KnowYourDisease.Com Nontoxic Nodular Goiter, Nontoxic Nodular Goiter Definition, Causes, Risk Factors, Symptoms, Diagnosis & Treatment, Thyroid Nodular Goiter
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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 an endocrine gland that 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, and tend to grow slowly.

There are different types of goiters. A nontoxic (or sporadic) goiter is a type of “simple” goiter that may be diffuse (enlarging the whole thyroid gland) or nodular (enlargement caused by nodules, or lumps, on the thyroid.) The development of nodules marks a progression of the goiter, and should be evaluated by your doctor.

Causes:
The exact causes of nontoxic goiter are not known. In general, goiters may be caused by underproduction or overproduction of thyroid hormones. However, a nontoxic goiter is usually characterized by normal thyroid function. Some possible causes of nontoxic goiter include:

  • Heredity (family history of goiters)
  • Regular use of medications such as lithium, propylthiouracil, phenabutazone, or aminoglutethimide
  • Regular intake of substances (goitrogens) that inhibit production of thyroid hormone. Some common goitrogens include foods such as cabbage, turnips, brussel sprouts, seaweed, and millet
  • Iodine deficiency
    • Iodine deficiency is very rare in the US and other developed countries, due to the use of iodized table salt. However, iodine deficiency 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:
A risk factor is something that increases your chances of getting a disease or condition. The following factors increase your chances of developing nontoxic goiter.
  • Sex: female (Nontoxic goiter is more common in women than men)
  • Age: over 40 years

If you have any of these risk factors, tell your doctor:

  • Family history of goiter
  • History of radiation therapy to head or neck, especially during childhood
Symptoms:
Nontoxic goiters usually do not produce noticeable symptoms. However, if you experience any of the symptoms below, do not assume it is due to nontoxic goiter. These symptoms may be caused by other, less serious health conditions. If these symptoms persist, see your physician.
  • Swelling on the neck
  • Breathing difficulties, coughing, or wheezing
  • Difficulty swallowing
  • Feeling of pressure on the neck
  • Hoarseness
Diagnosis:
Your doctor will ask about your symptoms and medical history, and perform a physical exam. If you are diagnosed with nontoxic nodular goiter, you should consult an endocrinologist.

Tests may include the following:

  • Examination of the Neck–your doctor will examine your neck, and will ask you to swallow to assess any thyroid enlargement.
  • Ultrasound–a test that uses sound waves to identify nodules of the neck and thyroid.
  • Blood Tests–blood samples taken to assess levels of thyroid hormones in particular, TSH (thyroid stimulating hormone).
  • Thyroid Scan (Scintigraphy)–a picture of your thyroid gland that is taken after you have been given a shot or drink of a radioisotope. The scan will show how your thyroid is functioning.
  • Fine Needle Aspiration Biopsy–a small needle will be inserted into a nodule in the thyroid to obtain a tissue sample. The sample will be examined to determine if it is benign, or malignant (cancer). In 50%-60% of all biopsies taken, the results are noncancerous.
  • Barium Swallow–a test to determine if the enlarged goiter is compressing the esophagus, thus causing swallowing difficulty.
Treatment:
Nontoxic goiters usually grow very slowly and may not cause any symptoms, and thus may not require treatment. However, if the goiter grows rapidly, or you have symptoms that affect your neck or obstruct your breathing functions, treatment may be required. 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 treatment plan for you. Treatment options include the following:

Hormone Suppression Therapy
This type of treatment works by using thyroid hormone medication to suppress secretion of thyrotropin (TSH). TSH is the thyroid-stimulating hormone which causes growth of the thyroid gland. Hormone suppression 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.) If nodules continue to grow during treatment, the thyroid gland may need to be surgically removed.

Surgery
Thyroidectomy is a surgical procedure to remove a portion, or all, of the thyroid gland. It is the treatment of choice in someone whose nontoxic goiter is so large to cause difficulty in breathing or swallowing. This type of surgery should be performed by a thyroid surgeon.

Prevention:
Be sure that your diet contains enough iodine (which is not a problem for residents of the US).
 
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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