Symptom Management: Goiters

Introduction 

Hey! Welcome back to the Thyroidcafe. Goiter. GOI-tur. It just sounds gross. When I had one, I freaked out. But there’s more to this word than its goopy sound. Goiters come in four forms and can be non-issues. But what causes goiters and how do we treat them? More importantly, when should we be concerned? Today on the blog, we address a common issue for those with all types of thyroid disease, goiters. 

So what is it?

Goiters are an enlarged thyroid gland and there are four different types. When the whole thyroid swells to form an obese butterfly, you have a Diffuse-Smooth goiter. If you have many “Lovely lady humps” all over your thyroid, it’s called Multinodular and if your goiter is hiding behind your breastbone, it’s a Retrosternal goiter. The most common form, and what I had, is a nodule. It’s just one random bump on your thyroid. 

And what causes goiters?

Ugh. You know the number one cause… thyroid disease. But there are other factors. The main one is too much, or too little, iodine. In most countries, salt contains added iodine. So if you’re like me, it’s not too little iodine. But it could be the Costco sized bag of salty chips I frequently devour. But aaanyways. Other causes are smoking, changes in hormones, lithium in some medications and radiation treatment. In my experience, stress causes goiters as well. 

Okay, okay. So how do we treat it?

For seventy years, doctors have known that thyroid replacement therapy reduces the size of goiters. So if you are having goiters, it’s a good time for your doctor to check your TSH, T3, and T4 levels.  In fact, ⅔ of all goiters reduce in size or eliminated by hormone treatment. Even if the goiter remains, we simply monitor them, unless they are accompanied by other symptoms, such as difficulty breathing or pain. 

When my goiter was treated, the doctor simple felt my neck. Then I went for an ultrasound and a needle biopsy. While “needle” makes it sound cringey, it was simple and pain free. After they studied the sample, there was no follow up needed. 

The “C word”

Only 13.7% of goiters  operated on are cancerous. While symptoms of thyroid cancer are very similar to goiters, (tight throat, voice changes etc.) there are some differences. If the soreness in the throat doesn’t change and you have difficulty breathing, or there is pain in your neck, your goiter may be more serious and needs to be looked at by a doctor. Even if it’s cancer, the five year survival rate for thyroid cancer is 98%.  So while it’s serious, there are treatment options.

Conclusion

While goiters can seem scary, they are like most things, the more you know the less you fear. I take comfort in knowing that goiters are a normal part of thyroid disease and very much treatable. If we make small lifestyle changes, we can prevent goiters from forming. Even if you’re like me, and have a propensity for chips, you can rest assured knowing goiters are probably nothing to worry about. I’m thankful that they are treatable part of this complex disease.