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.
What Is A Goiter
Goiter refers to enlargement of the thyroid gland, a butterfly shaped organ draped around the front and sides of the windpipe in the lower part of the neck.
The thyroid gland is normally about the size of two thumbs held together in the shape of a V. It can enlarge when it is inefficient in making thyroid hormones, inflamed, or occupied by tumors.
Thyroid gland enlargement can be generalized and smooth, a so called diffuse goiter or it can become larger due to growth of one or more discrete lumps within the gland, a nodular goiter.
A goitrous gland can continue producing the proper amounts of thyroid hormones, in which case it is called a euthyroid or nontoxic goiter or a goiter can develop in conditions with either overproduction of thyroid hormone, called toxic goiter, or the inability to make sufficient thyroid hormones, called goitrous hypothyroidism.
Is Hyperthyroidism During Pregnancy A Problem
Thyroid hormone levels that are just a little high are usually not a problem in pregnancy. However, more severe hyperthyroidism that isnt treated can affect both the mother and the baby. If you have hyperthyroidism, be sure your disease is under control before becoming pregnant. Learn more about causes, diagnosis, and treatment of hyperthyroidism during pregnancy.
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Does An Enlarged Thyroid Cause Symptoms
Anatomical changes to your thyroid, such as changes to the size or shape of your thyroid, are most often found incidentally.
Patients are often quite surprised that they even have a thyroid issue until they are notified by their physician during a routine exam.
Problems which cause changes in the shape and size of thyroid usually do NOT cause problems with the production of thyroid hormone.
This is important because the symptoms associated with dysregulated thyroid hormone production are often profound and easy to identify.
Instead, disorders to the shape and size usually are asymptomatic.
What this means is that they do NOT cause any symptoms.
Now, this isn’t true for all disorders because there are always exceptions.
These issues might present as problems swallowing, changes to your vocal cords or a change in your voice, or a bulge that is noticeable in your neck.
Occasionally, if your enlarged thyroid is due to swelling or inflammation, then you might also experience pain when touching your neck.
Some conditions which result in an enlargement of your thyroid gland are reversible and may go away on their own while others may persist and cause permanent thyroid damage .
Hopefully, you’re beginning to understand that in order to really understand what is happening with your thyroid gland you will need further evaluation.
Thyroid Nodules Diagnosis And Treatment
Most nodules are detected during a normal physical exam. They can also be detected during an ultrasound, CT scan, or an MRI. Once a nodule is detected, other procedures a TSH test and a thyroid scan can check for hyperthyroidism or hypothyroidism. A fine needle aspiration biopsy is used to take a sample of cells from the nodule and determine whether the nodule is cancerous.
Benign thyroid nodules arent life-threatening and usually dont need treatment. Typically, nothing is done to remove the nodule if it doesnt change over time. Your doctor may do another biopsy and recommend radioactive iodine to shrink the nodules if it grows.
Cancerous nodules are pretty rare according to the National Cancer Institute , thyroid cancer affects less than 4 percent of the population. The treatment your doctor recommends will vary depending on the type of tumor. Removing the thyroid through surgery is usually the treatment of choice. Radiation therapy is sometimes used with or without surgery. Chemotherapy is often required if the cancer spreads to other parts of the body.
Children can also get thyroid conditions, including:
- thyroid nodules
- thyroid cancer
Sometimes children are born with a thyroid problem. In other cases, surgery, disease, or treatment for another condition causes it.
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How Do You Diagnose A Goiter
As mentioned earlier, the diagnosis of a goiter is usually made at the time of a physical examination when an enlargement of the thyroid is found. However, the presence of a goiter indicates there is an abnormality of the thyroid gland. Therefore, it is important to determine the cause of the goiter. As a first step, you will likely have thyroid function tests to determine if your thyroid is underactive or overactive . Any subsequent tests performed will be dependent upon the results of the thyroid function tests. If the thyroid is diffusely enlarged and you are hyperthyroid, your doctor will likely proceed with tests to help diagnose Graves Disease .
If you are hypothyroid, you may have Hashimotos Thyroiditis and you may get additional blood tests to confirm this diagnosis. Other tests used to help diagnose the cause of the goiter may include a radioactive iodine scan, thyroid ultrasound, or a fine needle aspiration biopsy .
How Common Are Thyroid Nodules
Thyroid nodules are very common, especially in the U.S. In fact, experts estimate that about half of Americans will have one by the time theyre 60 years old. Some are solid, and some are fluid-filled cysts. Others are mixed.
