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GOITER
GOITER
• Definition
• Types
• Classification
• Causes
• Signs and symptoms
• Diagnosis
• Management
• Prevention
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 INTRODUCTION
• Goiter is an enlarged thyroid gland that causes swelling in the neck. It
can be a sign that the thyroid gland is producing too much or too little
thyroid hormone. Goiter is one of the most common thyroid disorders.
• Goiter happens when your thyroid gland grows larger. It has
several possible causes and may or may not be associated with
abnormal thyroid hormone levels. It’s treatable .
• Your entire thyroid can grow larger or it can develop one or more
small lumps called thyroid nodules Your thyroid gland is a small,
butterfly-shaped endocrine gland located in your neck, below
your Adam's apple. It produces the hormones thyroxine and
triiodothyronine. These hormones play a role in certain bodily
INTRODUCTION CONTINUE
• Metabolism
 Body temperature.
 Mood and excitability.
 Pulse and heart rate
 Digestion.
INTRODUCTION CONTINUE
• Anyone can have a goiter, but it’s about four times more likely to
develop in people assigned female at birth compared to people
assigned male at birth. Your risk of developing goiter also
increases as you age. They’re more common after age 40.
• People who have any of the following conditions may also be
more likely to develop goiter:
• Obesity
• Insuline resistance
• Metabolic syndrome
INTRODUCTION CONTINUE
You’re also at risk for developing goiter if your head and neck
have been exposed to radiation for medical treatments and/or if
you have a family history of thyroid disease.
• The most common cause of goiter worldwide is iodine
deficiency, which affects about 2.2 billion people.
• The more severe the iodine deficiency, the more likely someone
is to have goiter:
INTRODUCTION CONTINUE
 With mild iodine deficiency, the incidence of goiter is 5% to 20%.
 With a moderate iodine deficiency, the prevalence increases to
20% to 30%.
 With severe iodine deficiency, the incidence increases to greater
than 30%.
• The size of a goiter can range from very small and barely
noticeable to very large. Most goiters are painless, but if you have
thyroiditis (an inflamed thyroid gland), it can be painful.
DEFINITION
• Goiter is a condition where your thyroid gland grows larger. Your
entire thyroid can grow larger or it can develop one or more
small lumps called thyroid nodules.
TYPES
 Simple (diffuse) goiter: This happens when your entire thyroid
gland inflame and feels smooth to the touch.
 Nodular goiter: This type of goiter happens when a solid or
fluid-filled lump called a nodule develops within your thyroid
and makes it feel lumpy.
 Multinodular goiter: This happens when there are many
lumps (nodules) within your thyroid.
CLASIFICATION OF GOITER
 Toxic goiter: It happens when your thyroid is enlarged and
produces too much thyroid hormone.
 Nontoxic goiter: If you have an enlarged thyroid but normal
thyroid levels, it’s a nontoxic goiter. In other words, you don’t
have hyperthyroidism (overactive thyroid) or hypothyroidism
(underactive thyroid).
CAUSES
 Iodine deficiency: Your thyroid needs iodine to produce thyroid hormone.
If you don’t get enough iodine in your diet, your thyroid makes more cells
(and grows) to try to make more thyroid hormone.

 While this is the most common cause of goiter worldwide, it’s not common
in the United States. You can get the recommended amount of iodine in
your diet by including seafood, and iodized salt in your diet.

 Graves disease: Graves' disease is an autoimmune disease in which

your immune system attacks your thyroid, causing it to grow larger.
Graves’ disease also causes hyperthyroidism, which requires treatment.
CAUSES CONTINUE

 Thyroid cancer: Cancer of the thyroid gland often enlarges

your thyroid.
 Pregnancy: Human chorionic gonadotropin, a hormone that a
person produces during pregnancy, can cause their thyroid to
grow.
 Thyroiditis: Inflammation of the thyroid gland itself can cause
your thyroid gland to grow. This can happen for several
reasons.
SIGNS AND SYMPTOMS
 Lump in the front of your neck, just below your Adam’s apple.
 A feeling of tightness in your throat area.
 Hoarseness (scratchy voice).
 Neck vein swelling.
 Dizziness when you raise your arms above your head.
 Difficulty breathing and Coughing
 Wheezing (squeezing of your windpipe).
 Difficulty swallowing (squeezing of your esophagus).
S&S
• Some people who have a goiter may also have hyperthyroidism
(overactive thyroid). Symptoms of hyperthyroidism include:
 Rapid heart rate.
. Unexplained weight loss
. Diarrhea
 Sweating without exercise or increased room temperature.
 Shaking.
 Agitation.
S&S
• Some people with goiter may also have hypothyroidism
(underactive thyroid). Symptoms of hypothyroidism include:
 Fatigue(feeling tired).
 Constipation
 Dry skine
 Unexplained weight gain.
 Abnormal menstruation
DIAGNOSIS
 Physical Examination: The CHO may be able to tell if your
thyroid gland is enlarged by feeling your neck area for nodules
and signs of tenderness.
 Thyroid blood test: This blood test measures thyroid hormone
levels, which reveal if your thyroid is working properly.
 Antibody Test: This blood test looks for certain antibodies that
are produced in some forms of goiter. An antibody is a protein
made by white blood cells. Antibodies help defend against
invaders (for example, viruses) that cause disease or infection
in your body.
DIAGNOSIS CONTINUE
 Biopsy: A biopsy is the removal of a sample of tissue or
cells to be studied in a laboratory. You may need a thyroid
biopsy if there are large nodules in your thyroid gland. A
biopsy is taken to rule out cancer.
 MRI OR CT scan of your thyroid: If the goiter is very
large or spreads into your chest, a CT scan or MRI is used
to measure the size and spread of the goiter.
MANAGEMENT
• If the goiter is small and thyroid function is normal, people do not
typically need treatment.

It depends on how large your thyroid has grown, symptoms and

what caused it. Treatments include:

 No treatment if the goiter is small and isn’t distorbing.

 Medications: Levothyroxine is a thyroid hormone replacement
therapy. It can be prescribed if the cause of the goiter is an
underactive thyroid (hypothyroidism). Other medications are
prescribed if the cause of the goiter is an overactive thyroid
(hyperthyroidism). These drugs include: methimazole and
propylthiouracil. You can prescribe aspirin or a corticosteroid
MANAGEMENT CONTINUE
 Radioactive iodine treatment: This treatment, used in cases of an
overactive thyroid gland, involves taking radioactive iodine orally. The iodine
goes to your thyroid gland and kills thyroid cells, which shrinks the gland.
After radioactive iodine treatment, you’ll likely need to take thyroid hormone
replacement therapy for the rest of your life.
 Surgery: Your provider may recommend surgery to remove all or part of
your thyroid gland (thyroidectomy). You may need surgery if the goiter is
large and causes problems with breathing and swallowing. Surgery is also
sometimes used to remove nodules. Surgery must be done if cancer is
present. you may need to take thyroid hormone replacement therapy for the
rest of your life.
PREVENTION
• Goiter caused by iodine deficiency known as simple goiter is
the only type of goiter you can prevent. Consuming a diet that
contains fish and a healthy amount of iodized table salt
prevents you from getting simple goiters.
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