much or not enough hormone. If this happens, you may still need to take thyroid medicine.

  • Thyroid medicines: These medicines are given to replace, increase, or decrease your thyroid hormone levels. They may also be given to decrease symptoms such as choking.

Tests:

You may need one or more of the following:

  • Blood tests: You may need blood taken for tests. These tests tell your caregiver how high or low the levels of thyroid hormones are in your blood. The blood can be taken from a blood vessel in your hand, arm, or the bend in your elbow. You may need to have blood drawn more than once.

  • Fine-needle biopsy: For this test, a small piece of your thyroid gland is collected. A biopsy checks for problems such as thyroid cancer. Your caregiver may use medicine to numb the front part of your neck. A small needle is inserted to get the tissue sample from your thyroid gland. After the sample is taken, a bandage may be put over the biopsy area. The sample is sent to the lab for tests.

  • Imaging tests: Certain tests use a special dye to help pictures show up better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell your caregiver if you are allergic to shellfish, or have other allergies.

    • Chest x-ray: This is a picture of your chest. It shows caregivers if your thyroid goiter is blocking your airway, or pressing on nerves or blood vessels.

    • Computed tomography scan: This is also called a CT scan. An x-ray machine uses a computer to take pictures of your neck and chest. It may be used to look at your tissues, bones, muscles, and blood vessels. Before taking the pictures, you may be given dye through an IV (tube) placed in your vein.

    • Thyroid scan: This test shows caregivers how your thyroid is working. The working part of the thyroid gland absorbs (soaks up) the dye. Two to 48 hours later, caregivers put a machine called a scintillator over your neck. The machine takes pictures showing the areas of your thyroid that absorbed the dye.

    • Ultrasound: This is a test that uses sound waves to look inside your neck. Pictures of your thyroid gland show up on a TV-like screen.

Treatment options:

You may need any of the following:

  • Ethanol injection: This is usually done if you have a nodular thyroid goiter. Ethanol (alcohol) is given as a shot into the nodules to make them smaller. An ultrasound is used to help your caregiver put the shot to your thyroid gland. Ask your caregiver for more information about this treatment.

  • Iodine: This may be given if you have too little or no iodine in your diet. Iodine can be added to table salt, bread, and drinking water. You may also be given a shot of iodized oil when needed. Ask your caregiver for more information on how to increase the iodine level in your body.

  • Surgery: Caregivers may remove all or a part of your thyroid gland. This is done when you cannot take thyroid medicines, or have trouble breathing or swallowing. This may also be done when your thyroid goiter is retrosternal. Ask your caregiver for more information about thyroid surgery.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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