Understanding Goiter and Thyroid Enlargement

The thyroid is a butterfly-shaped gland located at the base of the front of the neck. It produces thyroid hormone, which controls your metabolism, temperature regulation, and keeps your muscles and organs working properly. Goiter refers to an enlarged thyroid gland. A single or multiple nodules, Graves’ disease, and hyperthyroidism can all lead to the development of a goiter. A goiter can develop in one or both sides of the thyroid gland. In some people, the goiter will start to grow down into the chest. This is referred to as a substernal goiter.

What Are the Symptoms of Goiter?

Goiters can often be seen or felt as a lump or mass in the neck. As goiters become bigger, they can put pressure on your windpipe (trachea) or food pipe (esophagus), causing symptoms such as:

  • Difficulty swallowing
  • Difficulty breathing (particularly when lying down)
  • Choking sensation
  • Pressure in the neck

What Causes Goiter?

In some parts of the world, goiters develop because of a lack of iodine in people’s diets. However, in the United States, where iodine is added to salt, goiters are most often caused by other problems. A family history of goiter increases the risk of developing goiter.

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What Are the Treatment Options?

When a patient starts to experience symptoms, treatment is often offered. The exact type of treatment is based on the cause of the goiter and the patient’s preferences. In some cases, thyroid surgery is the best treatment option. Discuss any possible symptoms or concerns you may have with your primary care provider, an endocrinologist, an ENT (ear, nose, and throat) specialist, or an otolaryngologist.

What Questions Should I Ask My Doctor?

  • I have difficulty breathing or swallowing. Could this be related to a goiter?
  • How big is my goiter?
  • Do I need to treat it, or can I just watch it?

Copyright 2021. American Academy of Otolaryngology–Head and Neck Surgery Foundation. Last reviewed April 2020.

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