Definition A goitre is an enlargement of the thyroid gland that is not due to cancer. The thyroid gland is located in the neck just below the Adam's apple.
What is going on in the body? Thyroid hormone is important for the body's metabolism. A goitre commonly occurs when the thyroid gland cannot make enough thyroid hormone to meet the body's needs, a condition known as hypothyroidism. The thyroid gland responds by getting bigger. This may allow it to make enough thyroid hormone.
What are the signs and symptoms of the condition? Someone with a goitre may not have any symptoms. If symptoms are present, they may include:
thyroid enlargement, which can range from slightly bigger to massively enlarged
What are the causes and risks of the condition? Goitre is seen most often in people who:
eat too little iodine in the diet
eat large amounts of certain foods such as cabbage, peanuts, peaches and spinach
are taking certain medications, such as lithium, iodides, and cobalt
have a family history of goitre
are female
What can be done to prevent the condition? Getting enough iodine in the diet can prevent some individuals from getting one form of goitre in countries where iodine is deficient. Avoiding foods and medications that can cause a goitre may also help prevent the condition. Some cases cannot be prevented.
How is the condition diagnosed? The doctor will take a medical history and perform a physical examination. A lump in the throat may indicate a goitre. It can also signal a more serious problem such as cancer of the neck or thyroid cancer. Blood tests and special x-rays are also used to help with the diagnosis.
What are the long-term effects of the condition? Untreated, goitre may lead to the compression of the trachea and oesophagus. Most goitres are small and do not cause serious long-term effects.
What are the risks to others? Goitre is not contagious so there are no risks to others.
What are the treatments for the condition? The goal of treatment is to reduce the size of the thyroid gland. Thyroid hormone replacement pills are the treatment of choice. These medications will supply some of the body's requirement for thyroid hormone in a person with hypothyroidism and allow the gland to rest.
If goitre is due to inadequate intake of iodine, taking small doses of iodide will relieve the condition. A person may need to avoid certain foods and medications in some cases of goitre. Rarely, surgery is necessary when the goitre does not respond to other treatment.
What are the side effects of the treatments? Too much thyroid hormone can cause toxic levels to build up in the body. This can lead to symptoms such as fast heartbeat, diarrhoea, and insomnia. If the goitre was brought on by a particular medication, the condition the medication was being used to treat could worsen or return if it is discontinued. Surgery carries the risks of bleeding, infection, and allergic reaction to anaesthesia.
What happens after treatment for the condition? The thyroid gland should decrease in size after treatment. This will improve symptoms.
How is the condition monitored? A person with goitre should be seen regularly by the doctor to monitor the status of the thyroid gland.
Author: Gail Hendrickson, RN, BS Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
