What are the indications and signs of a goiter?
The following are the primary symptoms of goiter:
- A bulge in the front of the neck, below Adam’s apple.
- Tightness in the throat
When the goiter is large or very large:
- Hoarseness (scratchy voice)
- Neck vein swelling
- Difficulty breathing (shortness of breath)
- Wheezing (due to windpipe squeezing)
- Difficulty swallowing (due to esophageal squeezing)
How is a goiter identified?
Several tests, including the following, can be performed to diagnose and evaluate goiter.
- Physical exam: By touching the neck area for nodules and signs of pain, the doctor may be able to identify if the thyroid gland has grown.
- Hormone test: This blood test is preferred to measure thyroid hormone levels to see if the thyroid is working appropriately.
- Thyroid scan: This imaging examination determines the size and function of the thyroid gland. Using a little amount of radioactive material, this procedure generates a computerized image of the thyroid gland. This test is rarely ordered since it is only helpful in particular circumstances.
- CT Scan: If the goiter is particularly large or has migrated into the chest, a CT scan or MRI of the thyroid will be performed.
What is the treatment for goiter?
The treatment for goiter is determined by the size of the thyroid, the symptoms, and the cause. No treatment/”watchful waiting” is one option. If your goiter is small and not troubling you, the doctor may determine that it is unnecessary to treat it. On the other hand, the goiter will be continuously monitored for any changes.
Thyroid hormone replacement therapy using levothyroxine is administered if an underactive thyroid is the cause of the goiter (hypothyroidism). If an overactive thyroid is the source of the goiter, other drugs (thionamides) are suggested. If the goiter is caused by inflammation, the doctor may prescribe NSAIDs or corticosteroid medicine.
- Radioactive iodine therapy
This treatment involves the administration of radioactive iodine orally in cases with the hyperactive thyroid gland. Iodine enters the thyroid gland and destroys thyroid cells, causing the gland to shrink. Therefore, thyroid hormone replacement medication is frequently required after radioactive iodine treatment for the rest of the patient’s life.
During a biopsy, a sample of tissue or cells is removed and submitted to the lab for analysis. For example, if there are significant nodules in the thyroid gland, a biopsy may be required. Likewise, to rule out malignancy, a biopsy is performed. Biopsies are always performed under ultrasound guidance.
Surgery is used to remove all or a portion of the thyroid gland. If the goiter is big and causing breathing and swallowing problems, surgery may be required. If cancer is present, surgery may be required, although small cancers can be eliminated through thermal ablation. Depending on how much of the thyroid gland is removed, the patient may require thyroid hormone replacement treatment for the remainder of his or her life.
- Thyroid RFA treatment
Thyroid Radiofrequency Ablation therapy is an alternative to surgery and safer than surgery. Thyroid RFA treatment is a minimally invasive outpatient procedure that uses thermal ablation to heat and shrink thyroid nodules. Thyroid RFA is performed by inserting a needle into thyroid nodule. The tip of the needle heats up, destroying the nodule, and causing it to shrink. The RFA therapy has been proven a safe and effective treatment for benign thyroid nodules and it can be used for micropapillary cancers.