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Goiter
Goiter is not itself a disease. The term simply refers to enlargement of the thyroid, sometimes visible as a swelling in the front of the neck. Enlargement of the thyroid can be a sign of hyperthyroidism or hypothyroidism. It even can occur when thyroid function is normal.
A goiter can be seen in hyperthyroidism of Graves' disease, in which the thyroid enlarges due to stimulation of the gland by the malfunctioning immune system. In hypothyroidism, it enlarges as part of the body's attempt to produce enough hormone to compensate for damage done to it by the disease, or because of inflammation* caused by the disease, or both.
Goiter can also occur in parts of the world where there is inadequate iodine in the diet. Found in seafood and most table salt preparations, iodine is an element essential for the formation of thyroid hormones in the body.
Nodules
Distinct swellings or lumps within the thyroid are called nodules. They are most common in women and their incidence increases with age. The large majority of thyroid nodules are benign*, but some may be cancerous. Thus they require prompt medical evaluation.
Sometimes the thyroid temporarily enlarges slightly during puberty oг pregnancy, without impairing its function or causing any other symptoms.
How Are Thyroid Diseases Diagnosed and Treated?
Diagnosis
To diagnose a suspected thyroid disorder, the doctor takes a medical history and performs a physical examination. Blood samples usually are taken to measure the levels of thyroid hormones and TSH, the pituitary hormone that stimulates the thyroid. The thyroid also may be checked using various scanning techniques. If a thyroid tumor is suspected, a sample of thyroid tissue may be removed for examination.
Treatment
Most thyroid diseases are highly treatable. Hyperthyroidism may be treated with a single dose of radioactive iodine, which destroys overactive thyroid cells. Alternatively, antithyroid medications may be prescribed to suppress formation of thyroid hormones. Surgical removal of most of the thyroid is another treatment. Hypothyroidism is treated with hormone replacement medication, which typically is continued for life.
A goiter of uncertain cause may disappear on its own, or it may be small and not need treatment. Goiters caused by thyroid discase usually shrink with treatment. Occasionally, surgery is needed for removing a very large goiter. Thyroid disease is not contagious. It often runs in families, and there is no way a person can prevent it. People who live in parts of the world where seafood is scarce and table salt is not iodized, however, need to make sure they take in sufficient amounts of iodine to avoid hypothyroidism and goiter.
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