What is Goitre?

Goitre is the swelling of the neck due to enlargement of the thyroid gland.

Causes & Risk Factors

Under the control of thyroid-stimulating hormone (TSH) from the pituitary, the thyroid gland produces thyroid hormones thyroxine (T4) and triiodothyronine (T3).  Thyroid hormones affect metabolism, heat production as well as growth and development.

Disorder of the thyroid, like all endocrine glands, can lead to the following:

• Goitre – gland swelling
• Hyperthyroidism – increased production of thyroid hormones
• Hypothyroidism – reduced thyroid function

The chance of a nodule being cancerous is low – around 5%, but the risk of it becoming cancerous is higher if the nodule grows in size or the patient is previously exposed to ionising radiation etc.

Symptoms

Swelling at the front of the neck that moves upwards with swallowing. The enlargement can affect all parts of the gland (diffuse) or be seen or felt as lumps (nodule – single or multiple / multinodular).

Patients with goitre can have normal thyroid function (euthyroid) and can result from iodine deficiency, present with hyperthyroidism (eg. Graves’ disease or diffuse toxic goitre, toxic multinodular goitre) or be hypothyroid (eg. Hashimoto’s thyroiditis).

Diagnosis

• Examination of the swelling
• Blood tests for TSH levels
• Ultrasound scan
• Fine needle aspiration cytology (FNAC), if necessary

Treatment

Not all nodules, single or multiple need to have surgery unless there is high likelihood of cancer or causing pressure symptoms on other organs in the neck.