What is goitre?
A goitre is an enlarged or swollen thyroid gland. The thyroid gland is a butterfly-shaped gland at the base of the neck. It secretes thyroid hormones, which are essential for normal brain development and growth in children, and for controlling many aspects of metabolism throughout a person's life.
What are the symptoms of goitre?
A goitre can show as an obvious lump or swelling at the bottom of the neck. Goitres are usually painless, but it can feel sore or tender around the thyroid area.
A large goitre can press on the windpipe or the oesophagus (or, 'gullet').
A goitre can also:
In some people, a goitre causes no obvious symptoms.
What causes goitre?
The main causes of goitre are:
- autoimmune diseases such as Hashimoto’s disease or Grave’s disease
- inherited thyroid conditions
- nodules or lumps in the thyroid gland
- a tumour or thyroid cancer
- a lack of iodine, a mineral that is used in the production of thyroid hormones. In Australia, iodine deficiency is not common, because iodine is added to most salt and almost all breads. But it can still occur.
- some medicines
- an injury or infection in the thyroid
Goitre is more common in:
- women who are pregnant or going through menopause
When should I see my doctor?
Consult a doctor if you see or feel a lump at the base of your neck, or if you have any of the other symptoms of goitre.
How is goitre diagnosed?
If you have a goitre, your doctor will talk to you and examine you. Specifically, they’ll carefully examine your thyroid gland, feeling its shape and size, checking for lumps.
You will have blood tests to see how well your thyroid gland is functioning. You might need scans or other tests such as:
- antibiody tests
- ultrasound scan of the thyriod
- computed tomography (CT) scan
- nuclear thyroid scan, where a small amount of weak radioactive substance is injected into the vein or given as a pill. (The substance then gathers in the thyroid, while a special camera takes images of the area from different angles.)
- biopsy, where a medical professional uses a fine needle to draw out a sample of tissue or fluid from the thyroid gland
How is goitre treated?
The treatment will depend on the cause. If the goitre is small and the thyroid is healthy, treatment might not be needed. Treatment options are medication, radiation and surgery. Your doctor should guide you towards the treatment that best suits you and your condition.
If your thyroid gland is producing too little thyroid hormone, you may be prescribed thyroid tablets to take regularly. This can decrease the size of the goitre.
If your body is producing too much thyroid hormone, then you may be prescribed anti-thyroid tablets to bring the levels back to normal.
Radiation or surgery
Radioactive iodine treatment is where iodine that’s been made radioactive is given in capsule form in a controlled hospital setting. The radioactive iodine spreads through the body and is absorbed only by thyroid cells, killing them but not affecting other (healthy) cells. It’s considered an effective and safe treatment for some types of thyroid disease, including thyroid cancer. It’s not, however, recommended for pregnant women or women considering becoming pregnant.
People with cancer or a large goitre that is causing difficulty breathing or swallowing might need surgery.
Can goitre be prevented?
To prevent goitre, you need the right amount of iodine in your diet. This substance occurs naturally in seawater and coastal soils, and is found in shellfish, seaweed (often used in sushi) and other foods. You can use iodised salt in your food. Most bread in Australia contains iodised salt, so eating bread regularly should help maintain your iodine levels.
The National Health and Medical Research Council recommends that women who are pregnant, considering becoming pregnant or breastfeeding should take a 150-microgram iodine supplement each day.
Do not consume too much iodine, as that can also lead to a goitre.
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Last reviewed: May 2020