Thyroid Nodules/Lumps and Goiter (Enlargement)

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Do you have an enlarged thyroid? If your doctor has diagnosed you as having a thyroid nodule, a thyroid lump, or an enlargement of the thyroid known as goiter, you'll want to know more about the diagnosis and treatment process, the relationship between nodules to thyroid cancer, and followup.

Thyroid nodules are very common. A nodule is a swelling or lump, which can be a solid or liquid filled cyst or mass.

Most are benign, but a small percentage can be cancerous. So you should always have a nodule evaluated by your physician as soon as you notice it. An estimated one in 12 to 15 women and one in 50 men has a thyroid nodule More than 90 percent of all thyroid nodules are not cancerous.

Some symptoms of thyroid nodules include palpitations, insomnia, weight loss, anxiety, and tremors, common in hyperthyroidism. Common hypothyroidism symptoms might include weight gain, fatigue, depression. Some people will cycle back and forth between hyperthyroid and hypothyroid symptoms. Others may have difficulty swallowing, a feeling of fullness, pain or pressure in the neck, a hoarse voice, or neck tenderness. And finally, many people have nodules wiht no obvious symptoms related to thyroid dysfunction at all.

A Short History of Goiters

The word “goiter” means that the thyroid gland has become abnormally enlarged.

  A goiter can occur when the thyroid gland is producing too much hormone (hyperthyroidism), too little hormone (hypothyroidism) and when the thyroid gland is working perfectly normally. The thyroid becomes large enough so that it can be seen as enlarged on ultrasound or x- rays, and may be enlarged enough to be visible under the skin of the throat.



Some symptoms of a goiter include tenderness to the touch, pressing on your windpipe or your esophagus, coughing, hoarseness, shortness of breath, fullness in your neck, choking or shortness of breath at night, or a feeling that food is getting stuck in your throat.

Small to medium size goiters are usually treated with thyroid hormone, which decreases the amount of TSH produced by the pituitary gland.   The size of the goiter itself will not decrease, but it should not continue to grow.  If the goiter size does increase, then surgery is usually recommended for the patient.

Goiter, and enlargement of the thyroid gland, is not new.  Calling it a "broncholele," Romans surgically removed enlarged thyroid portions, or used acidic solutions to burn them out.  While this may have ended the goiter, it also ended thyroid function--an essential mediator of many physiologic functions.

In 800 AD, the Chinese observed goiter as a condition.  Treatment eventually included providing seaweed to patients, and in serious cases, surgical removal of the goiter,  For goiter caused by iodine deficiency, seaweed was an effective cure, as kelp and other seaweeds contain large quantities of iodine.

By 1300 AD, Graves Disease had been observed in Chinese medicinal literature. Seaweed was used to treat goiter throughout the Middle Ages.

By 1800, scientists made the connection between iodine and diseases of the thyroid. A lack of iodine in the diet can contribute to enlargement of the thyroid. Low dietary iodine hampers the ability of the body to form the important thyroid hormone thyroxine, As a result,  high levels of thyroid stimulating hormone (TSH) speed cellular production that results in a swollen thyroid gland. 

When the connection between sea salt (high in iodine) was made, it was only a matter of time before iodized salt was first introduced in the United States. First used in 1924 in Michigan, iodized salt was a success in a region of the country now only formerly known as the "Goiter Belt."

Today, few people suffer from goiter caused by iodine deficiency.

If you have a swelling in your neck, be sure to see your physician. Online, you'll find a detailed informational guide about nodules and goiters, how they are diagnosed, and  available treatments for you to consider.

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