What Is A Thyroid Goiter
Thyroid goiter is a condition where there is an abnormal enlargement of your thyroid gland. The photo here shows how many thyroid goiters look, which is like the neck is swolen and fat. When you touch it, you can tell it isn’t fat since it is firm and doesn’t move much. Most thyroid goiters are painless, but they may produce symptoms due to their size itself. The most common symptom from a thyroid goiter is a lump in the neck. Other symptoms from a large thyroid goiter may include a sense of a lump in the throat, difficultly swallowing, difficulty breathing and even in extreme cases, voice changes and even vocal cord paralysis.
World wide, the most common cause of thyroid goiter is in locations where iodine in the diet is low or non-existent. This was similarly the case in the United States where thyroid goiter was commonplace until the contemporary iodination of table salt. Since then, the incidence of thyroid goiters have drastically been reduced in the United States.
Today, in the United States, thyroid goiter is more commonly associated with too much production of thyroid hormone , too little production of thyroid hormone , or multiple nodules within the thyroid gland itself .
There are two autoimmune conditions that can be causes of thyroid goiter.
Tests For An Enlarged Thyroid
Your doctor will feel your neck and may do blood tests to check your thyroid hormone levels. Other tests used to diagnose an enlarged thyroid gland include an ultrasound and a thyroid scan.
If you have heartburn, the following can help prevent throat tightness and other symptoms:
- avoid overeating
- avoid foods that trigger it
- take antacids or acid-blocking drugs
For a sore, tight throat caused by infection, pain relievers such as ibuprofen can ease the discomfort. You may also need a prescription for antibiotics from your doctor for bacterial infections like strep throat. You can gargle with a mixture of salt, baking soda, and warm water, or suck on a throat lozenge. Rest your voice until you feel better.
Anaphylaxis is treated under close medical supervision and with a shot of epinephrine. Other medications like antihistamines and corticosteroids may be necessary as well.
The treatment depends on what caused the tightness in your throat.
What Kind Of Follow
You will see your childs endocrinologist and head and neck surgeon one week after surgery. Expect to have labs done to assess calcium levels. Thyroid function labs will be drawn four weeks after surgery. Depending on the pathology, additional imaging may be obtained to see if radioactive iodine is needed. Some types of thyroid cancer will require regular blood work screening and scheduled ultrasounds.
Last reviewed by a Cleveland Clinic medical professional on 07/30/2018.
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Final Points To Remember About Thyroid Nodules
#1 if you have one or more thyroid nodules, remember that the vast majority are benign or non cancerous- so thats good news.
#2 When it comes to surgery- always, always, always Get a 2nd opinion- once you have your thyroid gland removed, There is no going back.! life as you know it, will never be the same.
You will now become permanently hypothyroid and that takes on its own unique treatment challenges.
After surgery, many people are told that its just a matter of taking thyroid replacement and you will feel fine. Unfortunately, very few people ever fee fine and have the outcome they were promised.
Weight gain, fatigue, brain fog, depression, hair loss, symptoms of either being overmedicated or under medicated will be the ongoing struggle for you.
With surgery, realize that, different doctors have different approaches- Some doctors like surgery and will want to remove the entire gland, while others feel that based on their surgical skill level, they can removed just the nodule and take a more conservative approach.
Another common concern that people have when it comes to complications of thyroid surgery, is damage to the Laryngeal nerve- these are the nerves that control vocal cords.
Discuss these concerns with your surgeon, and express your ultimate desire of trying to keep and preserve as much of your thyroid as you can.
That is going to wrap up todays video, I hope you enjoyed- until next time take care.
What Is The Treatment For Thyroiditis
Treatment for inflammation of the thyroid gland depends on the type of thyroiditis and the symptoms.
- Treatment for thyrotoxicosis includes beta blockers to decrease palpitations and decrease tremors;
- Treatment for low thyroid hormone includes thyroid hormone replacement;
- Treatment for thyroid pain includes anti-inflammatory medications such as aspirin or ibuprofen. Steroids such as prednisone may be used if pain is severe.;
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Thyroid Nodule Symptom # 3: A Sense That You Need To Swallow Something
- What to do about it?
Like all thyroid nodules that cause symptoms, these patients need a thyroid ultrasound to look at the size, location, and characteristics of the thyroid, how many noduls are present, and where they are located. Often thyroid glands that are big won’t have any ultrasound characteristics that are worrisome for cancer, so most of theses do not need a FNA thyroid needle biopsy. Thus big thyroids comprised of lots of nodules often don’t need a biopsy, which is in direct contrast to nodules that are single, or those that can be seen or felt . However, if a thyroid is big enough that it is causing the patient to be aware of it, and it is causing symptoms of something stuck in the throat, then surgery is probably necessary. Remember, thyroid surgery isn’t just for nodules that we think may be thyroid cancer, surgery is often necessary for benign, non-cancerous thyroid glands which are large and causing the patient symptoms. This situation is quite common. It is also important to know that large thyroid goiters, and nodules that are on the back side of the thyroid are often required to have a CAT scan, since these bigger thyroid glands are not seen as well with ultrasound. This is why you need a good endocrinologist who know which scan to order and which scans are not necessary. Remember, a large thyroid is called a goiter and we have an entire page on thyroid goiters.
