Symptoms of Goiter: Types, Causes, Diagnosis, and Treatment

Goiter Explained: Symptoms, Types, Causes, and Treatment

Goiter is a condition in which the thyroid gland grows larger and leads to neck swelling. This can be a precursor to many diseases, such as hormonal imbalances and nutrient deficiencies.

The NFHS IV (2015-2016) reports that among the population aged 15-49, 2% of the women and less than 1% of the men reported having goitre or thyroid disorders. Proper disease management involves knowledge about goitre symptoms, causes, and treatment.

Let's explore the different categories of goitres, diagnosis, and prevention methods to help you become better informed about maintaining your thyroid's health.

What is Goiter?

An enlarged butterfly-shaped gland housed in the base of the neck is referred to as a goitre. The thyroid regulates metabolism, manages heart rate, and also provides overall hormonal balance within the body.

A goitre in the neck area can cause an enlarged thyroid gland. A goitre might be associated with an imbalance of thyroid hormone levels, which can indicate too much (hyperthyroidism) or too little (hypothyroidism), or it can occur even if the hormone levels are normal (euthyroidism).

What are the Types of Goiter?

Depending on the type and nature of the goitre, the symptoms and medications may vary. The principal types of goitres are discussed in the table below:

Type of Goiter	Description
Multinodular Goiter	Multinodular Goiter is the most common type of Goiter that occurs when several nodules form in the thyroid gland. The nodules are usually discovered via examination or scans.
Diffuse Smooth Goiter	This is swelling of the entire thyroid gland, sometimes associated with an overactive and an underactive thyroid gland.
Retrosternal Goiter	In this case, the goitre develops behind the breastbone, may press on the windpipe, neck veins, or the oesophagus, and thus sometimes requires surgery.
Endemic Goiters	Also known as Colloid Goiter, it occurs when the diet has insufficient iodine. Iodine is required for the thyroid to produce hormones.
Toxic Goiter	This occurs when there is enlargement in the thyroid, which results in excessive production of goitre thyroid hormone.
Non-toxic Goiter	In this case, there is an enlargement of the thyroid, but hormone levels are normal, which could neither raise suspicion of hyperthyroidism nor hypothyroidism.

What are the Symptoms of Goiter?

The common symptoms of goitre include swelling in the front of the neck, which may appear as a small nodule, several nodules, or generalized enlargement of one or both sides. Besides, you may also experience:

Hoarseness
Tightness in your throat
Swollen veins in your neck
Dizziness when you raise your arms
Trouble breathing or swallowing
Coughing

If you are suffering from toxic goitre disease with hyperthyroidism, you can also experience:

Increased sweating
Diarrhea
Nausea
Rapid heartbeats
Shakiness or hand tremors
Loss of weight despite the appetite
High blood pressure
Sweating
Restlessness
Muscle weakness

In case you suffer from hypothyroidism, you will also be aware of the following:

Dry skin
Fatigue
Irritation of the menstrual cycle
Weight gain
Constipation
Lower activities and thought process
Depression
Decreased heart rate
Feeling numb in your limbs
Numbness in your hands

What are the Causes of Goiter?

Goiter is an adaptive reaction of the thyroid cells that hinders the production of thyroid hormones. Here are the significant causes of goitre:

Graves' Disease

It is also an autoimmune condition where the body system mistakenly attacks the thyroid gland, causing it to enlarge. It is accompanied by hyperthyroidism as well and must be medically treated.

Hashimoto's Disease

It is an autoimmune disease that characterizes Hashimoto's, causing thyroid gland inflammation. Some people are sensitive, with an overgrowth of the gland as well as the typical symptoms. The goitre usually improves spontaneously, but some patients need treatment with replacement doses of thyroid hormones.

Thyroid Cancer

Often, cancer cells in the thyroid will cause the thyroid to enlarge, thus leading to goitre.

Thyroiditis

The thyroid gland can become inflamed for several reasons, causing an enlargement of the thyroid, thereby forming a goitre.

