What is Goiter?

Goiter is the thyroid gland growing larger than normal and becoming visible. The thyroid gland is a butterfly-shaped endocrine gland located in front of our windpipe. Goiter is usually painless. Sometimes very large goitres can cause complaints such as cough, difficulty swallowing, shortness of breath, and hoarseness.

The most common cause of goiter in the world is iodine deficiency. In regions where the use of iodized salt is common, more or less production of thyroid hormones than normal causes the gland to enlarge and goiter formation. Treatment varies depending on the size of the goiter, the complaints it causes and the underlying cause. Small goiter cases that do not cause complaints or cause a detected disease can be followed.

What are the symptoms of goiter disease?

• Swelling that can be seen in the neck

• Feeling of hardness in the throat

• Cough

• Hardening, thickening of the voice

• Difficulty in swallowing

• Shortness of breath

How does goiter form?

The thyroid gland secretes two main hormones: T4, T3. These hormones regulate body metabolism and blood flow. It regulates the body's use of fat and carbohydrates and protein production. It controls body temperature and heart rate. The thyroid gland is also responsible for the production of calcitonin hormone.

The pituitary gland and hypothalamus located in the brain manage the production and release of T3 and T4. The hypothalamus acts as our body's thermostat. It stimulates the pituitary gland to produce TSH (thyroid-releasing hormone). The pituitary gland releases TSH according to the body's needs. Accordingly, the thyroid gland produces T4 and T3 according to the TSH stimulus it receives. Having goiter does not indicate that the thyroid gland is not functioning normally. Even if the thyroid gland is enlarged, our thyroid hormone level may remain normal. However, it can also be low or high. In other words, there is no connection between goiter development and hormone levels.

Goiter causes:

• Iodine deficiency

• Graves disease

• Hashimoto's disease

• Mutinodular goiter

• Single thyroid nodule

• Thyroid cancer

• Pregnancy

• Inflammatory disease of the thyroid � �s

Risk factors:

Goiter can affect anyone. It may be present at birth or develop later. Factors affecting the development of goiter:

• Iodine deficiency in the diet

• Being a woman

• Over the age of 40

• Family history of autoimmune diseases

• Pregnancy

• Menopause

• Some medications: Certain heart medications, psychiatric medications such as lithium

• Exposure to radiation

Complications:

Small goiters do not cause physical and cosmetic problems. Large goiters may cause shortness of breath, difficulty swallowing, cough, and hoarseness of the voice. Goiter may also occur due to reasons such as hypothyroidism or hyperthyroidism. These diseases can cause complaints such as fatigue, weight gain, or unintentional weight loss and sleep disorders.

Diagnosis:

• Blood tests: TSH, ST4, Anti TPO, Anti TG

• Ultasonography 

• Thyroid scintigraphy

• Biopsy

Treatment:

Observation: Small, non-complaint goiters

Medical treatment: If thyroid hormone disorder is detected, drug therapy, if inflammatory thyroid disease is detected, aspirin, non-steroidal anti-inflammatory or steroids treatment can be given.

Surgical: Surgical removal of the thyroid gland would be appropriate for thyroid gland or thyroid cancer that causes serious complaints.

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