Thyroid Goiter

What is a thyroid goiter?

  • A thyroid goiter is a condition where your thyroid gland grows larger than normal. The thyroid gland is a small, butterfly-shaped organ in the front of your neck. It makes hormones (special chemicals) that act as messengers to help control how your body works. Thyroid hormones help control your body temperature, heart rate, and growth. They also control how fast your body changes and uses food for your energy needs. The amount of thyroid hormones in your body may increase, decrease, or both when you have a goiter. In some cases, the levels of these hormones may be normal.

  • Having your thyroid goiter seen 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.

What are the types of thyroid goiter?

A thyroid goiter may be diffuse or nodular. A diffuse goiter is when the whole thyroid gland is swollen. A nodular goiter may have one or more lumps (nodes) on or in the gland. Thyroid goiters may also be retrosternal or substernal. When most of the goiter is below the level of your clavicle (collarbone), it is called retrosternal. A substernal goiter grows below your sternum (breastbone). There is a small chance that a thyroid goiter may be cancer.

What causes a thyroid goiter?

Having too little or no iodine in your diet is the most common cause of a thyroid goiter. A thyroid goiter may also be caused by the following:

  • Diseases:

    • Autoimmune: Autoimmune thyroid disorders include Graves and Hashimoto's disease. They happen when the immune system attacks your thyroid gland. The immune system is your body's defense system against infections and diseases. A problem with the immune system may make your body attack even its own cells, including your thyroid gland. When this happens, the cells of the thyroid gland increase in number and do not work properly.

    • Other diseases: These include other thyroid disorders such as cancer, Plummer's disease, Riedel's thyroiditis, and subacute thyroiditis. A thyroid goiter may also be caused by one or more nodules (lumps) or cysts in your thyroid. Ask your caregiver for more information about these diseases.

  • Inherited: Thyroid goiter may be passed on from parents to their children through their genes. Genes are little pieces of information that tell your body what to do or make.

  • Medicines: This may include medicines used to treat mental disorders, such as lithium.

What may increase my risk of having a thyroid goiter?

The following may increase your risk if you live in an area of the world where there is little or no iodine:

  • Being pregnant.

  • Eating certain foods.

  • Having a family member with thyroid goiter.

  • Smoking cigarettes.

What are the signs and symptoms of a thyroid goiter?

You may have no signs and symptoms at first. As your thyroid goiter gets bigger, you may be able to clearly see it. A thyroid goiter is usually not painful. As your thyroid grows, it may press on your airway or the veins in your neck. This can cause signs and symptoms including the following:

  • Coughing or choking.

  • Flushed (red) face, and swollen neck veins.

  • Hoarse voice.

  • Noisy, high-pitched breathing.

  • Pain or trouble when you swallow food or liquids.

  • Trouble breathing when you are in certain body positions, such as lying down.

  • You may also have signs and symptoms of hyperthyroidism or hypothyroidism. Hyperthyroidism is when you have more than the normal amount of thyroid hormones. Hypothyroidism is when you have less than the normal amount of thyroid hormones. Ask your caregiver for more information about the signs and symptoms of these conditions.

How is a thyroid goiter diagnosed?

Your caregiver will ask you about your signs and symptoms, and when they started. You may also be asked if you have had thyroid surgery or any medical conditions. You will be asked what medicine you are taking, or have taken in the past. You may also be asked about your family's health. Your caregiver will look at and feel your neck. You may need any 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.

How is thyroid goiter treated?

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.

  • 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 back to normal. They may also be given to decrease your symptoms, such as choking.

  • 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.

What can I do to help treat my thyroid goiter?

  • Diet changes: Eat a variety of healthy foods such as fruits, whole-grain breads, low-fat dairy products, beans, lean meat and fish. You may need to eat foods rich in iodine. Iodine is an important mineral used by the thyroid gland to make thyroid hormones. Ask your caregiver for a list of foods that contain iodine. You may need to use iodized salt when cooking and seasoning your food. Ask your caregiver if you need to be on a special diet.

  • Quit smoking: It is never too late to quit smoking. If you have an autoimmune thyroid disorder, smoking can cause a thyroid goiter. Smoking also harms your heart, lungs, and blood. You are also more likely to have a heart attack, lung disease, and cancer if you smoke. You will help yourself and those around you by not smoking. Ask your caregiver for more information about how to stop smoking if you are having trouble quitting.

When should I call my caregiver?

Call your caregiver if:

  • You cough often, or feel like you are choking.

  • You have new symptoms of thyroid goiter.

  • Your voice becomes hoarse or you have trouble swallowing.

  • You have questions or concerns about your condition, treatment, or care.

When should I seek immediate help?

Seek care immediately or call 911 if:

  • You have chest pain, or trouble breathing all of a sudden.

  • You start seeing things that are not there.

  • Your symptoms suddenly get worse become worse, even after taking your medicines.

Where can I find support and more information?

Having a thyroid goiter may be hard. You may feel embarrassed if the lump in your neck is large and others can see it. You may have a hard time coping with your symptoms. Talk to your caregivers, family, or friends about your feelings. Contact any of the following:

  • American Thyroid Association
    6066 Leesburg Pike, Suite 550
    Falls Church , VA 22041
    Phone: 1- 703 - 998-8890
    Phone: 1- 800 - 849-7643
    Web Address:
  • Endocrine and Metabolic Diseases Information Service
    National Institutes of Health
    6 Information Way
    Bethesda , MD 20892-3569
    Phone: 1- 888 - 828-0904
    Web Address:

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. 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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