A Goiter is one of the commonest types of thyroid disorders. It is characterized by an enlarged thyroid gland that results in swelling of the neck. Goiters do not cause any harm to a person. Depending on the type, and size of this enlarged gland, your doctor may prescribe you the treatment. In this article, you will get a clarity about its causes, symptoms, and treatment.

Facts on Goiter

Below are mentioned some major points related to Goiter.

1. Goiter is described as a condition that causes the thyroid gland to grow abnormally larger. This gland is located at the base of the neck of the person.
2. Normally, a Goiter is painless, and does not have any impact on the production of thyroid hormones in the body.
3. One of the major reasons for Goiter is an autoimmune disease.
4. Physical examination is the fundamental tool to diagnose Goiter. To get more clarity on this treatment, your doctor may advise you to perform blood tests and scans.
5. Unless the Goiter is large and causes discomforting symptoms, there is no need to perform any treatment.
6. In a few areas of the world, the occurrence of goiters is as high as eighty percent (80%). These areas include the remote hilly regions of southeast Asia, central Africa, and Latin America. Consumption of iodine in these areas is below 25 micrograms (mcg) daily. Children are mostly born with hypothyroidism.

What is Goiter?

Thyroid is a small gland that is located in the neck below the Adam’s Apple. This gland appears like a small butterfly. It is responsible for the secretion of the T4 hormones or thyroxine, and T3 hormone or triiodothyronine.

Both of these hormones have a significant role to play in the body of a person. This includes mood, pulse rate, excitability, body temperature, digestion, and more. These hormones aid in the production of hormones that aids in controlling the metabolism and various other vital procedures in the body.

Goiter Causes

Now that we have known what is Goiter, let us know what causes this condition to occur in the body.  Though Goiter is painless, but if it grows in an abnormal way, then it can interfere with the process of breathing and swallowing.

There are three scenarios when people develop a Goiter:

1. When the thyroid gland secretes excessive amounts of thyroid hormones (T3 and T4) in the body. This condition is termed as “hyperthyroidism”. The reason for the thyroid gland to become overactive is due to the result of Graves’ disease where the defense system of the body attacks the thyroid gland, and causes swelling in it.
2. Goiter can also happen when the body produces too little amount of these hormones, that is termed as “hypothyroidism”. When this underactive gland is stimulated to enhance secretion, it results in the swelling.
3. It is also seen in people who produce normal levels of thyroid hormones. This condition is termed as “euthyroidism”.
4. Another reason for occurrence of Goiter is due to the consumption of specific drugs that contains the medicine lithium for the treatment of specific mental health ailments and other medical conditions that causes it. Medicines such as antiretrovirals, immunosuppressants, heart drugs like Cordarone and Amiodarone can lead to Goiter.
5. Graves’ disease : Goiter is also caused due to an auto-immune condition. Grave’s disease is one of the examples of this disease. In this condition, the defense system of the body falsely damages the thyroid gland. This causes production of excessive amounts of hormones in the body. It can result in swelling of the thyroid gland.
6. Hashimoto’s thyroiditis : This is another key autoimmune disease that has the ability to damage the thyroid gland. Due to the auto-immune effect, the thyroid gland produces meager amounts of hormones that ultimately results in development of Goiter.
7. Thyroid cancer : Thyroid is one of the areas where cancer-causing cells can develop and spread. This can cause enlargement of the organ and damage its functionality.
8. Pregnancy : This is the phase when women secrete hormones that can results in an increase in size of the thyroid gland.
9. Thyroiditis : Under this condition, the thyroid gland becomes inflamed and enlarge.
10. Age : Women who are above the age of forty years, going through menopause or have family history of the condition are more susceptible to this condition.
11. Genetic : Goiter is a hereditary disease. This implies that if any person in your family is suffering from this disease, then there are higher chances for developing this condition.

Some of the less common causes that leads to Goiter are:

1. Smoking: Tobacco smoke has a chemical named “Thiocyanate” that is seen to cause interference with absorption of iodine in the body.
2. Hormonal changes: Pregnancy, menopause, and puberty, can impact the functioning of thyroid gland in the body.
3. Overconsumption of iodine: Excess consumption of iodine can also lead to Goiter.
4. Radiation therapy: When a person is exposed to radiations, especially the neck region, then it can cause swelling in the thyroid gland.

Types of Goiter

Goiter is defined into a few types depending on its causes.

1. Simple Goiter occur when the thyroid gland fails to produce the needed amounts of hormones to fulfill the requirements of the body. Due to which this gland grows in size to compensate for this shortage.
2. Endemic Goiter takes place in people who lives in specific areas of the world that fails to get adequate iodine. It is an essential compound that is useful for making thyroid hormone and regulating metabolism in the body. People who are in developed countries do not suffer from this type of Goiter, as in those places, iodine is added to salt on a routine basis.
3. Diffuse smooth Goiter is a type of Goiter that happens when the thyroid gland become swollen in the body.
4. Nodular Goiter is a type of Goiter that is classified as a lump on the thyroid. This type of Goiter is very common. Development of several lumps in the body can lead you to multinodular goiter.
5. Retrosternal Goiter is another type of Goiter that can develop behind the breastbone. This can restrict the windpipe, esophagus, and neck veins. It requires surgery to treat this condition.

