Goitre

Goitre is the term used to describe an enlarged thyroid gland.

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 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 cause local pressure symptoms.

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.

Types and causes of goitre

Women are more likely to get a goitre than men. Most goitres are benign (not cancer) but some are caused by a cancer. The tests are designed to establish this.

In addition to benign and malignant goitres there are different ways of classifying goitres:

  • an endemic goitre that affects many people in a population due to iodine deficiency
  • a toxic goitre where the enlargement of the thyroid is associated with hyperthyroidism – an overactive thyroid. This can be due to antibodies as in Graves’ disease.
  • A hypothyroid goitre is a thyroid that is enlarged and also underactive. This is most commonly due to the presence of antibodies that attack the thyroid and cause a gradual loss of function.
  • Thyroiditis – this is an inflammation of the thyroid gland that can occur after a viral illness or be due more commonly to antibodies in which case it is called autoimmune thyroiditis. These are benign conditions that can affect the function of the thyroid. 
  • physiological goitres – may occur during puberty and before/after pregnancy

Diagnosis of goitre

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

You may also need other diagnostic tests including:

  • thyroid function tests – a blood test to check your thyroid is working properly
  • an ultrasound scan – a scan to check the structure of your thyroid and whether it has any nodules that may be 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

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:

  • medication – if a goitre is overactive or underactive medication may be required
  • thyroid surgery – an operation to remove all or part of the thyroid gland. This may be recommended if a goitre is cancerous or large enough to give symptoms. 
  • radioiodine treatment – may be used to treat an overactive thyroid gland

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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.