A goiter is a swelling of the thyroid gland. It can be caused from a variety of conditions affecting the thyroid, such as underactivity of the gland (hypothyroidism), overactivity (hyperthyroidism), thyroid nodules or inflammation (thyroiditis). The thyroid can also become enlarged temporarily and subside on its own without treatment. Rarely, a goiter can be caused by thyroid cancer.

Outside of the United States, a goiter occurs most often because of a lack of iodine, which is the substance the gland uses to make thyroid hormone. The thyroid swells because it is being stimulated to produce more thyroid hormone by the pituitary gland, which releases thyroid stimulating hormone (TSH) into the bloodstream.

In the U.S. iodine has been added to table salt so that, today, a goiter caused from a lack of iodine is a rare occurrence.

Signs and Symptoms

  • Swelling of the neck
  • Hoarseness
  • Sore throat
  • Coughing
  • Difficulty swallowing
  • Feeling of pressure in the neck
  • Rarely, difficulty breathing at night

Treatment

Treatment for goiter will depend on what underlying condition is causing the disorder. If your blood tests show that you have hypothyroidism or thyrotoxicosis, these conditions will be treated accordingly, which may alleviate the goiter.

In some cases your doctor may recommend surgery if the goiter is large and is pressing on the trachea or esophagus. Your doctor will discuss your treatment options with you in greater detail.

Your doctor will run a number of diagnostic tests to determine what treatment is appropriate.