Thyroid Nodule Symptom # 2: A Lump In The Neck That You Can See Or Other People Can See
- What to do about it?
Thyroid nodules that the patient can see, or somebody else can see should almost always be examined by an ultrasound test. Depending on the characteristics of the nodule , the nodule may need a needle biopsy. Almost all thyroid nodules that can be seen should have a FNA thyroid needle biopsy.
Recommended Reading: How To Treat Thyroid Disease Naturally
What Are The Symptoms Of Goiter
The main symptoms of goiter include:
- A swelling in the front of the neck, just below the Adam’s apple
- A feeling of tightness in the throat area
- Dizziness when the arms are raised above the head
Other, less common symptoms include:
- Difficulty breathing
- Difficulty swallowing
Some people who have a goiter may also have hyperthyroidism, or overactive thyroid. Symptoms of hyperthyroidism can include:
- An increased resting pulse rate
- Rapid heartbeat
- Sweating without exercise or increased room temperature
Benefits And Limitation Of The Self
An at-home self-exam known as the “neck check” can help you find thyroid lumps or enlargements on your own thyroid gland. These growths may point to any number of thyroid conditions from nodules and goiters to;thyroid cancer.
Lumps in the neck can be caused by thyroid disease, and they can also be caused by a variety of other conditions, such as lymph node enlargement, lymphoma, an infectious abscess, or a traumatic injury.
In general, a neck check is not considered the most accurate or reliable way to identify thyroid disease. You can have serious thyroid disease if you have a completely normal neck check. On the other hand, a major growth can often be a sign of an easily treatable condition, such as an iodine deficiency.
In the end, there are limitations as to what a neck check can tell you. A 2017 report from the U.S. Preventive Services Task Force concluded that neck palpation was able to detect thyroid nodules in only 11.6% of cases. Ultrasound, an imaging procedure using sound waves, was five times more accurate in detecting abnormal growths.
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What Causes Thyroiditis
The thyroid can be attacked by different agents. The attacks cause inflammation and injury to the thyroid cells, leading to thyroiditis.
Some of the agents known to cause thyroiditis are antibodies , drugs, radiation and organisms . Conditions in which the body attacks itself are autoimmune diseases. Thyroiditis can be an autoimmune disease .
It is not certain why some people make thyroid antibodies. Thyroid disease is known to run in families. Thyroiditis can be caused by an infection or can be a side effect of certain drugs.
When To See A Doctor
If youre taking levothyroxine and begin to experience the symptoms of a Hashimotos flare-up, make an appointment with your doctor. They may need to adjust your dosage.
Your doctor can test your levels of thyroid hormone to make sure youre getting what you need from your current dosage of levothyroxine. They can then use the test results to decide if they need to adjust your dosage.
Sometimes you may be taking the proper dose of levothyroxine but still experiencing symptoms. In this case, something else may be causing your symptoms. Your doctor can work with you to determine what this may be.
Who Should Be Tested
If you think you have symptoms of a thyroid problem, ask your doctor if you should be tested. People with symptoms or risk factors may need tests more often. Hypothyroidism more frequently affects women over age 60. Hyperthyroidism is also more common in women. A family history raises your risk of either disorder.
Goitres And Production Of Thyroid Hormones
- In many people with a goitre, the goitre does not affect the amount of thyroid hormones that you make. You are then euthyroid, which means you make the correct amount of these hormones.
- In some people, the goitre is associated with an abnormality of thyroid function. You may make too much thyroid hormone or too little . This can be shown with a simple blood test of your thyroid function.;See the separate leaflet called Thyroid Function Tests.
Note: you can also develop an overactive or underactive thyroid without having a goitre.
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Are Thyroid Nodules Cancer
The vast majority more than 95% of thyroid nodules are benign . If concern arises about the possibility of cancer, the doctor may simply recommend monitoring the nodule over time to see if it grows.
Ultrasound can help evaluate a thyroid nodule and determine the need for biopsy. A thyroid fine needle aspiration biopsy can collect samples of cells from the nodule, which, under a microscope, can provide your doctor with more information about the behavior of the nodule.
What Will Happen During A Partial Thyroidectomy
- General anesthesia is usually given before a partial thyroidectomy. This medicine will keep you asleep and free from pain during surgery. You may instead be given local anesthesia to numb the area. You may feel some pressure during surgery, but you should not feel any pain.
