Goitre (enlarged thyroid): causes, symptoms and when to get checked
A goitre is an enlarged thyroid gland that shows as swelling at the front of the neck. This article covers causes, symptoms, tests, treatment and warning signs.
Scientist and Chief Medical OfficerDr. Ambed Mishra, PharmD, PhDEducational information only, not medical advice. Always ask a qualified doctor about your own health. In an emergency call 112 (India) or 911 (US). Read the full disclaimer.
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A swelling at the front of the neck can be worrying, but a goitre is not usually serious. Even so, it should be checked so the cause can be found. This article explains what the NHS, MedlinePlus and NIDDK say about goitre. It is general education and not a diagnosis.
What is a goitre?
The NHS describes a goitre as a swelling at the front of the neck caused by an enlarged thyroid, the small gland that makes hormones. It says goitres are not usually serious but should be checked by a GP. MedlinePlus lists goitre as one of the types of thyroid disease, along with hyperthyroidism, hypothyroidism, thyroid nodules, thyroiditis and thyroid cancer.
Symptoms
The NHS says a goitre usually causes a painless swelling at the front of the neck, which may feel smooth or lumpy and may affect only one side. Other possible symptoms are:
- A cough that will not go away
- A hoarse voice or voice changes
- A feeling of something stuck in the throat
- Wheezing
- Difficulty swallowing or breathing
The NIDDK says that in Hashimoto's disease a goitre can cause a feeling of fullness in the throat but is usually painless.
What causes a goitre?
The NHS lists these causes:
- An overactive or underactive thyroid
- Harmless lumps, called nodules, on the thyroid
- Hormone changes during puberty, pregnancy or menopause
- An inflamed thyroid, called thyroiditis
- Autoimmune conditions such as Graves' disease
- Iodine deficiency, which is rare in the UK
- Thyroid cancer, which is rare
The NIDDK lists a goitre among the symptoms of hyperthyroidism and of Hashimoto's disease. Graves' disease is the most common cause of hyperthyroidism, and Hashimoto's disease is the most common cause of hypothyroidism.
How is it checked?
The NHS says tests usually include blood tests, an ultrasound scan, or a needle biopsy of the thyroid, to find the cause. MedlinePlus lists TSH, T4 and T3 blood tests, thyroid antibody tests, a thyroid scan and uptake test, an ultrasound and needle biopsy among thyroid tests. A doctor decides which are needed.
Treatment
The NHS says most goitres are small and cause no problems, so they may not need treatment. If an underactive or overactive thyroid is the cause, medicines can usually treat it. If the goitre makes breathing or swallowing difficult, surgery to remove some or all of the thyroid may be needed. MedlinePlus says treatment depends on the problem, its severity and the symptoms, and may include medicines, radioiodine therapy or surgery. Your doctor, often an endocrinologist, decides.
Iodine
The NIDDK says people with thyroid disease may be sensitive to iodine, and that very large amounts from seaweed, iodine supplements or some cough syrups can worsen thyroid conditions. During pregnancy, the NIDDK says too much iodine can cause a goitre in the baby. Do not start or stop supplements without talking to your doctor.
When to see a doctor
See a doctor if you notice a swelling at the front of your neck, a voice change that does not go away, or a lump in the neck. MedlinePlus lists a lump in the neck, trouble breathing, trouble swallowing, pain when swallowing and hoarseness that does not improve as possible symptoms of thyroid cancer, which is one reason to get checked.
The NHS says to go to hospital or call emergency services if you have trouble breathing or a wheezing noise when you breathe, and not to drive yourself. In an emergency, call your local emergency number (112 in India, 911 in the United States).
This article is for education only and does not replace advice from your own doctor.
Common questions
Is a goitre serious?
The NHS says goitres are not usually serious but should be checked by a GP.
What are the symptoms of a goitre?
The NHS says a usually painless swelling at the front of the neck, and sometimes a cough, hoarse voice, feeling of something stuck in the throat, wheezing or trouble swallowing or breathing.
How is a goitre tested?
The NHS says tests usually include blood tests, an ultrasound scan or a needle biopsy of the thyroid.
Does a goitre always need surgery?
No. The NHS says most goitres are small and may not need treatment, and surgery may be needed if breathing or swallowing becomes difficult.
Important: please read
- Educational information only. This article is general health education. It is not medical advice, diagnosis or treatment. Reading it does not create a doctor–patient relationship with MyDoctor or with anyone else.
- Ask a qualified doctor. Always talk to a qualified, registered doctor about your own health. In India, that means a doctor registered with the National Medical Commission (NMC) or a State Medical Council. In the United States, a licensed physician. Elsewhere, a doctor licensed where you live.
- Never ignore or delay professional advice because of something you read here. Do not start, stop or change any medicine or treatment without your doctor.
- Emergencies: call 112 in India, 911 in the United States, or your local emergency number. Do not wait for an online answer.
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- About the sources. This article summarises, in our own words, information from the public health bodies named under Sources. Health knowledge changes, and this summary may not reflect the latest research or your personal situation.
- Liability. To the extent permitted by law, MyDoctor (MODERNUS HEALTH TECHNOLOGIES PRIVATE LIMITED) accepts no liability for any decision made on the basis of this content.
Sources
- NHS. Goitre www.nhs.uk
- NIH MedlinePlus. Thyroid Diseases medlineplus.gov
- NIDDK (NIH). Hashimoto's Disease www.niddk.nih.gov
- NIDDK (NIH). Hyperthyroidism (Overactive Thyroid) www.niddk.nih.gov
Dr. Ambed Mishra, PharmD, PhD
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Dr. Ambed Mishra is a clinical (patient care) scientist, author and former professor. He is Group CEO and Chief Medical Officer of MODERN US HEALTH (MODERN US GROUP), Austin, Texas, the group behind MyDoctor, and a senior consultant who teaches and trains MD/DO physicians, PharmD and PhD professionals, nurses and other healthcare professionals in patient care in the United States and India.
More about Dr. Ambed Mishra
- More than ten years of full-time leadership in United States healthcare, building patient care services that improve medication adherence and bring doctors, pharmacists and nurses together around each patient.
- Leads the MD and engineering teams behind MyDoctor: clinic and hospital management software, electronic health records and telehealth for hospitals and physician groups in the United States and India.
- Former Assistant Professor and Clinical Preceptor at Rajiv Gandhi University of Health Sciences, Bangalore, and senior researcher with hospitals, universities and patient care groups in India and the United States.
- More than 30 published research and review articles and case reports, and more than 15 international conference presentations in India, Australia, Canada, the United States, Spain and other countries.
- Chief Medical Officer and Global Program Head of a nonprofit mission that helps cover hospital and doctor visit bills for patients in need in India, Nepal, the United States and other countries.
The author's office answers questions about articles, research, speaking and collaboration. It cannot give personal medical advice.