A swelling of the thyroid gland at the front of the neck.

About goitre

A goitre presents as a swelling at the front of the neck caused by an enlarged thyroid gland. Most thyroid swellings are harmless but if this is a new finding you should see a GP to get it checked.

Your thyroid is butterfly-shaped gland at the base of your neck. It produces two hormones – thyroxine (T-4) and triiodothyronine (T-3), which regulate your metabolism.

Symptoms of goitre

Some goitres are small and don't cause any symptoms. In other cases, a goitre may cause a large swelling on your neck and stops your thyroid from working properly.

Local symptoms include:

  • coughing
  • difficulty swallowing
  • hoarseness
  • difficulty breathing
  • a tight feeling in your throat

Goitres can be nodular (caused by lumps) or smooth. In each case the thyroid function can be normal or abnormal.

Causes of goitre

Women are more likely to get a goitre than men. There are different causes of goitre, including:

  • an iodine deficiency
  • hyperthyroidism – an overactive thyroid
  • hypothyroidism – an under active thyroid
  • thyroiditis – an inflammatory condition of the thyroid gland
  • some autoimmune conditions such as Graves' disease
  • physiological causes – including puberty and before/after pregnancy
  • thyroid cancer
  • some medicines and certain foods
  • non-cancerous (benign) growths

Diagnosis of goitre

Your GP may be able to diagnose a goitre by examining your neck and thyroid gland.

You may also need other diagnostic tests including:

  • a thyroid function test – a blood test to check your thyroid is not overactive or underactive
  • an ultrasound scan – a scan to check the structure of your thyroid and whether it has any nodules that can't be felt or are of concern
  • a biopsy (fine needle aspiration) – a thin needle is used to take small sample of thyroid tissue so it can be examined under a microscope
  • a radioactive iodine scan – a radioactive iodine is injected into a vein in your arm, which builds up in your thyroid and shows up on a scan

Treating a goitre

There are different treatment options for goitre depending on its size, symptoms and cause. If your goitre is small, and it isn't causing you any problems, you may not need treatment.

Treatment options may include:

  • thyroid surgery – a total or partial thyroidectomy is an operation to remove all or part of the thyroid gland. This may be recommended if a goitre is large and/or has symptoms that are causing problems. The results of thyroid surgery are closely related to the practice volume and experience of the surgeon. Ask your surgeon about this.
  • medication – if a goitre is caused by an overactive thyroid, medication to treat the condition may also decrease the size a goitre
  • radioiodine treatment – sometimes used to treat an overactive thyroid gland and will decrease the size of a goitre

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Published: 6 January 2020 | Review: 6 January 2023

Disclaimer: This information is published by Cromwell Hospital and is based on reputable sources of medical evidence and experience from over 30 years of treating patients. It has been peer reviewed by Cromwell Hospital doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional. If you have any feedback on the content of this patient information document please email info@cromwellhospital.com or telephone 020 7460 5901.