- A simple goiter can occur without a known reason. It can occur when the thyroid gland is not able to make enough thyroid hormone to meet the body's needs. This can be due to, for example, a lack of iodine in a person's diet. To make up for the shortage of thyroid hormone, the thyroid gland grows larger.
- Toxic nodular goiter is an enlarged thyroid gland that has a small, rounded growth or many growths called nodules. These nodules produce too much thyroid hormone.
- Simple goiters may occur in people who live in areas where the soil and water do not have enough iodine. People in these areas might not get enough iodine in their diet.
- The use of iodized salt in many food products in the United States today prevents a lack of iodine in the diet.
- Certain medicines (lithium, amiodarone)
- Cigarette smoking
- Certain foods (soy, peanuts, vegetables in the broccoli family)
- Persons over age 40
- People with a family history of goiter
Some people with a simple goiter may have symptoms of an underactive thyroid gland.
In rare cases, an enlarged thyroid can put pressure on the windpipe (trachea) and food tube (esophagus). This can lead to:
- Breathing difficulties (with very large goiters)
- Swallowing difficulties
Exams and Tests
If you have a very large goiter, you may have swelling in your neck vein. As a result, when the doctor asks you to raise your arms above your head, you may feel dizzy.
Blood tests may be ordered to measure thyroid function:
- Free thyroxine (T4)
- Thyroid stimulating hormone (TSH)
- Thyroid scan and uptake
- Ultrasound of the thyroid
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Treatments for an enlarged thyroid include:
- Thyroid hormone replacement pills, if the goiter is due to an underactive thyroid
- Small doses of Lugol's iodine or potassium iodine solution if the goiter is due to a lack of iodine
- Radioactive iodine to shrink the gland, especially if the thyroid is producing too much thyroid hormone
- Surgery (thyroidectomy) to remove all or part of the gland