Goitre

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Goitre is characterized by enlargement of the thyroid gland which causes swelling of the neck. Known as gladanda in Ayurveda, it usually occurs due to a deficiency of iodine in the body. However, it can also be caused due to various reasons such as an overactive or underactive thyroid gland, deficiency of iodineand thyroid cancer. In some cases, the swelling of the gland is quite noticeable and becomes quite large after a certain period of time. Although it can be diagnosed with thyroid function tests, people affected by goitre face difficulty in breathing, swallowing food or even drinking a glass of water. Here are few facts about goitre which you should be aware of.

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Causes

Although goitre can be caused by various factors, in some cases the exact cause of the condition cannot be identified. Here are some of the common causes of goitre –

Iodine deficiency – It is one of the key reasons that put you at an increased risk of goitre. Since iodine is essential for the production of thyroid hormones by the gland, lack of this mineral in the body leads to underproduction of these hormones leading to goitre. Here are 5 sources of iodine and their benefits.

HyperthyroidismAn overactive thyroid gland caused excess production of the thyroid hormones which in turn leads to swelling of the gland.

HypothyroidismGoitre can develop due to under activity of the thyroid gland which causes swelling of the gland due to decreased production of hormones by the gland.

SmokingThe presence of thiocyanate, a chemical present in the tobacco smoke interferes with the utilisation of iodine in the body thereby causing goitre. Read about 25 things that happen inside your body when you smoke.

Hormonal imbalance – Hormonal changes that occur during menopause and puberty affect functioning of the thyroid gland leading to goitre. Read about 10 common causes of thyroid imbalance.

Inflammation of thyroid gland – In some cases, inflammation of the thyroid gland caused due to certain medications and bacterial or viral infections causes goitre.

Thyroid cancer – Thyroid cancer in rare cases causes swelling of the gland leading to goitre. Read about cancer in India — the 10 most common types you should be aware of.

Here are some key facts about thyroid gland you need to know.

Types

Goitre can be classified into two types namely –

Diffuse goitre: In this case, the entire thyroid gland swells which is larger in size and feels smooth when touched.

Nodular goitre: It causes development of small lumps or nodules in the thyroid gland due to fluid build-up. These can be present in the form of single or multiple nodules.

Read about thyroid disease – types and its various causes.

Symptoms

The main symptom you should look out for, if suffering from goitre is swelling of the thyroid gland which leads to formation of a lump on the neck. The lump on front of the neck will move even as you swallow food or water. Apart from this, other symptoms associated with this disease are:


  • Coughing

  • A tightness around the throat which could cause difficulty in swallowing (dysphagia)

  • A hoarseness in your speaking voice which could also cause irritation


Some of the less common symptoms of goitre include:

  • A high-pitched noise may form while breathing

  • Difficulty in inhaling and exhaling

Diagnosis

If you feel lump on your neck, you need to immediately consult a doctor to know its exact cause. To confirm the condition, your doctor will conduct a physical exam and may ask you to swallow to feel swelling or lump in the thyroid area. If you have a goitre which is slightly larger than normal, you may experience swelling in a particular vein of the neck. This may cause a certain degree of dizziness, especially when the doctor asks you to lift your arm above your head.

The doctor may also ask you to take a few blood tests to understand functioning of the thyroid gland. These include:


  • Free thyroxine test

  • Thyroid stimulating hormone (TSH) test


You may also be asked to undergo other tests such as a thyroid scan or thyroid ultrasound to rule out the possibility of any abnormalities or cancerous areas in the thyroid gland. If a lump is found in the ultrasound, you will be asked to undergo a biopsy to check if you suffer from thyroid cancer.

Read about thyroid profiling — 5 tests to check your thyroid function.

Treatment

There are number of treatment options that are currently used to treat goitre. Here are the common ones that are safe as well as effective.

Radioactive iodine: The main goal of this treatment option is to reduce the size of the enlarged thyroid gland to its actual size. In this, radioactive iodine is administered orally. This approach is particularly effective, if goitre is caused due to excessive production of the thyroid hormone due to enlargement of the gland.

Medications: Drugs such as levothyroxine act as a replacement of the thyroid hormone and thus, aid in the treatment. However, anti-inflammatory medications such as aspirin and corticosteroids are recommended to treat inflammation of the thyroid gland. These drugs help in reducing the discomfort caused by the lump in the neck. Medications may not really make the lump disappear, but they lessen the pain and swelling thereby providing some relief. Read more about medicines for thyroid Disease – Types, Side-effects and Interactions.

Surgery: If large-size goitre is caused, then it can be removed through surgery. However if the thyroid gland is removed completely, the patient will have to take synthetic thyroid hormone for the rest of the life.

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