Because many thyroid nodules dont have symptoms, people may not even know theyre there. In other cases, the nodules can get big enough to cause problems. But even larger thyroid nodules are treatable, sometimes even without surgery.
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Other Causes Of Hyperthyroidism
Hyperthyroidism can also result from thyroid nodules. These are lumps that develop inside the thyroid and sometimes begin producing thyroid hormones. Large lumps may create a noticeable goiter. Smaller lumps can be detected with ultrasound. A thyroid uptake and scan can tell if the lump is producing too much thyroid hormone.
Thyroid Nodules: When To Worry
Suppose you go to your doctor for a check-up, and, as shes feeling your neck, she notices a bump. Then, suppose she tells you theres a nodule on your thyroid. Is it time to panic?
No, say experts at Johns Hopkins Department of Otolaryngology and Head and Neck Surgery. Thyroid nodules even the occasional cancerous ones are treatable.
Heres what you need to know about thyroid nodules and how concerned you should be if you develop one.
How Will I Know What Does An Enlarged Thyroid Gland Mean
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Imaging And Evaluating Your Thyroid
Ultrasound is a nearly painless procedure which allows radiologists to look at the size, shape, texture and other characteristics of your thyroid gland.
Because the thyroid gland is near to the surface of your skin it can easily be assessed with this type of imaging.
Doctors are often taught that the only way to hurt someone with an ultrasound is by throwing the machine at them.
Ultrasound is very important if you have an enlarged thyroid because it can further help to diagnose what exactly you are dealing with.
If you have a single large thyroid nodule, ultrasound can pick up that nodule and give information regarding the size, shape, and consistency of the nodule.
This information can help to determine if the nodule is benign ) or potentially cancerous and also help determine if you need a biopsy.
Other conditions which cause thyroid enlargement may be consistent and make your thyroid look “irregularly inconsistent” throughout the entire gland.
Conditions which cause this type of pattern tend to result in inflammation of the entire gland or may be caused by nutrient deficiencies such as iodine deficiency.
In addition to ultrasound testing, there are other ways to check your thyroid gland such as uptake tests or CT scans .
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What Makes Yale Medicines Approach To Thyroid Imaging Unique
Dr. Kent describes the doctors and scientists at Yale Medicine as best in class. “We have a close relationship with endocrinologists and endocrinology surgeons, she says. We speak the same language and we learn from each other.
For the patient, this means that care is streamlined between the doctor who treats the condition and the doctor who interprets the scans, makes a diagnosis and performs a biopsy. This provides a better, safer experience.
Also, a cytology technician is always in the room during a biopsy, in order to look at the biopsy samples under a microscope and ensure that there is enough information to make a definitive diagnosis.
Who Is At Risk For Hyperthyroidism
You are at higher risk for hyperthyroidism if you
- Are a woman
- Are older than age 60
- Have been pregnant or had a baby within the past 6 months
- Have had thyroid surgery or a thyroid problem, such as goiter
- Have a family history of thyroid disease
- Have pernicious anemia, in which the body cannot make enough healthy red blood cells because it does not have enough vitamin B12
- Have type 1 diabetes or primary adrenal insufficiency, a hormonal disorder
- Get too much iodine, from eating large amounts of foods containing iodine or using iodine-containing medicines or supplements
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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.
Help My Thyroid Is Enlarged
Ever noticed that your neck looks larger when looking in the mirror?Have you ever been told that your thyroid sticks out? Have you been told it has to come out?There may be more to the story! First read all the most common causes and treatments which patients have used for an enlarged thyroid, which hasnt always entailed surgery. ~Janie, hypothyroid patient and site creator
This is an autoimmune version of thyroid disease, which means your thyroid is being attacked by your own immune system, which causes the thyroid to swell from inflammation. The enlargement is commonly called a goiter and can range from very slight to a very noticeable enlargement. And its very treatable! Read the Hashimotos page. Learn why you have to insist on BOTH antibodies tests, not just one, to diagnose Hashis.and what patients have learned in treating it successfully, which ends up decreasing the swelling. There is also more in the Hashimotos chapter in the revised STTM book.
Here is an excellent story by a thyroid patient who was able to shrink her nodules with iodine and NDT, called The Case of the Missing Thyroid Nodules.
Congratulations.but some see their thyroid enlarge a bit thanks to the HCG hormone rise in their bodies when pregnant.
