A goitre is an enlarged or swollen thyroid gland. The thyroid gland is a butterfly-shaped gland at the base of your 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. This article explains what a goitre is, and what to do about it.
What causes goitre?
The main causes of goitre in Australia are:
- autoimmune diseases such as Hashimoto’s disease or Grave’s disease
- inherited thyroid conditions
- nodules or lumps in the thyroid gland
- thyroid cancer
Around the world, the main cause of goitre is a lack of iodine, a mineral that is used in the production of thyroid hormones. In Australia iodine deficiency is not as common, because iodine is added to most salt and almost all breads. But it can still occur.
Goitre is more common in:
- women who are pregnant or going through menopause
A goitre can show as an obvious lump or swelling at the bottom of your neck. Goitres are usually painless, but you might feel sore or tender around the thyroid area.
A large goitre can press on your windpipe or your oesophagus (or, 'gullet').
A goitre can also:
In some people, a goitre causes no obvious symptoms.
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:
- ultrasound scan of your thyriod
- computed tomography (CT) scan
- nuclear thyroid scan, where a small amount of weak radioactive substance is injected into your 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
The treatment will depend on the cause. If the goitre is small and your thyroid is healthy, you might not need treatment. If you do, your 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
Your doctor may suggest radioactive iodine treatment, 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.
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.
When to seek help
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.
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Last reviewed: March 2018