About the disease
Nodular goiter is an endocrinological disease, whereby the thyroid gland becomes enlarged because of the multiple nodules growing on it. There are two types of nodular goiter: toxic and non-toxic. Toxic goiter causes the enlarged thyroid gland to produce too much thyroid hormone. This can result in hyperthyroidism, which affects the metabolism. Non-toxic nodular goiter does not cause the thyroid to produce excessive amounts of thyroid hormone, but it can still affect its overall performance.
Non-toxic nodular goiter rarely causes any significant symptoms. At most, the patient may feel compression against their neck. If there are several nodules in the thyroid gland, the patient may also experience breathing problems and feel swelling in the neck.
The exact cause for nodular goiter is still unknown. Long-term iodine deficiency, which can be caused by bad dietary habits, can cause nodular goiter. Genetic predisposition is also believed to play an important role in the development of nodular goiter. In some cases, a hormonal disorder and primary hyperthyroidism can also contribute to the appearance of nodules in the thyroid gland.
Symptoms
- Swelling in the neck
- Enlarged veins
- Hoarseness
- A growth in the neck, which can be felt
- Painful sensations in the thyroid gland
- Pain when swallowing
- Weight changes
Diagnosis
- An ultrasound of the thyroid gland is usually enough to determine whether someone has nodular goiter. This imagining technique can show the amount of nodules, their size and position. It can also determine whether the nodules are fluid-filled or if they resemble cysts.
- A needle-aspiration biopsy is performed to rule out the possibility of cancer in the thyroid gland. The doctor examines a sample of the nodule to establish whether it is benign or malignant.
- A TSH test evaluates the amount of thyroid hormone produced by the thyroid gland, to see if the levels are abnormal. This test also helps to determine whether nodular goiter is toxic or non-toxic.
Treatment
- A thyroidectomy is a surgical procedure, whereby part or all of the thyroid glandis resected. Any nodules present will also be removed. Surgery may be deemed necessary if the nodules make it difficult for the patient to breathe or eat. If the patient has also developed hypothyroidism, beta-blockers are prescribed to control the levels of thyroid hormone in the body. If it has been determined that nodular goiter was caused by an iodine deficiency, doctors can also prescribe radioiodine, which is taken orally. In the event of a total thyroidectomy, daily drug treatment is required to replace the function of the thyroid gland. If the patient has non-toxic nodular goiter, surgery is rarely required.
Authors: Dr. Nadezhda Ivanisova, Dr. Farrukh Ahmed
