What Makes The Thyroid Changes Size Frequently And Lab Values Are Normal

Goiter

Goiter is an enlargement of the thyroid gland in the neck. A goiter can exist caused past a variety of factors and conditions, and treatment ranges from watchful waiting (no handling) to surgery.

Overview

thyroid gland with goiter — Thyroid gland

What is goiter?

Goiter is a condition in which the thyroid gland grows larger. The thyroid gland is a small, butterfly-shaped gland located in the cervix, below the Adam's apple.

The thyroid gland produces the hormones thyroxine (also called T4) and triiodothyronine (too called T3). (Most of the T4 is changed to T3 outside of the thyroid.) These hormones play a part in certain bodily functions, including body temperature, mood and excitability, pulse rate, digestion and others.

Symptoms and Causes

What causes goiter?

Goiters have different causes, depending on their type.

Simple goiters develop when the thyroid gland does not make enough hormones to meet the torso's needs. The thyroid gland tries to make upward for this shortage by growing larger.
Owned goiters occur in people in certain parts of the world who do not get enough iodine in their diet (iodine is necessary to make thyroid hormone). For instance, a lack of iodine in the diet is still a common trouble in parts of central Asia and cardinal Africa. Considering iodine is added to table salt in the The states and other countries, this type of goiter usually does not occur in these countries.
Sporadic goiters, in near cases, accept no known cause. In some cases, certain drugs tin can cause this type of goiter. For instance, the drug lithium, which is used to treat certain mental health conditions, as well as other medical conditions, can crusade this blazon of goiter.

Other risk factors for goiter include the following:

Hereditary (inherited from family unit)
Female gender
Age over 40

Other diseases and conditions tin as well cause a goiter. These include:

Graves' affliction. Graves' affliction is an autoimmune illness (your trunk'due south immune organisation mistakenly attacks your healthy body). In this instance, the immune system attacks the thyroid gland and the thyroid grows larger.
Hashimoto's disease. This is another autoimmune affliction. In this case, the affliction causes inflammation (swelling) of the thyroid gland. This causes it to produce fewer thyroid hormones, resulting in a goiter. This type of goiter unremarkably gets amend on its own over time.
Nodular goiter. In this status, growths called nodules occur on one or both sides of the thyroid gland, causing it to grow larger.
Thyroid cancer. Cancer of the thyroid gland often enlarges the thyroid.
Pregnancy. Human chorionic gonadotropin, a hormone that a woman produces during pregnancy, can cause the thyroid to grow.
Thyroiditis. Inflammation of the thyroid gland itself tin can cause the thyroid gland to grow. This can happen subsequently the person has an affliction acquired by a virus, or subsequently a woman gives birth.
Exposure to radiation. A person who has had medical radiation treatments to the caput and neck (merely not diagnostic procedures, such as a CT scan) has a greater risk of developing goiter.

What are the symptoms of goiter?

The chief symptoms of goiter include:

A swelling in the front of the neck, just below the Adam'southward apple
A feeling of tightness in the pharynx area
Hoarseness (scratchy voice)
Neck vein swelling
Dizziness when the arms are raised above the caput

Other, less mutual symptoms include:

Difficulty breathing (shortness of jiff)
Coughing
Wheezing (due to squeezing of the windpipe)
Difficulty swallowing (due to squeezing of the esophagus, or "food tube")

Some people who have a goiter may also have hyperthyroidism, or overactive thyroid. Symptoms of hyperthyroidism tin include:

An increased resting pulse rate
Rapid heartbeat
Diarrhea, nausea, airsickness
Sweating without exercise or increased room temperature
Shaking
Agitation

Some people with goiter may also take hypothyroidism, or underactive thyroid. Symptoms of hypothyroidism can include:

Fatigue (feeling tired)
Constipation
Dry skin
Weight proceeds
Menstrual irregularities

Diagnosis and Tests

How is goiter diagnosed?

Several tests tin can be used to diagnose and evaluate goiter, including the following:

Physical exam: Your physician may be able to tell if the thyroid gland has grown past feeling the cervix area for nodules and signs of tenderness.
Hormone test: This claret test measures thyroid hormone levels, which tell if the thyroid is working properly.
Antibody test: This blood examination looks for certain antibodies that are produced in some forms of goiter. An antibody is a protein fabricated past white blood cells. Antibodies help defend confronting invaders (for example, viruses) that crusade disease or infection in the body.
Ultrasound of the thyroid: Ultrasound is a procedure that sends high-frequency sound waves through body tissues. The echoes are recorded and transformed into video or photos. Ultrasound of the thyroid reveals the gland'due south size and finds nodules.
Thyroid scan: This imaging test provides information on the size and role of the gland. In this exam, a small amount of radioactive material is injected into a vein to produce an paradigm of the thyroid on a computer screen. This test is not ordered very often, since it is only useful in certain circumstances.
CT scan or MRI (magnetic resonance imaging) of the thyroid: If the goiter is very large or spreads into the chest, a CT scan or MRI is used to measure the size and spread of the goiter.

Direction and Treatment

How is goiter treated?

Handling for goiter depends on how large the thyroid has grown, symptoms, and what caused information technology. Treatments include:

No handling/"watchful waiting." If the goiter is small and is not bothering you, your doctor may determine that it doesn't demand to be treated. Even so, the goiter volition exist closely watched for any changes.
Medications. Levothyroxine (Levothroid®, Synthroid®) is a thyroid hormone replacement therapy. Information technology is prescribed if the cause of the goiter is an underactive thyroid (hypothyroidism). Other medications are prescribed if the crusade of the goiter is an overactive thyroid (hyperthyroidism). These drugs include methimazole (Tapazole®) and propylthiouracil. The doctor might prescribe aspirin or a corticosteroid medication if goiter is caused by inflammation.
Radioactive iodine treatment. This treatment, used in cases of an overactive thyroid gland, involves taking radioactive iodine orally. The iodine goes to the thyroid gland and kills thyroid cells, which shrinks the gland. After radioactive iodine handling, the patient usually has to take thyroid hormone replacement therapy for the rest of his or her life.
Biopsy. A biopsy is the removal of a sample of tissue or cells to be studied in a laboratory. A biopsy may be needed if there are big nodules in the thyroid gland. A biopsy is taken to dominion out cancer.
Surgery. Surgery is performed to remove all or part of the thyroid gland. Surgery may be needed 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. Depending on the amount of thyroid gland removed, the patient may need to have thyroid hormone replacement therapy for the balance of his or her life.