Impaired responsiveness to TSH,
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Enlargement Of The Thyroid
The term non-toxic goiter refers to enlargement of the thyroid that is not associated with overproduction of thyroid hormone or malignancy. The thyroid can become very large so that it can easily be seen as a mass in the neck. This picture depicts the outline of a normal size thyroid in black and the greatly enlarged goiter in pink. There are a number of factors that may cause the thyroid gland to become enlarged. A diet deficient in iodine can cause a goiter, but this is rarely the cause because of the readily available iodine in our diets. A more common cause of goiter in America is an increase in thyroid stimulating hormone in response to a defect in normal hormone synthesis within the thyroid gland. The thyroid stimulating hormone comes from the pituitary and causes the thyroid to enlarge. This enlargement usually takes many years to become manifest.
What do thyroid goiters look like and how do you treat them? Find out in our thyroid goiter basics slideshow.
Causes Of Hashimotos Thyroiditis
Doctors arent entirely sure why the immune system, which is supposed to defend the body from harmful viruses and bacteria, sometimes turns against the bodys healthy tissues.
Some scientists think a virus or bacterium might trigger the response, while others believe it may involve a genetic flaw. A combination of factorsâincluding heredity, sex, and ageâmay determine your likelihood of developing the disorder.
Researchers estimate that 70%â80% of autoimmune thyroid disease susceptibility is from a family history of autoimmune disease.
Pregnancy puts metabolic stress on a woman. The thyroid undergoes noticeable modifications to cope. These changes are typically reversible after birth, though pregnancy can sometimes be a trigger for postpartum thyroiditis. Postpartum thyroiditis is a condition in which the thyroid becomes inflamed within the first year after birth. In most cases, postpartum thyroiditis is limiting to weeks or months after delivery but occasionally develops into Hashimotos disease.
Other hormonal events
Hashimotos is seven times more likely to occur in women than men. Hormonal events like puberty, pregnancy, or menopause may contribute to the development of Hashimotos.
It is not uncommon for someone with one autoimmune condition to have another like celiac disease, type one diabetes, rheumatoid arthritis, or lupus. This condition of have two or more autoimmune disorders is polyautoimmunity.
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Thyroid Goiter: When Is A Ct Scan Ordered
When physical examination and or ultrasound cannot completely determine how far the goiter actually goes, then a CT scan should be ordered. The CT scan will show areas that the thyroid goiter extends and prepare the expert thyroid surgeon their safe and effective approach to remove all of the goiter gland and spare all other structures. Even though a thyroid goiter may extend extensively below the sternum and go well into the chest, these goiters can almost routinely be removed through a relatively straight forward low collar incision in the lower neck. If your surgeon is telling you that they need to “split your chest” or “open your sternum”, make sure that you have identified a highly experience thyroid surgeon. Again, such approaches are almost never actually required.
Hypothyroidism Diagnosis And Treatment
Your doctor will perform blood tests to measure your TSH and thyroid hormone levels. A high TSH level and low thyroxine level could mean that your thyroid is underactive. These levels could also indicate that your pituitary gland is releasing more TSH to try to stimulate the thyroid gland to make its hormone.
The main treatment for hypothyroidism is to take thyroid hormone pills. Its important to get the dose right, because taking too much thyroid hormone can cause symptoms of hyperthyroidism.
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Goiters: Abnormally Large Thyroid Glands
A goiter is an abnormally large thyroid gland. A goiter develops either because the whole gland is swollen or the gland has multiple growths or nodules on it. While some people with a goiter have no symptoms, others may have symptoms of an overactive or underactive thyroid.
- Hyperthyroidism is the medical term for an overactive thyroid, which produces too much thyroid hormone. Symptoms may include: Anxiety, rapid heart rate, diarrhea, weight loss.
- Hypothyroidism refers to an underactive thyroid, which products too little thyroid hormone. Symptoms may include: Depression, fatigue, constipation, weight gain.
What Causes a Goiter?Causes of goiters include:
Treatments for GoitersTreatment depends on the cause of the goiter and your symptoms. If your goiter is caused by low iodine intake, you may be treated with iodine supplements and thyroid hormone.
If your goiter is caused by Hashimotos thyroiditis, and you have hypothyroidism, treatment typically involves taking a pill containing thyroid hormone every day.
If the goiter is caused by hyperthyroidism, you may be treated with radioactive iodine, which is given as a pill and causes the thyroid gland to shrink and make less thyroid hormone. Radioactive iodine is only absorbed by the thyroid gland, so it does not harm other cells in your body. Another treatment involves removal of part or the entire thyroid by a surgeon. You may need to take thyroid hormones after surgery.