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Johns Hopkins Symptoms and Remedies

Johns Hopkins Medicine

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Goiter

What is it?

A goiter is an enlargement or swelling of the thyroid, a gland in the throat that secretes a hormone which regulates body growth and metabolism. Goiters vary in size and, though sometimes unsightly, are generally painless. Rarely, a goiter may press against the trachea or esophagus, causing difficulty in breathing or swallowing. The disorder affects women four times more often than men.

What Causes It?

  • A goiter is a common manifestation of Graves' disease (hyperthyroidism) and Hashimoto's thyroiditis, two serious thyroid disorders.
  • Benign or malignant tumors of the thyroid gland may result in a goiter.
  • Certain drugs designed to slow thyroid hormone production may cause goiters.
  • Goiters may appear in women because of hormonal changes that occur with pregnancy.
  • Goiters can be caused by insufficient amounts of iodine in the diet. This is now rare in the United States since the advent of iodized salt.

Prevention

  • There is no known way to prevent goiter except in cases caused by a dietary insufficiency of iodine.

Diagnosis

  • Patient history and physical examination are needed.
  • Blood tests, taken to evaluate the functional status of the thyroid gland, may also help to determine the underlying cause of the goiter.
  • Thyroid scan with radioactive iodine or an ultra- sound exam may be done.
  • Fine-needle biopsy may be performed to rule out malignancy.

How to Treat It

  • Thyroid-hormone-replacement therapy may ease the demand on the gland to produce thyroid hormone, which may cause it to decrease in size.
  • Surgical removal of all or part of the thyroid may be necessary if the goiter is large, causes difficulty in breathing or swallowing, or is due to a malignant tumor.
  • Your doctor may alter your prescription if the goiter is due to a medication.
  • A diet that includes iodized salt and fish is advised in the unlikely event of iodine deficiency.

When to Call a Doctor

  • Call a doctor for any swelling in the neck.