Goitre and Thyroid Nodules
A goitre is an enlarged thyroid gland, seen as a swelling in the front of the neck that moves up when you swallow. A thyroid nodule is a lump within the gland; a goitre with many lumps is called a multinodular goitre. Iodine deficiency was historically a major cause in Nigeria, and goitres remain common, especially in women. Most goitres and nodules are not cancer, but every one needs blood tests, an ultrasound scan and, for some nodules, a needle biopsy.
Find a General Surgery SpecialistMedically reviewed by Dr Debo Odulana, Founder and Chief Executive, Mezo. Last reviewed . This page is general information, not a diagnosis. Care is decided with you after an examination.
Symptoms
- A swelling in the front of the neck that moves when you swallow
- A feeling of tightness or a lump in the throat
- Difficulty swallowing, or breathlessness when lying flat (large goitre)
- A hoarse voice
- Weight loss, fast heartbeat, sweating and tremor (overactive thyroid)
- Weight gain, tiredness, feeling cold and constipation (underactive thyroid)
When to See a Doctor
See a doctor for any swelling in your neck, so thyroid blood tests and an ultrasound can be done. See a specialist promptly if a lump is growing quickly, is hard or fixed, if your voice has become hoarse without a cold, or if you have swollen glands in the neck. Go to an emergency department if you have noisy breathing or difficulty breathing or swallowing.
Treatment options
- Thyroid function blood tests (TSH and T4)
- Ultrasound scan of the neck
- Fine needle aspiration (FNA) biopsy of suspicious nodules
- Monitoring with repeat scans for small, benign nodules
- Medication for an overactive or underactive thyroid
- Thyroidectomy (removal of part or all of the thyroid) for large goitres, pressure symptoms, suspicious nodules or cancer
- Radioactive iodine for some overactive glands, where available
What it costs on Mezo
Published cash prices for the operations used to treat this condition. Your own quote follows an examination.
Common Questions
Is goitre caused by not eating enough salt?
Lack of iodine causes goitre, and iodised salt was introduced to prevent it. Most salt sold in Nigeria is iodised, so many goitres today have other causes, such as nodules or autoimmune thyroid disease. Eating more salt will not shrink an existing goitre and is bad for blood pressure.
Is a thyroid nodule cancer?
Most are not. The ultrasound appearance and, where needed, a needle biopsy decide which nodules need removing. Thyroid cancers found early generally have a very good outlook.
Will my voice change after thyroid surgery?
The nerves to the voice box run close to the thyroid. Temporary hoarseness is not unusual after surgery; permanent voice change is uncommon with an experienced surgeon. Your surgeon should discuss this risk with you.
Will I need tablets for life after thyroidectomy?
After total thyroidectomy, yes: a daily thyroxine tablet replaces the hormone, with blood tests to check the dose. After removal of half the gland, many people need no tablets.
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