CRDAMC Homepage | CRDAMC Library Phone #: (254) 288-8366 | CRDAMC Library Fax #: (254) 288-8368

Search Health Library

Nontoxic Nodular Goiter

(Sporadic Goiter; Simple Goiter; Nodular Enlargement of the Thyroid Gland)

Definition

A goiter is an enlargement of the thyroid. The thyroid is a gland. It produces hormones that help regulate your body’s metabolism. It is located on the front of the neck, right below the Adam’s apple. Goiters are seldom painful. They tend to grow slowly.

There are different types of goiters. This sheet focuses on nontoxic (or sporadic) goiter. It is a type of simple goiter that may be:

  • Diffuse—enlarging the whole thyroid gland
  • Nodular—enlargement caused by nodules, or lumps, on the thyroid

The development of nodules marks a progression of the goiter. It should be evaluated by your doctor.

Goiter (Enlargement of the Thyroid Gland)

Copyright © Nucleus Medical Media, Inc.

Causes    TOP

The exact causes of nontoxic goiter are not known. In general, goiters may be caused by too much or too little thyroid hormones. There is often normal thyroid function with a nontoxic goiter. Some possible causes of nontoxic goiter include:

  • Family history of goiters
  • Regular use of medications such as lithium, propylthiouracil, phenylbutazone, or aminoglutethimide
  • Taking a lot of substances (goitrogens) that inhibit production of thyroid hormone—common goitrogens include foods such as cabbage, turnips, Brussel sprouts, seaweed, and millet
  • Iodine deficiency—though rare in the United States and other developed countries, it is a primary cause of goiter in other parts of the world, particularly in mountainous areas, or areas that experience heavy rainfall or flooding

Risk Factors    TOP

Nontoxic goiter is more common in women and in people over age 40.

The following factors increase your chance of developing nontoxic goiter:

  • A diet low in iodine
  • Family history of goiter
  • History of radiation therapy to head or neck, especially during childhood

Symptoms    TOP

Nontoxic goiters usually do not have noticeable symptoms, unless they become very large. Symptoms may include:

  • Swelling of the neck
  • Breathing difficulties, coughing, or wheezing with large goiter
  • Difficulty swallowing with large goiter
  • Feeling of pressure on the neck
  • Hoarseness

Diagnosis    TOP

You will be asked about your symptoms and medical history. A physical exam will be done. Your doctor may recommend a specialist. An endocrinologist focuses on hormone related issues.

Your body fluids and tissues may be tested. This can be done with:

Images may be taken of your body structures. This can be done with:

Treatment    TOP

Nontoxic goiters usually grow very slowly. They may not cause any symptoms. In this case, they do not need treatment.

Treatment may be needed if the goiter grows rapidly, affects your neck, or obstructs your breathing.

If a nontoxic goiter progresses to the nodular stage, and the nodule is found to be cancerous, you will need treatment. Talk with your doctor about the best plan for you. Treatment options include the following:

Hormone Suppression Therapy

Thyroid hormone medication is used to suppress secretion of thyrotropin (TSH). TSH is the thyroid-stimulating hormone that causes growth. This therapy is most effective for early stage goiters that have grown due to impaired hormone production. It is less effective for goiters that have progressed to the nodular stage.

Radioactive Iodine

Radioactive iodine treatment is used to reduce the size of large goiter. It is used in the elderly when surgical treatment is not an option.

Surgery    TOP

Thyroidectomy is done to remove part or all of the thyroid gland. It is the treatment of choice if the goiter is so large that it makes it difficult to breathe or swallow.

Prevention    TOP

Be sure that your diet contains enough iodine.

RESOURCES:

The American Thyroid Association
http://www.thyroid.org
The Hormone Foundation—Endocrine Society
http://www.hormone.org

CANADIAN RESOURCES:

The College of Family Physicians of Canada
http://www.cfpc.ca
Thyroid Foundation of Canada
http://www.thyroid.ca

References:

Bonnema SJ, Bennedbek FN, Ladenson PW, Hegedus L. Management of the nontoxic multinodular goiter: a North American Survey. J Clin Endocrinol Metab. 2002;87(1):112-117.
Bonnema SJ, Nielsen VE, Boel-Jorgensen H, et al. Improvement of goiter volume reduction after 0.3 mg recombinant human thyrotropin-stimulated radioiodine therapy in patients with a very large goiter: a double-blinded, randomized trail. J Clin Endo Metab. 2007;92(9):3424-3428.
Diehl LA, Garcia V, Bonnema SJ, et al. Management of the nontoxic multinodular goiter in Latin America: comparison with North America and Europe, an electronic survey. J Clin Endocrinol Metab. 2005;90(1):117-123.
Freitas JE. Therapeutic options in the management of toxic and nontoxic nodular goiter. Seminars in Nuclear Medicine. 2000;30(2):88-97.
Last reviewed December 2015 by Kim A. Carmichael, MD
Last Updated: 12/20/2014

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

To send comments or feedback to our Editorial Team regarding the content please email us at healthlibrarysupport@ebsco.com. Our Health Library Support team will respond to your email request within 2 business days.

Health Library: Editorial Policy | Privacy Policy | Terms and Conditions | Support
36000 Darnall Loop Fort Hood, Texas 76544-4752 | Phone: (254) 288-8000