- After one or more incisions are made, your surgeon will remove part of your thyroid gland. If you have cancer, your surgeon may also remove the tissue and lymph nodes around your thyroid gland. If you are awake during surgery, you may be asked to speak to your healthcare providers.
- One or more drains may be placed into your incision to remove extra fluids from the surgery area. Your incision will be closed with stitches or surgical glue and covered with a bandage.
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How Do Doctors Diagnose Hashimotos Disease
Doctors diagnose Hashimotos disease based on
- medical history and physical exam. Your doctor will start by taking a medical history and performing a physical exam. In addition to asking about symptoms, the doctor will check your neck for a goiter, which some people with Hashimotos disease can develop.
- blood tests. Your doctor will order one or more blood tests;to check for hypothyroidism and its causes. Examples include tests for
- the thyroid hormones T4 and T3
- thyroid-stimulating hormone, or TSH
- thyroid peroxidase antibodies , a type of thyroid antibody that is present in most people with Hashimotos disease
You probably wont need other tests to confirm you have Hashimotos disease. However, if your doctor suspects Hashimotos disease but you dont have antithyroid antibodies in your blood, you may have an ultrasound of your thyroid. The ultrasound images can show the size of your thyroid and other features of Hashimotos disease. The ultrasound also can rule out other causes of an enlarged thyroid, such as thyroid nodulessmall lumps in the thyroid gland.
Feel The Bumps And Enlargements
Gently touch the area around your thyroid gland to try to palpate any enlargement, bumps, or protrusions. To differentiate between the thyroid and the other structures of your neck:
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Causes Of An Enlarged Thyroid
Knowing that your thyroid is enlarged is not a diagnosis by itself.;
It’s more helpful to think of an enlarged thyroid gland as an observation or as a description of what is happening.;
This is because there are actually many different conditions which result in thyroid gland enlargement.;
These conditions range from infections, inflammation of the gland, nutrient deficiencies, cancer and even autoimmune disease.;
An important part of treating an enlarged thyroid gland is correctly identifying and diagnosing what is happening.;
This important step can be done through blood testing and imaging .;
The range of medical conditions which can cause thyroid gland enlargement include:;
- Thyroid nodules;and thyroid cysts
- Thyroiditis caused by inflammation, infection or autoimmune disease
- Hashimoto’s thyroiditis;
- Iodine deficiency;
These diseases can be differentiated based on how they present , how they affect the size of your thyroid gland , how they look on ultrasound imaging and how they affect thyroid hormone production.;
Causes Of Your Thyroid Pain
While thyroid pain can be caused by many possible reasons; the disorders that are commonly responsible for thyroid pain are as follows:
- Thyroid cyst causes pain in the thyroid gland
- Viral thyroiditis: a viral infection caused by mumps virus, coxsackie virus, adenovirus etc
- Thyroid tumor can cause severe thyroid pain
- Subacute granulomatous thyroiditis , also referred to as painful sub-acute thyroiditisorde Quervains thyroiditis is a common thyroid disorder that can cause pain and tenderness in front of the neck or throat.
- Hashimotos disease
- Advanced carcinoma of the thyroid gland that spreads to distant body sites causes unbearable thyroid pain along with other complications
- A goiter is benign enlargement of the thyroid gland that can cause pain in the thyroid gland
- Trauma or injury to the neck or throat can also result in severe thyroid pain in neck
- Inflammation of the thyroglossal fistula orthyroglossal cyst is associated with thyroid pain
- Hyperthyroidism can cause thyroid pain
- Thyroid nodules causes pain and swelling of the thyroid gland
See also: Coping with Thyroid Cancer Treatment
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How Does Eating Diet And Nutrition Affect Hashimotos Disease
The thyroid uses iodine, a mineral in some foods, to make thyroid hormones. However, if you have Hashimotos disease or other types of autoimmune thyroid disorders, you may be sensitive to harmful side effects from iodine. Eating foods that have large amounts of iodinesuch as kelp, dulse, or other kinds of seaweed, and certain iodine-rich medicinesmay cause hypothyroidism or make it worse. Taking iodine supplements can have the same effect.
Talk with members of your health care team about
- what foods and beverages to limit or avoid
- whether you take iodine supplements
- any cough syrups you take that may contain iodine
However, if you are pregnant, you need to take enough iodine because the baby gets iodine from your diet. Too much iodine can cause problems as well, such as a goiter in the baby. If you are pregnant, talk with your doctor about how much iodine you need.
What Do You Do When Your Child Has A Thyroid Nodule
The first step if your child has a thyroid nodule is to get an ultrasound. This will help your healthcare provider assess the quality of your childs nodule and determine if additional workup is needed. In some cases a repeat ultrasound is needed, and in some cases a biopsy. This all depends on what it looks like on the ultrasound. Some nodules require labs to look at how the thyroid is functioning.
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