Goitre: Causes, Symptoms, and Treatment

What is Goitre?

Goitre is an enlargement of the thyroid gland. Thyroid is a butterfly-shaped gland located at the base of the neck that produces thyroid hormones. A goitre may be due to an overall enlargement of the thyroid, or it may be the result of lumps (nodules) in the thyroid. A goitre may be associated with no change in thyroid function or with an increase or decrease in thyroid hormones.

Goitre Causes and Risk Factors

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

Causes of goitre includes:

• Hyperthyroidism – increased production of thyroid hormones
• Hypothyroidism – reduced thyroid function
• Lump - lumps (nodules) on the thyroid. Nodules in the thyroid gland are very common and mostly harmless. Less than 5% of the lumps are cancerous. However, the risk is higher if the nodule grows in size, or the patient has previously been exposed to ionising radiation.
• Hormonal changes during puberty, pregnancy, or menopause

Goitre Symptoms

Some people with goiters have no symptoms other than a swelling at the neck. This may be discovered during a routine medical exam or an imaging test for another condition. If the goitre enlarges significantly and quickly, it may cause obstructive symptoms such as:

• A persistent cough
• Changes in your voice or hoarseness
• A sensation of something being lodged in your throat
• A wheezing sound while breathing
• Difficulty swallowing or breathing

In patient’s where the goitre is associated with disturbance in thyroid hormone productions, they may experience symptoms related to Hyperthyroidism (over-production of the thyroid hormones) or Hypothyroidism (under-production of the thyroid hormones).

Overactive Thyroid (Hyperthyroidism):

Symptoms of hyperthyroidism can include:

• Unintentional weight loss
• Fast heart rate (tachycardia)
• Heightened sensitivity to warm temperatures
• Excessive sweating
• Shaking or tremors
• Irritability and feeling anxious
• Muscle weakness
• Frequent bowel movements
• Irregular menstrual cycles
• Difficulty sleeping
• Elevated blood pressure
• Increased appetite

Underactive Thyroid (Hypothyroidism):

Symptoms of hypothyroidism can include:

• Persistent fatigue
• Sensitivity to cold temperatures
• Excessive sleepiness
• Dry skin
• Constipation
• Muscle weakness
• Difficulty with memory or concentration

Goitre Diagnosis

Diagnosing a goitre involves thoroughly examining the swelling and may include various tests to assess thyroid function and structure.

• Examination of the swelling
• Blood tests for thyroid hormone levels/ autoantibodies level ( if autoimmune condition is suspected)
• Ultrasound scan of the neck
• Fine needle aspiration cytology (FNAC), if necessary

Goitre Treatment

Treatment depends on the cause of the goitre, symptoms, and complications resulting from the goitre. Small goiters that aren't noticeable and don't cause problems may not need treatment.

Treatment options include:

1. Observation: Not all nodules, single or multiple, need to have surgery unless there is a high likelihood of cancer or causing pressure symptoms on other organs in the neck. Regular monitoring may be sufficient if the goitre is small and not causing symptoms.
2. Medications: Thyroid hormone replacement therapy can be prescribed if the goitre is due to hypothyroidism. Anti-thyroid medications may be used for hyperthyroidism.
3. Radioactive iodine: This treatment can help shrink an enlarged thyroid in cases of hyperthyroidism.
4. Surgery: In cases where the goitre is large, causing difficulty swallowing or breathing, or if there are concerns about cancer, surgical removal of part or all of the thyroid gland may be necessary.

Take Charge of Your Thyroid Health

Regular check-ups with a healthcare provider can help ensure effective management and maintain overall thyroid health.

For more information or concerns about goitre, consult a medical professional at Gleneagles Hospital Penang.

Source: https://www.nhs.uk/conditions/goitre/