A goitre is a swelling in the neck as a result of an enlarged thyroid gland. The thyroid gland produces hormones known as thyroxine (T4) and triiodothyronine (T3) which help maintain the body’s metabolism. Many cells and tissues depend on these hormones.
The thyroid gland lies just in front of the trachea in the lower part of the neck. It has a right and left lobe which are connected by a narrow band of thyroid tissue. It is in the shape of a butterfly. A normal thyroid cannot be seen or felt. However, when it enlarges it can be seen as a lump in the front of the neck and this is known as goitre. This lump can move up and down with swallowing.
When you have a goitre, your thyroid gland may be overactive or underactive; producing too much or too little hormones. There are two main types of goitre. They are:
- Diffuse goitre – The entire thyroid gland is swollen and larger than normal but feel smooth.
- Nodular goitre – Solid or fluid-filled lumps develop within the thyroid and make the gland feel lumpy to touch. The nodules could be single or multiple.
What Causes Goitre?
There are various causes of goitre depending on the type.
The causes of diffuse goitre include;
- Grave’s disease – This is an autoimmune disease which causes the thyroid gland to swell and produce too much of thyroxine (T4). The immune system produces antibodies which are causing damage to the thyroid gland.
- Thyroiditis – Inflammation of the thyroid gland. This can be due to various causes. Another autoimmune disease known as Hashimoto’s thyroiditis can cause damage to the thyroid gland. Bacterial and viral infections also cause different types of thyroiditis. Radiotherapy treatment to the neck can also result in inflammation of the thyroid gland.
- Iodine deficiency – Iodine is needed by the thyroid gland to produce the hormones thyroxine and triiodothyronine, T4 and T3 respectively. If there is a lack of iodine in the diet, the thyroid gland swells up to try to make enough of the hormones.
- Medications such as lithium and amiodarone can cause the thyroid gland to swell as a side effect.
- There are also hereditary factors that cause the thyroid gland to swell. This normally occurs at certain times in life, for example, in pregnancy or during puberty.
The causes of nodular goitre can be
- Cyst – A non-cancerous sac like swelling filled with fluid.
- Adenoma – A solid non-cancerous tumor.
- A cancerous tumor which is usually a rare cause.
How to Identify Early Stages of Goitre
Usually there are no symptoms associated with goitre apart from the swelling in the neck. This swelling ranges from very small and barely noticeable to very large. There may be pain in the case of an inflammation. However, normally, goitres are painless.
A large swelling may press on the trachea and oesophagus obstructing breathing and passage of food. There may also be coughing and changes in voice (hoarseness). Goitre associated with an overactive thyroid or underactive thyroid may present with symptoms of the underlying state of activity of the gland.
Symptoms of an overactive thyroid include
- Palpitations (fast heart beat)
- Heat intolerance
- Increased sweating
- Increased appetite
- Weight loss
- Hair loss
Symptoms of an underactive thyroid include
- Cold intolerance
- Hair loss
- Weight gain
- Personality changes
Clinical Diagnosis of Goitre
During a hospital visit, your doctor can be able to pick up the signs of goitre. A goitre is usually diagnosed by physical examination done by a doctor.
Blood tests such as thyroid function test and a full blood count would be performed. Your doctor may also perform some scans to help with diagnosis. Be sure to visit the hospital if you have any symptoms.
Can goitre be Treated?
Treatment is dependent on the underlying cause. However if the swelling is small and barely noticeable, nothing is really done but monitoring. Radioiodine treatment and surgery could also be done.