Diagnosing and treating goiter

Goiter is an abnormal growth at the base of one’s neck near the Adam’s apple. Symptoms Sometimes goiters does not cause any symptoms at all. However, the common ones, when they do occur, are:

  • Swelling at the base of the neck
  • Coughing
  • Difficulty in breathing
  • Hoarseness
  • Difficulty in swallowing
  • The feeling of tightness in the throat
  • Swelling of the neck vain
  • Feeling dizzy when the arms are raised above the head

Risk factors The risk of developing goiter is high if

  • Auto-immune diseases are traced in the family history
  • You have had radiation therapy in the neck or chest area
  • You consume medicines such as immunosuppressants, heart drugs (Cordarone or Pacerone), antiretrovirals, or psychiatric drugs (Lithobid).
  • One is pregnant or going through menopause
  • One smokes cigarettes
  • One is older than 40

Diagnosis Simple diagnosis of Goiter would be to simply feel the neck and to swallow while monitoring the response. Other ways to diagnosis goiter are:

  • Antibody test A blood test to measure abnormal antibodies that are produced if you predisposed to auto-immune thyroid disease.
  • Hormone test Hormone test is done to measure hormone levels in the blood which could reveal if the thyroid glands are working properly.
  • Thyroid scan This is an imaging test which provides information about the function and size of the thyroid gland.
  • Ultrasound The size of the thyroid gland is seen and the presence of nodules are determined in the imaging test. The presence of nodules cause changes in the level of hormones produced by the gland.
  • MRI or CT scan A more detail report can be obtained by these imaging tests if the goiter has spread into the chest or is very large.
  • Biopsy A tissue or fluid sample is obtained through a procedure where a needle is inserted into the thyroid gland. The sample is examined and subjected to other tests if necessary.

Treatment The size, causes, and symptoms determine the treatment for goiter. If the goiter is small and does not bother the person, there will be no treatment given by the doctor. The goiter will be monitored closely in case it grows or changes. In such cases, treatment would be started through options such as

  • Medication When the thyroid gland is inflamed, aspirin or a corticosteroid would be prescribed. In the case of hypothyroidism, Levothroid or Synthroid would be prescribed to replace the missing hormones. The necessary drugs would be prescribed to bring the thyroid hormone levels back to normal.
  • Surgery Surgery is recommended in case there is a very large goiter which causes difficulty in breathing or swallowing. Also, if the thyroid is overactive a surgical procedure called thyroidectomy to remove all or a part of the thyroid gland may be recommended.
  • Radioactive iodine This is a treatment taken orally which can shrink the size of the goiter.

There are several types of goiter:

  • Diffuse smooth goiter This occurs when the entire thyroid is swollen.
  • Nodular goiter A common type of goiter where a lump or many lumps (multinodular goiter) develop in the thyroid.
  • Retrosternal goiter A type of goiter that grows behind the breast bone. It can constrict the neck veins, esophagus or windpipe. This could sometimes require surgery.

The kind of treatment needed is determined by the type of goiter and the symptom it shows.