Goitre

Goitre is an enlarged thyroid gland. The thyroid gland is a butterfly-shaped gland at the base of your neck. It makes thyroid hormones, which are needed for:

• normal brain growth in children
• controlling your metabolism

Goitre is a sign that there is something wrong with your thyroid gland. It's more common in females than males.

Goitre can show as an obvious lump or swelling in your neck. Goitres are usually painless, but it can feel sore or tender around your thyroid area.

In some people, goitre causes no symptoms.

A large goitre can press on your windpipe or your oesophagus (food pipe). This can cause:

• difficulty swallowing
• a hoarse voice
• a cough
• breathing problems
• snoring
• dizziness

If you have goitre, you might also have:

• hyperthyroidism (too much thyroid hormone)
• hypothyroidism (too little thyroid hormone)

The main causes of goitre are:

• autoimmune diseases such as Hashimoto's disease or Grave's disease
• nodules or lumps in your thyroid gland
• a lack of iodine in your diet
• a tumour or thyroid cancer

What is iodine?

Iodine is a mineral. Your body uses iodine to make thyroid hormones.

In Australia, not having enough iodine is not that common. This is because iodine is added to most breads as iodised salt.

But iodine deficiency can still occur. You need more iodine when you are pregnant or breastfeeding.

See your doctor if you see or feel a lump at the base of your neck, or if you have any of the other symptoms of goitre.

If you have goitre, your doctor will ask about your symptoms and examine you. They'll look at your thyroid gland. They will feel its shape and size, and check for lumps.

Your doctor will organise blood tests to see how well your thyroid gland is functioning. An ultrasound scan may be recommended to check the structure of your thyroid gland.

If you need more tests your doctor may order an imaging test called a radionuclide thyroid scan.

You may also need a biopsy. This is when a doctor takes a sample of your thyroid gland. This sample is tested for disease.

Your treatment will depend on the cause of your goitre.

If your goitre is small and your thyroid function is normal, you might not need treatment.

Medicines for goitre

You might be given thyroid medicines if your thyroid gland is making to too much or too little thyroid hormone.

If you have a painful swelling of your thyroid, your doctor may recommend pain-relief medicines or corticosteroid medicines.

Other treatment options

Radioactive iodine (RAI) treatment is another treatment choice. It's usually given to people whose goitre is caused by thyroid cancer. It can also be given to some people with Graves' disease or nodules or lumps in the thyroid.

Radioactive iodine comes as a tablet. The radioactive iodine spreads through your body. It's absorbed only by your thyroid cells, killing them. It doesn't affect your healthy cells.

You may need surgery if you have a large goitre that is causing difficulty breathing or swallowing. You may also need surgery if you have nodules or lumps in the thyroid. This is called a thyroidectomy.

A large goitre can be uncomfortable. It can also make it hard to:

• breathe
• swallow
• cough

Goitres can also affect how much thyroid hormone you make.

Only goitre caused by a lack of iodine in your diet can be prevented.

Iodine is in many foods, but the actual amount of iodine food contains can vary. It depends on where the food is grown and how it's made.

Good sources of iodine are:

• cheddar cheese
• eggs
• milk
• oysters
• sushi (with seaweed)
• tinned salmon

In Australia, iodised salt is in all bread except for organic bread. Eating bread regularly may help keep your iodine levels up. You can also buy iodised table salt.

Women who are pregnant or breastfeeding need a bit more iodine as they provide all their baby's iodine.

Read more about foods high in iodine.

To learn more about goitre, you can visit the Australian Thyroid Foundation site.

Hormones Australia also offers resources on conditions affecting the thyroid gland.

If you want to know more about goitre, call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak to, 24 hours, 7 days a week.