Goiter occurs when the thyroid gland becomes enlarged. Sometimes the entire gland swells, while small lumps known as nodules develop in other cases. This change in size can happen even if thyroid hormone levels remain normal, or they may rise or fall depending on the underlying cause.
The thyroid, a butterfly-shaped gland located just below the Adam’s apple, produces hormones that control essential functions such as metabolism, body temperature, mood, heart rate, and digestion. When this gland grows abnormally, it signals that something is off, even if it doesn’t cause immediate pain.
Why Goiter Deserves Attention
Goiter isn’t always a medical emergency, but it shouldn’t be ignored. It can be painless and barely noticeable—or grow large enough to make breathing or swallowing difficult. In some cases, it may be linked to serious conditions like thyroid cancer or autoimmune diseases. Identifying the type and cause of goiter early allows for better management and avoids complications.
Types of Goiter
Goiters are classified by how they grow and how they affect hormone levels:
- Simple (Diffuse) Goiter: The entire thyroid swells evenly and feels smooth.
- Nodular Goiter: A solid or fluid-filled lump forms in the gland, making it feel uneven.
- Multinodular Goiter: Multiple lumps form, sometimes producing extra thyroid hormone.
Based on hormone activity:
- Toxic Goiter: Produces excess thyroid hormone (hyperthyroidism).
- Nontoxic Goiter: The thyroid is enlarged, but hormone levels are normal.
Who Is More Likely to Develop Goiter?
Anyone can develop a goiter, but it’s more likely in women and in people over the age of 40. Certain factors increase the risk:
- Obesity
- Insulin resistance
- Metabolic syndrome
- Exposure to radiation (especially around the neck)
- Family history of thyroid disorders
What Causes Goiter?
Several factors can lead to thyroid enlargement:
- Iodine Deficiency: The most common cause globally. The thyroid enlarges in an attempt to capture more iodine for hormone production.
- Graves’ Disease: An autoimmune condition that overstimulates the thyroid, causing it to grow and become overactive.
- Hashimoto’s Disease: Another autoimmune disorder where the thyroid becomes inflamed, and sometimes swells as it tries to compensate.
- Thyroid Cancer: Abnormal cell growth may cause a noticeable lump or swelling.
- Pregnancy: Hormonal changes during pregnancy may temporarily enlarge the thyroid.
- Thyroiditis: Inflammation of the thyroid can cause temporary or permanent enlargement.
- Certain Medications: Some drugs, like lithium, may interfere with thyroid function and cause swelling.
In some cases, the cause remains unknown—these are called sporadic goiters.
Recognizing the Symptoms
The most noticeable sign is a lump in the neck, just below the Adam’s apple. Other symptoms may include:
- A tight feeling in the throat
- Hoarseness
- Swollen neck veins
- Dizziness when raising the arms
- Difficulty breathing or swallowing
- Persistent cough or wheezing
If the goiter affects hormone production, symptoms may follow:
- Hyperthyroidism (overactive thyroid): Rapid heartbeat, weight loss, diarrhea, sweating, shaking, and nervousness.
- Hypothyroidism (underactive thyroid): Fatigue, constipation, dry skin, weight gain, and irregular periods.