Medically reviewed by
Dr. Katie Rothwell, ND, a licensed Naturopathic Doctor with clinical focus in thyroid conditions and Hashimoto's disease through The College of Naturopaths of Ontario, Canada.
A goiter is simply an enlarged thyroid gland. The thyroid gland, located in the neck, is responsible for producing hormones that regulate various bodily functions, such as energy metabolism.
When the thyroid gland enlarges, it can lead to a visible swelling in the neck. There are various possible causes of goiter, including iodine deficiency, autoimmune disorders, and certain medications. Effective treatment of this condition will largely depend on the underlying cause.
If an iodine deficiency causes the goiter, increasing iodine intake can help shrink the goiter. Iodine is necessary for thyroid hormone production, so increasing its intake may help restore the proper functioning of the thyroid gland.
This can be achieved through dietary changes or supplements, albeit under the directions of your healthcare provider. Medications may sometimes be prescribed to regulate thyroid hormone levels and shrink the goiter. In more severe cases, surgery may be necessary to remove part or all of the thyroid gland.
This article highlights the following:
- Some common causes of goiter
- Some facts and myths about goiter
- Some treatment options for goiter
What Causes a Goiter?
A goiter is typically caused by an underlying thyroid problem. However, in some cases, the cause of goiter may be unknown, as in the case of sporadic goiters. If you suspect you have a goiter or are experiencing symptoms such as a visible swelling in the neck, difficulty swallowing or breathing, or changes in appetite or weight, it is important to see a doctor for an evaluation and diagnosis.
The most common cause of goiter worldwide is iodine deficiency. Iodine is an essential nutrient required for the production of thyroid hormones. Without enough iodine, the thyroid gland enlarges as it tries too hard to compensate for the deficiency in attempting to capture as much iodine as possible to produce the thyroid hormone.
Other causes of goiter include:
- Autoimmune disorders: Autoimmune disorders such as Hashimoto’s thyroiditis and Graves’ disease can cause the immune system to attack the thyroid gland, leading to inflammation and enlargement.
- Thyroid nodules: Nodules are growths on the thyroid gland that can cause it to become enlarged. A goiter caused by one or more thyroid nodules is known as a nodular goiter.
- Pregnancy: Pregnancy can cause changes in thyroid hormone levels that can result in goiter. Increased production of estrogen can lead to an enlarged thyroid gland. Human chorionic gonadotropin, a hormone produced by the placenta during pregnancy, may also cause the thyroid to increase in size.
- Side effects of medications: Certain medications, such as lithium, can interfere with thyroid hormone production and cause the thyroid gland to enlarge.
10 Myths and Facts about Goiter
Myth #1: Only iodine deficiency causes goiter.
Fact: While iodine deficiency is a common cause of goiter, there are several other causes, including autoimmune disorders, thyroid nodules, pregnancy, certain medications, and radiation exposure.
Myth #2: All goiters are cancerous.
Fact: Most goiters are benign and not cancerous. However, it is essential to have any goiter evaluated by a healthcare provider to determine if further testing or treatment is necessary.
Myth #3: Goiter is always a sign of thyroid cancer.
Fact: While goiter can be a sign of thyroid cancer, it is more commonly caused by non-cancerous conditions such as iodine deficiency, autoimmune disorders, and thyroid nodules. An overactive thyroid gland (hyperthyroidism) or an underactive thyroid gland (hypothyroidism) can also cause the thyroid gland to become enlarged.
Myth #4: Goiters are only a cosmetic problem.
Fact: While goiters may be, as it were, unsightly, they can also cause a range of symptoms, including difficulty swallowing, coughing, hoarseness, and difficulty breathing.
Myth #5: Surgery is always necessary to treat goiter.
Fact: Surgery may be necessary in more severe cases or if the goiter is causing significant symptoms. It is, however, not always the first-line treatment for goiter. The treatment will depend on the underlying cause and severity of the goiter. In some cases, simple measures such as increasing iodine intake or taking medications may be enough to shrink the goiter.
Myth #6: Goiter is contagious.
Fact: Goiter is absolutely not contagious. It is typically caused by an underlying thyroid problem and cannot be spread from person to person.
Myth #7: Only women get goiters.
Fact: Both men and women can develop goiters. While women are more likely to develop goiter than men, men can also develop the condition.
Myth #8: Goiter is always visible and causes neck swelling.
Fact: While some cases of goiter may cause swelling in the neck, not all cases are visible. In some cases, the enlargement of the thyroid gland may be small and not easily noticeable.
Myth #9: Goiter is always accompanied by symptoms.
Fact: Some people with goiter may not experience any symptoms, while others may experience symptoms such as difficulty swallowing, hoarseness, and breathing problems depending on the size and location of the goiter. In fact, many people with goiters experience no pain or discomfort at all.
Myth #10: Goiter can be treated with iodine supplements alone.
Fact: While iodine supplements can help treat goiter caused by iodine deficiency, it is not always the appropriate treatment. Treatment options depend on the underlying cause of the goiter and may include medication, surgery, or hormone replacement therapy.
Treatment Options for Goiter
It is crucial to work with a healthcare provider to determine the best course of treatment for goiter. Your healthcare provider should be able to help identify the underlying cause and develop a treatment plan tailored to your needs.
Sometimes, a goiter may be small and not cause significant symptoms. In that case, treatment may not be recommended as the goiter may simply require some monitoring over time for any changes. Your healthcare provider may only intervene if it becomes more prominent or starts causing symptoms.
The following are some ways a goiter may be shrunk:
- Iodine supplements: If the goiter is caused by an iodine deficiency, increasing iodine intake may help shrink the goiter. This can be done through dietary changes or supplements. However, it is essential to note that excessive iodine intake can also be harmful, so it is important to consult with a healthcare provider before taking iodine supplements. Your healthcare provider can help determine the appropriate dosage of iodine, if even necessary.
- Medications: In some cases, medications may be prescribed to regulate thyroid hormone levels and shrink the goiter. These may include a thyroid hormone replacement drug such as levothyroxine or antithyroid drugs such as methimazole which can reduce the amount of thyroid hormone produced by the gland.
- Radioactive iodine therapy: Radioactive iodine therapy is a treatment that involves taking a radioactive iodine pill, which is absorbed by the thyroid gland. The radiation in the pill can reduce thyroid hormone production and shrink the gland by destroying overactive cells. This treatment is typically used for people with hyperthyroidism or thyroid cancer.
- Surgery: If the goiter is causing significant symptoms, is growing rapidly, or is cancerous, surgery may be necessary to remove part or all of the thyroid gland.
- A goiter is typically caused by an underlying thyroid problem. Effective treatment of this condition will largely depend on the particular underlying cause.
- Iodine deficiency is the primary cause of goiter worldwide. The thyroid gland enlarges as it tries to compensate for limited iodine.
- Other causes of goiter include autoimmune disorders such as Hashimoto’s thyroiditis and Graves’ disease, thyroid nodules, pregnancy, and certain medications such as lithium.
- Treatment options for goiter include iodine supplementation, medications, radioactive iodine therapy, and surgery.
- While iodine supplements can help treat goiter, it is not always recommended, as excessive iodine intake could harm the thyroid. Iodine should only be taken as and when recommended by your primary healthcare provider.
- While surgery may be necessary if the goiter is causing severe symptoms, it is rarely the first treatment approach for a goiter.
- In some cases, such as sporadic goiters, the cause may be unknown or not well-understood. Some instances of goiter may also not present significant symptoms and may not even be visible.
- It is important to consult a healthcare provider for a diagnosis if you experience some of the typical symptoms of a goiter.