Nontoxic Nodular Goiter

Definition

A goiter is an enlargement of the thyroid. The thyroid is a gland. It makes hormones that help regulate the body’s use of energy. It is located on the front of the neck, below the Adam’s apple. Goiters are usually not painful. They tend to grow slowly.

There are different types of goiters. This is about nontoxic goiters which may be:

• Diffuse—enlarging the whole thyroid gland
• Nodular—enlargement caused by nodules, or lumps, on the thyroid

Goiter (Enlargement of the Thyroid Gland).

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Causes

The exact cause of nontoxic goiters is not known. In general, goiters may be caused by too much or too little thyroid hormones. The thyroid often works normally with a nontoxic goiter. Some possible causes of nontoxic goiter include:

• Family history of goiters
• Iodine deficiency
• Regular use of medicines such as:
  • Lithium
  • Propylthiouracil
  • Phenylbutazone
  • Aminoglutethimide

Risk Factors

Nontoxic goiter is more common in women and in people over age 40. It is also more common in undeveloped countries.

Other things that may raise the risk of nontoxic goiter are:

• A diet low in iodine
• Family history of goiter
• History of radiation therapy to head or neck—especially during childhood

Symptoms

Nontoxic goiters often do not have symptoms unless they grow too big. Symptoms may include:

• Swelling of the neck
• Problems breathing, coughing, or wheezing—with large goiter
• Swallowing problems—with a large goiter
• A feeling of pressure on the neck
• Hoarse voice

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. The doctor may advise seeing a specialist on hormone-related issues.

Tests may be done, such as:

• Blood tests
• Biopsy of a nodule usingfine needle aspiration

Diagnosis is based on symptoms and tests.

Images may be taken of the thyroid and nearby areas using:

• Ultrasound
• Thyroid scan
• Barium swallow
• X-ray

Treatment

Nontoxic goiters usually grow very slowly. They may not cause any symptoms. In this case, treatment is not needed.

Treatment may be needed if the goiter grows fast and affects the neck or breathing.

If a nontoxic goiter nodule is found to be cancerous, it will also need treatment. Treatment options include:

Prevention

Getting enough iodine in the diet helps prevent nontoxic goiter. In the US, iodine can be found in table salt and a variety of foods.