Nontoxic Nodular Goiter
(Sporadic Goiter; Simple Goiter; Nodular Enlargement of the Thyroid Gland)
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
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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:
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
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
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:
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:
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.
- Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016;26(1):1-133.
- Gharib H, Papini E, Garber JR, et al; AACE/ACE/AME Task Force on Thyroid Nodules. American Association of Clinical Endocrinologists, American College of Endocrinology, and Associazione Medici Endocrinologi Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules. Endocr Pract. 2016;22(5):622-39.
- Nontoxic Multinodular Goiter. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/nontoxic-multinodular-goiter.
- Mark D. Arredondo, MD
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