Goitre

Goitre Goitre

What is Goitre?

The thyroid is a butterfly-shaped organ situated in front of the neck just below the laryngeal prominence (the Adam’s apple). An abnormal enlargement of the thyroid gland is referred to as a goitre A goitre may be an overall diffuse enlargement of the thyroid gland, or it may be due to irregular growth of thyroid cells that form one or more nodules in the thyroid. A goitre may or may not be associated with changes in thyroid function. In fact, most people with a goitre usually have a normal thyroid function.

Symptoms of Goitre? 

Most people with Goitre do not have symptoms. The swelling might be found incidentally or during an imaging test, such as an ultrasound or CT scan, that is done for another reason. Sometimes, patients may have abnormalities in their thyroid blood check-up and those patients may also have a Goitre on examination. Some people with Goitre feel or see a lump in their neck. Or they have symptoms from having too much thyroid hormone (thyrotoxicosis) or low thyroid hormone (hypothyroidism) in the body. 

If a Goitre presses on the throat or airway, it can cause local symptoms like:​

 

  • Difficulty breathing – Especially during physical activity, at night while sleeping, or when bending the head forward or sideways.
  • Coughing
  • A choking feeling
  • Trouble swallowing

The most common cause of Goitres worldwide in years past was a lack of iodine in the diet. This is changing rapidly as food iodisation has become very common. Nowadays, autoimmune thyroid disease counts as the most common cause of Goitre. Simple nontoxic Goitre is frequently noted at puberty and during pregnancy-these represent times of increased demand on the thyroid gland and the gland may increase in size at these times, overshooting and becoming bigger than necessary. 

Other Known causes include

  • Intrinsic thyroid hormone production defects
  • Consumption of foods that contain substances that inhibit the production of thyroid hormone (goitrogens, e.g., cassava, broccoli, cauliflower, cabbage)
  • Usage of drugs that can decrease the synthesis of thyroid hormone (e.g., amiodarone or other iodine-containing compounds, lithium)
  • Graves’ Disease
  • Hashimoto’s Thyroiditis
  • Thyroid Malignancy.
  • Benign Multinodular Goitre.
  • Thyroiditis.

Is Goitre Always Indicates Hyperthyroidism?

Goitre may occur due to various reasons, as mentioned above. If Goitre is associated with symptoms like palpitation, weight loss, increased sweating, trembling of hands, and increased frequency of bowel movements, hyperthyroidism should be suspected. Hyperthyroidism can happen without Goitre in some patients as well.

It depends on the etiology of the Goitre. If goitre is caused by increased demand, such as pubertal Goitre or during pregnancy, it will go away on its own.Goitre associated with thyroid functional abnormalities like Graves’ Disease or Primary Hypothyroidism will settle with treatment of underlying conditions.

What Kind Of Treatment Is Available For Goitre At Magna?

Goitre can be treated with many modalities like medications, Radioiodine ablation, and, if required, surgery. Many times, patients will require only close monitoring and may not require any treatment. At MAGNA, most of the evaluations to diagnose the etiology of Goitre are available. Experienced Endocrinologists are available at MAGNA to make the treatment decisions. A Surgical Endocrinologist or ENT surgeon's opinion can be sought if surgery is required.

The size or position of a Goitre may obstruct the trachea (main airway) and the voice box. Signs and symptoms of obstructive Goitre may include:

  • Difficulty swallowing
  • Difficulty breathing with exertion
  • Cough
  • Hoarseness
  • Snoring

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