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Posted on May 27, 2015
Goiter refers to an abnormal growth of your thyroid gland. Though goiters are typically unproblematic, a large goiter can cause a cough and make it difficult for you to swallow or breathe. A goiter can be result of over- or underproduction of thyroid hormones or lumps that develop in the gland itself.

Contributory factors causing goiter
Suffering from goiter doesn't necessarily mean that your thyroid gland is working abnormally. Even when it's inflamed, your thyroid may produce normal amounts of hormones. It might also, however, produce inadequate levels of thyroxine (T-4) and T-3 (triiodothyronine) hormones.

There are a number of reasons behind swelling of your thyroid gland:
  • Iodine deficiency: Iodine is the prime requirement for the production of thyroid hormones and is found in seawater and in the soil of coastal areas. A diet which lacks iodine is the main cause of goiter. It is not a case in countries where iodine is routinely added to table salt and other foods. 
  • Graves' disease: Goiter can sometimes occur due to overproduction of thyroid hormone (hyperthyroidism). In Graves' disease, antibodies produced by your immune system accidently attack your thyroid gland causing it to make surplus thyroxine. This in turn causes the thyroid to swell. 
  • Hashimoto's disease: Goiter can also occur due to underproduction of thyroid hormone (hypothyroidism). Hashimoto's disease is an autoimmune disorder which damages your thyroid so that it produces too little. The pituitary gland then makes more TSH to stimulate the thyroid which causes the gland to enlarge. 
  • Multinodular goiter: In Multinodular goiter, several nodules develop in both sides of your thyroid, resulting in swelling of the gland. 
  • Inflammation: Thyroiditis is an inflammatory condition that can cause pain and swelling in the thyroid. It may lead to hyperthyroidism or hypothyroidism.
Not all goiters have signs and symptoms, but when they do, it includes:
  • A noticeable inflammation at the bottom of the neck that may be particularly obvious when you shave or put on makeup
  • Heaviness in your throat 
  • Coughing
  • Change in voice 
  • Difficulty swallowing and breathing
Treatment for goiter depends on its size, symptoms and the underlying cause. Your endocrinologist may suggest:
  • Supervision: If your goiter is not too large and doesn't cause problems, and your thyroid is functioning normally, your endocrinologist may ask you to adopt a wait-and-see approach.  
  • Medications: If you have hypothyroidism, your doctor will prescribe Levothyroxine, which will resolve the symptoms of hypothyroidism and slow the release of thyroid-stimulating hormone from your pituitary gland, often decreasing the size of the goiter. For swelling of your thyroid gland, your doctor may suggest aspirin or a corticosteroid medication to treat the inflammation.  
  • Surgery: Removing all or certain portion of your thyroid gland is an option if you have a large goiter that’s causing problems. Surgery is also recommended for thyroid cancer. Post surgery, you may need to take Levothyroxine depending on the amount of thyroid removed. 
  • Radioactive iodine: In certain cases, radioactive iodine is used to treat an overactive thyroid gland. It is taken orally and reaches your thyroid gland through your bloodstream, destroying thyroid cells. The treatment significantly reduces the size of the goiter.

Continuous monitoring of your condition may be required is symptoms reappear.
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