Signs of Goiter

People who have develop Goiter, can either show none of these signs, or show below symptoms:

1. Swelling in the lower region of the neck
2. Tightness in the throat
3. Huskiness
4. Shortness of breath
5. Trouble in swallowing
6. Coughing
7. Dizziness when your arms are elevated over the head
8. Swelling in the neck vein
9. Changes in personality
10. Wheezing
11. A high resting pulse rate
12. Increased heartbeat
13. Constipation
14. Diarrhea
15. Vomiting
16. Shaking
17. Forgetfulness
18. Nausea
19. Gaining Weight
20. Sweating without physical activity, or high temperature
21. Agitation
22. Dryness in the skin
23. Irregularities in Menstruation
24. Cold intolerance
25. Loss of hair

Diagnosis of Goiter

To diagnose a Goiter, your doctor may simply feel your neck and ask you to swallow while monitoring your response. Other ways to diagnose a goiter include:

1. Hormone test : Measuring certain hormone levels in a blood test can reveal whether your thyroid gland is working properly.
2. Antibody test : This blood test measures abnormal antibodies that are produced if you have a predisposition to autoimmune thyroid disease.
3. Ultrasound : This imaging test lets your doctor see the size of your thyroid gland and determine whether it contains any nodules (which can change the levels of hormones it produces).
4. Thyroid scan : This imaging test provides information about the size and function of your thyroid gland.
5. MRI or CT scan : These imaging tests may be used if your goiter is very large or has spread into the chest.
6. Biopsy : This procedure involves inserting a needle into your thyroid gland to obtain a tissue or fluid sample, which is then examined under a microscope or subjected to other tests.

Goiter Treatment

Simple goiters do not need any specialized treatment. They are preventable via adequate consumption of iodine in several nations. There are a wide range of iodine supplements that you can buy online.

Active treatment of Goiter is needed to be done in only those cases that can lead to symptoms. If the size of Goiter is small, as well as thyroid function is normal, then treatment is not offered. The exact treatment for the Goiter depends on the causes, size, and its symptoms.

If the Goiter is small, and does not cause any discomfort, then it may not require any treatment. If it grows abnormally or gets modified then it should be treated. Below are some of the options that your doctor may prescribe you to treat this condition.

1. Medications : Your doctor can advise you to consume aspirin or prescribe a corticosteroid if there is an inflammation in the gland.
2. People with hypothyroidism, or underperforming thyroid, would need to consume Synthroid, or Levothroid to replace the deficiency of hormones.
3. In case of hyperthyroidism, or an overactive thyroid, your doctor will prescribe you medicines to reduce the aggravated levels of thyroid hormone to its normal levels.
4. Surgery : If your doctor notices an abnormal increase in the size of the Goiter, then he may even recommend a surgical procedure named “thyroidectomy”. This method helps in the removal of certain parts of the thyroid gland. Such extremely large size can pose difficulties while swallowing, or breathing.
5. Radioactive Iodine : This treatment is given to reduce the size of the thyroid gland and bring it to normal levels. Radioactive iodine is consumed orally via mouth.

Specialized Treatment for Goiter

If the doctor needs further clarity of the condition, he may advise you to perform below specialized tests.

1. Ultrasound scans that are helpful in the visualization of your thyroid gland.
2. On the identification of a Goiter, your doctor can find out any basic issues associated with the operation of the thyroid gland such as hypothyroidism, and hyperthyroidism.
3. Thyroid function tests are blood tests that aids in measuring levels of TSH, and T4 hormone. According to findings of a carefully monitored mechanism, TSH stimulates the thyroid gland to synthesize more thyroxine and T4 instructs the thyroid gland to reduce production of thyroxine. In people who have an overactive thyroid, T4 levels are high, and TSH levels are low. This is exactly opposite in case of people with an underactive thyroid.
4. Radioactive iodine scan helps the doctor to get a clear and comprehensive picture of the gland that follows an injection of harmful radioactive iodine.
5. Ultrasound scan is carried out to evaluate the gland as well as the size of the enlarged thyroid gland, or Goiter.
6. Fine-needle aspiration is a form of a biopsy that helps in the elimination of cells from within the thyroid gland that are performed when cancer is diagnosed.
7. Hypothyroidism is dealt with a synthetic replacement procedure of thyroid hormone. The dose amount of synthetic form of T4 hormone, or thyroxine is slowly increased till normal thyroid operation is restored. Your doctor can prescribe you synthetic formulations of T4/ TSH or both.
8. In case of over production of thyroid hormone or Hyperthyroidism, anti-thyroid drugs, like thionamide drugs lessen excess levels of hormone in the body. Radioactive iodine helps in stopping production of thyroid hormone or reduction of thyroid function.
9. Goiter surgery lessens the size of swelling where the Goiter causes troublesome symptoms, that includes difficulty swallowing, and breathing. Thyroidectomies is a surgical procedure that is performed using general anesthetic for the removal of the impacted region of the thyroid gland.

Conclusion

Goiter does not indicate inefficient or abnormal functioning of the Thyroid gland. In most of the cases, the condition does not cause any pain, and discomfort to a person. Due to which it is generally not required to treat this condition. However, if it causes trouble while swallowing food, breathing, or interferes with the functioning of the thyroid gland, then you should seek doctor’s assistance.

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