The thyroid is a gland found in your neck just below your Adam's apple. It secretes hormones that help regulate bodily functions, including metabolism, the process that turns food into energy. It also regulates heart rate, respiration, digestion and mood.  A condition that causes increased size of the thyroid is called a Goiter. A Goiter may develop in anyone, but is more common in women.  A simple Goiter can occur without a known reason. They can occure when the thyroid gland is not able to make enough hormones to meet the body's needs or because of infection, cigarette smoking, or certain medicines.

Simple Goiters may occure in people who live in areas where the soil and water do not have enough iodine. In the past people in these areas might not get enough iodine in their diet. However, the use of iodized salt in many food products in the United States today generally prevents a lack of iodine in the diet.  Another type of thyroid growth, called a sporadic Goiter, can form if your diet includes too many Goiter promoting foods, such a soybeans, rutabagas, cabbage, peaches, peanuts, and spinach. Keep in mind one would have to eat huge amounts of the afore mentioned products to cause a Goiter. These foods can supress the manufacturing of thyroid hormones by interfering with your thyroid's ability to process iodine.  Not all Goiters cause signs or symptoms. Those that may occur include:

  • A visible swelling at the base of your neck that may be particularly obvious when you shave or put on make up
  • A tight feeling in your throat
  • Coughing
  • Hoarseness
  • Difficulty swallowing
  • Difficulty breathing

A Goiter may be a temporary problem that will remedy itself over time without medical intervention, or a symptom of another, possibly severe, thyroid condition that requires medical attention.  Commonly a doctor will evaluate a Goiter using some or all of the following techniques:

Feeling the thyroid-By feeling the thyroid, the doctor can estimate the size of the gland, tell whether it is growing or not, and tell if it has any lumps in it that might be suspicious for cancer. 

Blood Test- Measurment of the levels of thyroid stimulation hormone (TSH) and T4 in the blood stream are important because they help the doctor determine whether or not the Goiter is making anormal amount of thyroid hormone.  

If the gland has a lump in it the doctor may order a thyroid scan or an ultrasound to see if there are any masses.  The thyroid scan is performed by having the patient take oral capsules that contain a harmless radioactive tracer.  After four, six, or twenty four hours, a detector is placed over the thyroid gland. The amount of radioactive iodine that wound up in the thyroid gland is measured and a picture is taken of the distribution of iodine in the thyroid.  In a normal gland, the iodine is taken up to the same degree through out the entire gland. If there is an area of the thyroid that does not take up the iodine well, then it must be investigated further. The majority of these "cold" areas are benign, but about 5-10% of them are thyroid cancers.

If the thyroid were large enough to press on the swallowing tube, breathing tube or the nerves of the voice box, this pressure might cause difficulty swallowing, shortness of breath, or a hoarse voice quality. It might be important to treat a Goiter that was growing in order to keep it from eventually pressing on imprtant structures and causing problems. 

Often a Goiter gets large enough that it can be seen as a mass in the neck. When other people begin to notice the mass, it is usually big enough to begin causing compression of other vital neck structures-but not always. Sometimes, the large Goiter causes no symptoms other than being a cosmetic problem. If it's big enough to be seen by your neighbors, you will need medications or surgery, or it will most likely continue to grow.

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