Pregnancy

Human Chorionic Gonadotropin, a hormone released during pregnancy, enlarges the thyroid and can cause goitre.

Iodine Deficiency

Thyroid hormones are generated only in the presence of iodine. When iodine is deficient in the body, the thyroid tries to increase hormone production by proliferating cells.

Note: A small deficiency in iodine increases the chances of goitre between 5% and 20%.

Diagnosis of Goiter Disease

Goitre diagnosis is usually made by the doctor's simple visual inspection of the neck. After that, you need additional tests to find out the cause and its effects, as well as possibly further action for treatment, if required. Some of these tests can be:

Blood Test for Thyroid

The blood test measures the levels of thyroid hormones to determine whether your thyroid is functioning well.

Test for Antibodies

This detects specific antibodies related to certain kinds of goitre. Antibodies are proteins in white blood cells that help protect your body against infections and diseases.

Thyroid Ultrasound

This uses high-frequency sound waves to measure the thyroid, which is then captured and turned into pictures or videos. This enables the doctor to study the thyroid in terms of its size and the presence of nodules.

Biopsy

This is a procedure where a small sample of tissue or cells is taken from the thyroid for lab analysis. It may be required if there are large nodules in the thyroid, so the doctor checks for malignancy.

Thyroid Uptake and Scan

This is an imaging test that evaluates the size and function of your thyroid. A small amount of radioactive material is injected into a vein to help form a computer picture of your thyroid. It is ordered less frequently and usually only for specific conditions.

CT Scan or MRI

If the goitre is large or extends within the chest, a CT scan or MRI is obtained to assess its size and extent.

Treatment of Goiter Disease

The goal of goitre treatment is to normalize the levels of thyroid, thereby lessening goitre. Goitre treatment without surgery can also be done. However, a decision on treatment is made by the doctor, depending on what causes the goitre and how severe it is:

Medication

A person suffering from hypothyroidism may need some pills containing thyroid hormone; such may help restore the thyroid to its normal parameters. However, a sizeable nodular goitre with excessive amounts of scar tissue is unlikely to shrink. Any inflammation-based goitres may require aspirin or corticosteroids.

Surgery

If goitre causes discomfort, thyroxin is in excess and cannot be controlled by drugs, reaches a size interfering with breathing or performance of other activities, or is diagnosed as cancerous, the surgeon will excise the affected portion of the thyroid gland.
Depending on the extent of the surgery, you may need to take thyroid hormone replacement medications for the rest of your life following surgery.

Radioactive Iodine

Goitre removal can also be done with radioactive iodine. This can be in the form of a pill you would take that targets an overactive thyroid. This treatment kills cells to decrease the size of the thyroid. You will probably be on hormone medication after receiving this kind of treatment.

Goiter may imply a variety of underlying health issues; however, timely diagnosis and proper treatment can effectively manage it. Knowing the symptoms, causes, and prevention methodologies is crucial for maintaining thyroid health.

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FAQ

What is goitre ICD-10?

In the ICD-10 coding system, goitre has been classified under the codes E04.0 to E04.9, relating to goitre, i.e., toxic and nontoxic goitre. These codes facilitate practitioners in documenting and categorizing goiter-related conditions to diagnose, treat, and secure insurance

Can goitre treatment be done without surgery?

Yes, there are many treatments for goitre other than surgery; it can be treated either with drugs like levothyroxine, which regulates hormonal levels or even with radioactive iodine therapy in cases of hyperthyroidism. However, a doctor can only recommend the ideal treatment based on your specific condition.

What are some effective measures for goitre prevention?

Ensuring adequate iodine intake through a well-balanced diet is essential for goitre prevention, as it is the leading cause of goitre. Other measures can also be ensured, such as proper health check-ups on thyroid function and consumption of diets rich in essential nutrients.

What if I feel the onset of goitre symptoms?

If you have goitre symptoms, such as neck enlargement, swallowing pain, or hormonal imbalance, consult a doctor immediately. After performing a complete check-up, including a physical examination and necessary tests, the doctor will find the cause of your problem and recommend the best treatment.