Goiter is an abnormal swelling of the thyroid gland. The thyroid gland is butterfly-shaped and is located in the neck, just below the Adam's apple. In some cases of goiter, pain does not occur although the thyroid gland may swell large enough to cause coughing, sore throat, and/or shortness of breath. Goiter can be caused by various health problems. The appropriate treatment method is selected based on the cause and severity of the goiter.
Step
Method 1 of 3: Diagnosing a Goiter
Step 1. Learn all about goiter
To be able to diagnose and treat goiter effectively, first learn all about goiter. A goiter is an abnormal (usually benign) growth of the thyroid gland. When a goiter occurs, thyroid production can be increased, decreased, or normal.
- Goiter is usually painless although it can cause coughing, shortness of breath, difficulty swallowing, diaphragmatic paralysis, and superior vena cava (SVC) syndrome.
- The method of treatment is determined based on the cause, symptoms that occur, and the size of the goiter.
Step 2. Learn the various symptoms of goiter
Be aware of goiter by studying the various symptoms that can be caused by this condition. If any of the following symptoms occur, consult a doctor to confirm the diagnosis:
- The base of the neck swells, which you can clearly see when shaving or applying cosmetics.
- Throat feels tight
- Cough
- Hoarseness
- Difficulty swallowing
- Hard to breathe
Step 3. Prepare before consulting a doctor
Since goiter is a rather complicated disease (it can be caused by a variety of things, each of which is cured by a specific method of treatment), have some questions ready to ask your doctor, for example:
- What is the cause of my goiter?
- Is my condition dangerous?
- What is the appropriate treatment method to address the cause of my goiter?
- Are there other treatment methods I can use?
- Can I use the "wait and watch" method?
- Will my goiter get bigger?
- Do I have to take medication? If so, how long should the medication be taken?
Step 4. Consult a doctor
Your doctor will likely perform various tests to confirm the diagnosis. The tests performed depend on the patient's medical history and the doctor's suspicions regarding the cause of the patient's goiter.
- The doctor may perform hormone tests to check the levels of hormones produced by the patient's thyroid and pituitary glands. If hormone levels are found to be too low or high, goiter may be caused by the condition. The doctor will take a blood sample from the patient, then send it to a laboratory for testing.
- Antibodies may also be checked (with a blood test) because abnormal antibodies can trigger goiter.
- In an ultrasound examination, a device, which emits and captures reflected high-frequency sound waves, is positioned around the patient's neck. The results of the reflection of high-frequency sound waves form an image on a computer screen so that doctors can detect abnormalities that cause goiter.
- A thyroid gland scan may also be done to confirm the diagnosis. The radioactive isotope is injected into a vein in the elbow, and the patient is asked to lie down. The camera displays an image of the thyroid gland on a computer screen so that the doctor can detect the cause of the goiter.
- A biopsy is usually done to rule out cancer. To perform a biopsy, the doctor takes a small amount of the patient's thyroid gland tissue.
Method 2 of 3: Using Medical Treatment
Step 1. Minimize the swelling of the thyroid gland with radioactive iodine
In some cases, radioactive iodine is effective in reducing the swelling of the thyroid gland.
- Radioactive iodine can be taken orally. Once consumed, radioactive iodine reaches the thyroid gland via the bloodstream. In the thyroid gland, radioactive iodine destroys thyroid cells. Since the 1990s, this method is common in Europe.
- This method is very effective in dealing with goiter. In 90% of goiter patients, the size and volume of the thyroid gland decreases by 50-60% after 12-18 months.
- This method can cause a decrease in the performance of the thyroid gland. However, these effects are very rare and usually appear within the first two weeks after using this method. If you are worried, consult your doctor first before starting to do this method.
Step 2. Use certain medications
If the patient is diagnosed with hypothyroidism (a decreased performance of the thyroid gland), the doctor may prescribe medication to treat the condition.
- Thyroid hormone replacement medications, such as "Synthroid" and "Levothroid," are effective in relieving many symptoms of hypothyroidism. This drug also causes the pituitary gland to reduce hormone production, the body's compensatory response that can cause the goiter to shrink.
- If taking hormone replacement medication doesn't make the goiter smaller, medication can still be used to treat other symptoms. However, your doctor may also recommend a corticosteroid cream or aspirin.
- Thyroid hormone replacement medications are usually used safely by most patients although they can cause side effects such as chest pain, increased heart rate, headache, insomnia, diarrhea, nausea, and irregular periods.
Step 3. Talk to your doctor about surgical removal of the goiter
The goiter can be surgically removed. In this operation, the doctor makes a 7, 5-10 cm long incision in the center of the neck, above the thyroid gland, then removes all or part of the thyroid gland. The operation usually lasts four hours and, in most cases, the patient can go home the same day.
- If the goiter is so large that it compresses the neck and esophagus and causes shortness of breath and choking at night, doctors usually recommend surgical removal of the goiter.
- In rare cases, thyroid cancer can cause goiter. If a goiter is suspected to be caused by cancer, your doctor may recommend surgical removal of the goiter.
- Surgical removal of the goiter may also be performed for cosmetic reasons. Sometimes, patients want goiter removed because it interferes with the appearance. However, insurance may not cover the cost of goiter removal surgery performed for cosmetic reasons.
- After having a goiter surgically removed, patients usually need to take thyroid hormone replacement medication (which is generally used to treat hypothyroidism) for life.
Method 3 of 3: Using Home Remedies
Step 1. Wait and watch
If the test results show that the thyroid gland is functioning normally and the goiter is not large or impairs health, your doctor may recommend the "wait and watch" method. If in the future the goiter gets bigger or causes health problems, the right treatment method can be done.
Step 2. Increase your iodine intake
Goiter sometimes occurs as a result of iodine deficiency. So, increasing the consumption of foods containing iodine can cause goiter to shrink.
- Everyone needs to consume at least 150 micrograms of iodine per day.
- Shrimp and other shellfish and sea vegetables, such as kelp, hiziki, and kombu, are high in iodine.
- Raw cheese and organic yogurt are rich in iodine. 240 ml of yogurt contains 90 micrograms of iodine. 30 grams of raw cheddar cheese contains 10-15 micrograms of iodine.
- Cranberries are high in iodine; 120 grams of cranberries contain 400 micrograms of iodine. Strawberries are also a good source of iodine; 240 grams of strawberries contain 13 micrograms of iodine.
- Potatoes and navy beans are also high in iodine.
- Use iodized salt.
