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Goitre Content Supplied by NHS Choices
Diagnosis

If you think you have a goitre, see your GP. They can examine your neck to see if there's any evidence of thyroid gland swelling and may request blood tests to check the function of your thyroid gland.

Thyroid function test

A thyroid function test is a type of blood test. A sample of your blood is taken and measured for levels of:

  • thyroid-stimulating hormone (TSH)
  • thyroxine and triiodothyronine (the thyroid hormones)

If you have lower or higher-than-average levels of these hormones, it could mean you have a thyroid condition or are at risk of developing one in the future.

Read more detailed information about:

diagnosing an overactive thyroid

diagnosing an underactive thyroid

Referral to a specialist

Your GP may refer you to a specialist thyroid clinic or a specialist in hormone-related conditions (an endocrinologist) if you have a thyroid swelling and:

  • it's getting bigger
  • you have a family history of thyroid cancer
  • you've had radiation treatment to your neck
  • you have swollen lymph nodes in your neck
  • you're a child or teenager
  • you're 65 or over
  • your voice has changed
  • you're making a high-pitched noise as you breathe (stridor)
  • you're having difficulty breathing or swallowing

If you're referred to a specialist, you may have further tests in hospital. These are described in more detail below.

Radioactive iodine scan

This involves a small amount of radioactive iodine being injected into your vein. The iodine builds up in your thyroid gland, which can then be studied using a special camera.

The scan can provide useful information about the structure and function of your thyroid gland. As the amount of radiation used is very small, it's perfectly safe for most people. However, it may not be suitable if you're pregnant.

Ultrasound scan

An ultrasound scan uses high-frequency sound waves to create an image of part of the inside of your body. It can be used to:

  • build up a picture of the inside of your thyroid gland
  • assess the size of your thyroid gland
  • check whether there are any enlarged nodules in your thyroid gland not found during the physical examination

Fine-needle aspiration

Fine-needle aspiration is a procedure where a sample of the goitre is extracted so the cells inside it can be tested. This procedure is often known as a biopsy.

During the procedure, a fine needle on the end of a syringe is inserted into the goitre in your throat. A sample of the fluid or tissue inside the goitre is sucked through the needle into the syringe.

The sample can be examined under a microscope to determine what kind of cells are inside the goitre.

Autoimmune condition
An autoimmune condition is when your immune system (the body's defence system) produces antibodies (proteins) that should fight infections, but instead attack your body's healthy tissues.
Hormones
Hormones are groups of powerful chemicals produced by the body and have a wide range of effects.
Thyroid gland
The thyroid gland is found in the neck. It produces hormones that are released into the bloodstream to control the body's growth and metabolism (the process that turns food into energy).
Treatment

Treatment for a goitre can include medication, hormone therapy and surgery.

The treatment you receive will depend on:

  • the size of the goitre
  • the symptoms the goitre is causing
  • whether you have any underlying thyroid condition

Your condition may just be monitored if tests reveal your thyroid gland is working normally and the goitre is small.

If your goitre is interfering with your breathing or swallowing and it hasn't responded to other forms of treatment, you may need surgery to remove part or all of your thyroid gland. This procedure is known as a thyroidectomy.

Treating thyroid gland problems

If tests reveal a problem with your thyroid gland, you may receive treatment for:

  • an overactive thyroid gland (hyperthyroidism) - which may include taking a type of medication known as thionamides or a type of radiotherapy called radioiodine treatment
  • an underactive thyroid gland (hypothyroidism) - which usually involves taking a synthetic hormone called levothyroxine to replicate your normal thyroid function (hormone therapy)

Read more about:

treating hypothyroidism

treating hyperthyroidism

Iodine supplements

A well-balanced diet usually provides all the iodine your body needs, and iodine supplements aren't usually required in developed countries like the UK. Your GP can give more advice about extra supplements, if needed.

Iodine supplements are available in many health food shops without a prescription. However, always consult your GP before taking them as the amount of iodine needed varies from person to person.

Taking too much iodine may cause other health problems, and it could also have toxic effects.

Thyroidectomy

Before a thyroidectomy, you'll be given a general anaesthetic so you're unconscious and unable to feel anything.

During surgery, the surgeon makes a cut (incision) in the front of your neck so they can see your thyroid gland.

How much of the thyroid gland is removed depends on the underlying condition causing the goitre. The procedure reduces the size of your goitre and the amount of thyroid hormones being produced.

The surgeon will attempt to remove enough of your thyroid gland to relieve your symptoms, while leaving enough so normal thyroid hormone production can continue.

However, if this isn't possible, you may require hormone therapy after surgery.

Surgery to remove the thyroid gland is usually safe, but as with all surgical procedures there's a risk of complications, such as postoperative infection.

Complications of a thyroidectomy

The risks of complications occurring after thyroid gland surgery are estimated to be 1-2%. Before having the procedure, you should discuss the risks with your surgeon.

Nerve damage and parathyroid gland damage are two other possible complications of thyroid gland surgery. These are briefly described below.

Nerve damage

The thyroid gland is very close to the two laryngeal nerves, which control your vocal cords. If these are accidentally damaged during surgery, your voice and breathing could be affected.

Permanent damage to the laryngeal nerves affects 1-2 people in every 100 who have this type of surgery. Temporary damage may affect up to 5 people in every 100.

Parathyroid gland damage

The parathyroid glands help regulate the amount of calcium in your body. If the parathyroid glands are damaged, you'll probably need to take calcium supplements for the rest of your life.

Hormones
Hormones are groups of powerful chemicals that are produced by the body and have a wide range of effects.
Incision
An incision is a cut made in the body with a surgical instrument during an operation.
Thyroid gland
The thyroid gland is found in the neck. It produces hormones that are released into the bloodstream to control the body's growth and metabolism (the process that turns food into energy).
White blood cells
White blood cells are the part of blood that fight infection and disease.
 
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