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Goiter

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DIABETES AND ENDOCRINE SYSTEM

Endocrine System

In 1656, Thomas Wharton described the distinct nature of what he termed the thyroid gland, distinguishing it from the larynx, as this structure had been considered a laryngeal gland from the time of Andreas Vesalius in the 16th century. It was nearly 200 more years before the function of the thyroid was elucidated. The normal adult thyroid gland weighs 10-25 g and has 2 lobes connected by an isthmus. Goiter is an enlargement of your thyroid gland. Although generally not uncomfortable, goiter may interfere with swallowing or breathing. The possible causes are numerous.

Treatment

Treating a goiter depends on the size of the enlargement, your signs and symptoms, and the underlying cause. Your doctor may recommend:

  • Observation. If your goiter is small and doesn't cause you much of a problem, and your thyroid is functioning normally, your doctor may suggest a wait-and-see approach.

  • Medications. If you have hypothyroidism, the thyroid hormone replacement medication levothyroxine (Levothroid, Synthroid) slows down the release of thyroid-stimulating hormone from your pituitary gland and often decreases the size of the goiter. For subacute thyroiditis, your doctor may suggest aspirin or a corticosteroid medication to treat the inflammation. For goiters associated with hyperthyroidism, you may need medications to normalize hormone levels.

  • Surgery. Removing all or part of your thyroid gland (thyroidectomy) is an option if you have a large goiter that is uncomfortable or causes difficulty breathing or swallowing, or in some cases, if you have nodular goiter causing hyperthyroidism. Surgery is also the treatment for thyroid cancer. You may need to take levothyroxine after surgery, depending on the amount of thyroid removed.

  • Radioactive iodine. In some cases, radioactive iodine is used to treat an overactive thyroid gland. The radioactive iodine is taken orally and reaches your thyroid gland through your bloodstream, destroying thyroid cells. The treatment results in diminished size of the goiter but may also cause an underactive thyroid gland. Hormone replacement with the synthetic thyroid hormone levothyroxine then becomes necessary, usually for life.

Goiter > 1 > 2 > 3 > 4

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