Goiter (Enlarged Thyroid): Types, Symptoms, Causes, and Treatment
A goiter is a condition affecting the thyroid gland. It causes an irregular growth of this gland usually due to the abnormal cellularchanges forming one or more lumps or nodules in the thyroid tissues.
A goiter may or may not be associated with any change in thyroid functions or an increase or decrease in the secretion of thyroid hormones.
What are the types and symptoms of goiter?
Most patients with goiter do not have any specific symptoms other than a visible swelling in the front of the neck. In some cases, the enlargement of the thyroid caused due to goiter is too small to be visible. In such cases, it is likely to be diagnosed during a routine physical examination and an imaging test done for other conditions.
The symptoms depend on the type of goiter, how it affects the thyroid functions, the rate of growth of the gland, and whether it is obstructing breathing. Depending on the underlying causes, a goiter can be categorized into different types as given below:
Obstructive goiter
The position and the large size of the goiter can sometimes obstruct the air passages and the voice box. This is called an obstructive goiter.
The symptoms of an obstructive goiter may include:
- Difficulty in swallowing
- Difficulty in breathing, especially on exertion
- Hoarseness of voice
- Cough
- Snoring
Hyperthyroidism (overactive thyroid)
The symptoms of hyperthyroidism may include:
- Rapid weight loss
- Tachycardia (rapid heartbeat)
- Increased sensitivity to heat
- Tremors
- Excess sweating
- Irritability
- Reduced sleep
- Frequent bowel movements
- Muscle weakness
- Changes in the menstrual pattern
- Increased appetite
- High blood pressure
- Faster growth in height in children
- Bone growth outpacing the expected growth in children
Hypothyroidism (underactive thyroid)
The symptoms of hypothyroidism may include:
- Unusual fatigue
- Increased sleepiness
- Increased sensitivity to cold
- Dryness of the skin
- Muscle weakness
- Constipation
- Problems with memory and concentration
Our Respiratory Therapy Webinars are aimed at evaluating the different types of goiters and the specific treatment options for each. This can help medical professionals provide the best treatment to their patients and improve the outcomes.
What are the causes of a goiter?
Iodine deficiency
Iodine plays a key role in the production of thyroid hormones. A deficiency of iodine in the diet can result in a decline in the hormone production in the thyroid. As a result, the pituitary gland sends signals to the thyroid to produce more hormones leading to thyroid growth or goiter.
Hashimoto's disease
It is an autoimmune disorder that occurs when the immune system attacks healthy tissues. The inflamed and damaged tissues of the thyroid gland do not produce enough hormones resulting in hypothyroidism.
When the decline in the production of thyroid hormones is detected by the pituitary, it prompts the thyroid gland to produce more hormones, causing it to become enlarged.
Graves' disease
It is another autoimmune disorder that occurs when the immune system produces certain proteins that mimic the thyroid stimulating hormone (TSH). This abnormal protein stimulates the thyroid to overproduce hormones leading to excessive thyroid growth and hyperthyroidism.
Some other causes of goiter include thyroid nodules, thyroid cancer, and thyroiditis.
Our Respiratory Therapy Continuing Education CEUsoffer comprehensive guidelines for the treatment of goiter based on the specific causes and symptoms of the condition.
What are the risk factors for goiter?
- A lack of dietary iodine is the most common risk factor for goiter.
- Goiter is more common in people above the age of 40 years.
- Women are more likely to develop this condition than men. Thyroid problems are also common in women during pregnancy and menopause.
- Patients with a family history of goiter or other thyroid disorders are more vulnerable to developing this condition. Researchers have identified some genetic factors that could be associated with a higher risk of this condition.
- Some medical treatments, such as heart medications like amiodarone, and a psychiatric medication called lithium, can increase the risk.
- Radiation exposure during treatments for cancer can increase the risk of goiter if the treatment is directed at the neck and chest areas.
Treatment of a goiter
The treatment of goiter depends on the extent of the thyroid enlargement, symptoms, and the underlying conditions.
If the goiter is small and the thyroid functions are normal, a wait-and-watch approach with routine check-ups may be recommended. However, if the enlargement is affecting the functions of the gland, the patient may need one or more of the following treatments.
Medications
Drugs for the treatment of goiter may include the following:
Medication for increasing hormone production
If the patient has an underactive thyroid, it can be treated with thyroid hormone replacement therapy. Drugs like levothyroxine and liothyronine can be prescribed to replace the thyroid hormone. This can prevent the excessive stimulation of the pituitary gland thereby reducing the release of TSH. These treatments often help to reduce the size of the goiter.
Medications for reducing hormone production
If the patient has an overactive thyroid, it may be treated with anti-thyroid drugs like methimazole that disrupt the hormone production.
Other than these, some patients also need treatment for blocking hormonal activities. Beta-blockers like atenolol can be prescribed for managing the symptoms of hyperthyroidism and disrupting the excess secretion of thyroid hormones.
If inflammation in the thyroid causes pain, it can be treated with painkillers like aspirin, naproxen sodium, and ibuprofen.
Surgery
Surgical intervention may be needed for the removal of all or a part of the thyroid gland to prevent or manage the following complications:
- Difficulty in breathing and swallowing
- Thyroid cancer
- Development of thyroid nodules that cause severe hyperthyroidism
Radioactive iodine treatment
Radioactive iodine is a form of treatment recommended for patients with an overactive thyroid gland. The doses of radioactive iodine are taken orally. The thyroid gland has the ability to take up the radioactive iodine that destroys the cells in the thyroid. This treatment can help to lower the production of hormones and reduce the size of the goiter.
Conclusion
The treatment of goiter depends on the underlying conditions and the levels of thyroid hormones. You can attend our Respiratory Therapy Conference to learn the latest diagnostic and treatment methods for the management of goiter.