A goiter is a swelling of all or part of the thyroid gland. The thyroid gland affects the body's metabolism and is located in the neck, wrapped around the lower end of the windpipe, or trachea. There are a number of different types of goiters with a variety of causes, including iodine deficiency, diseases where the thyroid is over or underactive, and, rarely, cancer. Hypothyroidism is the name of the condition where the thyroid gland is underactive and does not produce enough thyroid hormones. Goiters and hypothyroidism may occur together because the disorder sometimes causes enlargement of the thyroid gland.
The symptoms of hypothyroidism are found in a lot of other illnesses and include tiredness, feeling the cold, dry skin, and constipation. As the thyroid gland is underactive, it produces fewer thyroid hormones, slowing down the metabolism and leading to physical and mental sluggishness. Sometimes, the thyroid gland enlarges in an attempt to increase hormone production, leading to the formation of a goiter. If this becomes large enough, goiter symptoms may be experienced, such as a hoarse voice, coughing, and problems with swallowing and breathing.
Although, due to their many different causes, the methods used for treating goiters are not always the same, where goiters and hypothyroidism are concerned, drug treatment of the underactive thyroid can sometimes reduce the goiter as well. Treating hypothyroidism involves replacing the missing thyroid hormones with synthetic versions, taken in the form of daily medication for life. A large goiter, which is causing breathing or swallowing difficulties, may need to be treated surgically. The whole or part of the thyroid gland may have to be removed, and thyroid medication may be required if too much of the gland is lost.
Sometimes goiters and hypothyroidism are not linked, and an underactive thyroid gland may occur without any enlargement. When a goiter is present, it may be smoothly enlarged or it may contain small lumps known as nodules. Some nodules may need to be investigated using a test such as an ultrasound scan, and a sample of tissue may be taken from the lump using a needle. This is done because, rarely, nodules may turn out to be malignant, or cancerous. Even when a nodule turns out to be malignant, if it is the most common form of thyroid cancer it can often be cured by surgical removal.
The outlook for goiters and hypothyroidism is usually positive, because a small goiter may shrink in size when hypothyroidism is treated. Larger goiters may be successfully removed surgically, relieving pressure on the trachea and esophagus. The symptoms of hypothyroidism commonly reduce once the optimum dose of replacement thyroid hormone is established.