This page explains the common causes of a goiter, including thyroid nodules, autoimmune disease, and hormone imbalances, and how blood tests and ultrasounds are used to find the cause.
The word goiter simply means:
➡ An enlarged thyroid gland
It does not automatically mean cancer or a serious problem.
A goiter is a thyroid gland that has grown bigger than usual.
The thyroid normally sits flat and small in the neck.
With a goiter, it may become:
Swollen
Lumpy
Noticeably enlarged
Sometimes you can see or feel it, and sometimes only a doctor notices.
A goiter happens when the thyroid is being pushed to work harder than normal.
This can happen for several reasons, including:
Thyroid hormone imbalance
Autoimmune disease
Nodules
Inflammation
Iodine problems
So a goiter is usually a sign of another thyroid issue, not a disease by itself.
The most common causes include:
Autoimmune attack that makes the thyroid inflamed and enlarged.
Overactive thyroid that grows bigger from overstimulation.
One or more nodules can make the gland look enlarged.
Rare in the U.S., but a common cause worldwide.
Temporary inflammation of the thyroid.
Many people with a goiter feel nothing at all.
Possible symptoms include:
A visible swelling in the front of the neck
A feeling of tightness in the throat
Trouble swallowing
Hoarseness
Coughing
A sense of pressure when lying down
Small goiters often cause no symptoms.
When a doctor notices an enlarged thyroid, they usually check:
Most important first test:
TSH
This shows whether the thyroid is:
Underactive
Overactive
Or functioning normally
An ultrasound helps show:
Size of the thyroid
Whether nodules are present
Structure of the gland
Depending on results:
Thyroid antibody tests
Biopsy of nodules
Imaging tests
A goiter can happen with:
Normal thyroid levels
Low thyroid levels (hypothyroidism)
High thyroid levels (hyperthyroidism)
So having a goiter does not automatically tell you whether your thyroid is too fast or too slow.
Usually, no.
➡ Most goiters are not related to cancer.
Cancer risk is mainly connected to specific nodules, not simply to the thyroid being enlarged.
Treatment depends on the cause.
Thyroid hormone medication may shrink the goiter
Treatment may include:
Anti-thyroid medication
Radioactive iodine
Sometimes surgery
Often doctors recommend:
Watching and monitoring
Periodic ultrasounds
No treatment unless it grows or causes problems
Surgery may be considered if the goiter:
Is very large
Causes trouble breathing or swallowing
Looks suspicious
Keeps growing
Sometimes yes, sometimes no.
Small goiters may shrink with treatment
Some stay the same size for years
Large goiters may not shrink without surgery
It depends on the underlying cause.
If you’re told you have a goiter, typical next steps are:
Blood tests to check thyroid function
Thyroid ultrasound
Monitoring or treatment based on results
Most people with goiters do very well.
Goiter simply means an enlarged thyroid
It is usually a sign of another thyroid issue
Most goiters are not dangerous
Evaluation is straightforward
Treatment depends on the cause
The next page will explain a common temporary condition: