Conditions: Goiter

Goiter (also known as thyromegaly)

A goiter is an enlarged thyroid gland.

A goiter with multiple nodules is a multinodular goiter.

A goiter with multiple nodules and without hyperthyroidism is a non-toxic multinodular goiter.

A goiter that extends into the chest, behind the sternum (breastbone) is a substernal goiter.

What causes a goiter?

Worldwide, the most common cause for goiter is a lack of iodine in the diet. In the United States, with a prevalence of iodinized salt, iodine deficiency is rare. Factors other than iodine deficiency that lead to the development of a goiter include the following:

• multiple enlarged nodules

• thyroid cancer

• Grave’s disease

• Hashimoto’s (chronic lymphocytic) thyroiditis

• genetic predisposition

What problems can come from a goiter?

Most importantly, determination if a goiter contains cancer must be undertaken.

Non-cancerous problems associated with a goiter may include hyperthyroidism, hypothyroidism, compression of the trachea or esophagus, and cosmetic.

how is a Goiter evaluated?

History and physical exam by a physician is a good starting point.

Ultrasound, initially.

Blood testing to evaluate for hyperthyroidism and hypothyroidism. Other blood testing may be indicated to evaluate for Hashimoto’s thyroiditis or Grave’s disease.

A radioiodine uptake scan may be helpful.

Other testing, such as ultrasound guided fine needle aspiration biopsy may then be indicated.