Goiter
What is goiter? Information about the causes, symptoms, and different types of abnormal thyroid growth.
Symptoms and Causes
Goiter occurs when the thyroid gland enlarges, leading to abnormal gland function.
There are two types of goiter depending on its characteristics:
- Diffuse or simple goiter: The entire thyroid enlarges evenly.
- Nodular goiter: Only certain parts of the thyroid enlarge, forming nodules.
Current treatments offer a good prognosis, as the condition resolves without complications.
Symptoms
Goiter often does not present symptoms. When they do appear, the most characteristic ones include:
- Swelling in the lower part of the neck.
- Difficulty swallowing.
- Breathing problems.
- Hoarseness.
- In cases of hypothyroidism: drowsiness, dry skin, cold intolerance.
- In cases of hyperthyroidism: fatigue, nervousness, weight loss.
Causes
The main causes of goiter are:
- Endemic goiter: Usually caused by iodine deficiency in the diet.
- Sporadic or non-toxic goiter: Occurs as a result of certain autoimmune diseases or medications containing lithium or amiodarone.
- Toxic or hyperthyroid goiter: Associated with excessive hormone production, leading to hyperthyroidism.
- Hypothyroid goiter: Occurs when there is a deficiency in hormone production.
Risk Factors
The likelihood of developing goiter increases in the following cases:
- Female sex.
- Over 60 years old.
- Pregnant women, especially those undergoing antithyroid treatments.
- Family history.
- Low-iodine diet.
Complications
Goiter usually does not cause complications. However, if it grows excessively, it may put pressure on the airways. The most severe complications arise from hormonal imbalances associated with abnormal thyroid growth, including heart problems, infertility, osteoporosis, or stroke.
Prevention
In most cases, goiter cannot be prevented. It is recommended to consume iodized salt to maintain adequate iodine levels in the body.
Which Doctor Treats Goiter?
Endocrinologists diagnose and treat goiter.
Diagnosis
Goiter is diagnosed through observation and palpation. Additional tests are performed to determine the type of condition and rule out other diseases:
- Thyroid ultrasound: Evaluates the presence of nodules, thyroid morphology, and function.
- Thyroid scintigraphy: Detects the presence and characteristics of nodules.
- Thyroid function test: Measures thyroid hormone levels in the blood to detect whether they are normal, elevated, or decreased.
- Fine-needle aspiration biopsy: Examines nodule cells to determine whether they are benign or malignant.
Treatment
If the goiter is small and does not cause symptoms, treatment is unnecessary, and its progression is monitored regularly. When the goiter is larger and causes hormonal imbalances, a personalized treatment plan is required:
- Hypothyroidism: Medications to increase hormone production, such as levothyroxine.
- Hyperthyroidism: Drugs to reduce hormone levels, such as methimazole.
- Surgery: If the goiter does not shrink despite hormone regulation, surgical intervention may be necessary to remove the affected lobe (hemithyroidectomy or partial thyroidectomy) or the entire gland (total thyroidectomy).
