Thyroid

The thyroid is a small, bow-tie shaped gland at the base of the neck near the Adam’s Apple. This very small gland has a big job in the body. It maintains the body’s essential metabolism and digestion functions and even affects the menstrual cycle in some women. When the thyroid becomes enlarged, it could be an indicator of one or several issues related to the thyroid.

An enlargement of the thyroid is also commonly called a goiter. The enlargement of the thyroid can put pressure on the windpipe or esophagus causing coughing, a hoarse voice and a very uncomfortable feeling in the neck. You may experience shortness of breath while sleeping and other “choking” feelings while eating or sleeping. Often an enlarged thyroid, or goiter, can be seen through an x-ray or via an isotope injected in the body that captures an image of the thyroid. Goiters are most commonly caused by iodine deficiencies in the thyroid, one of the critical elements to the proper chemical reaction that occurs in the thyroid to do its job effectively. An enlarged thyroid can also be linked to certain autoimmune disorder, like Graves’ disease, which causes the body to attack important antibodies in the thyroid.

Most of the time, a goiter or enlarged thyroid can be treated with hormone replacement treatments. However, more complex or severe cases of thyroid goiters may require surgery. Surgery may be recommended if there are also nodules growing on the thyroid. A nodule is a mass, usually benign, that can be likened to a lump or cyst. They are often liquid filled, like a cyst. Most nodules are harmless, but some can be an indicator of thyroid cancer and should be tested.

Nodules can give people similar symptoms as hyperthyroidism or hypothyroidism, where the thyroid is either overactive or under performing. They can also be a sign of hyperthyroidism. Some of the symptoms of this problem are restlessness, anxiety, tremors in the hands and weight loss. Conversely, the signs of hypothyroidism are weight gain, depression and lack of energy. Some nodules cause people’s thyroid levels to go back and forth between the two extremes causing a disruption in day-to-day life.

Some nodules may not show any thyroid trouble. Therefore, it’s important for doctor to check the nodules and your thyroid levels. A couple of different tests can be administered to determine the cause of your enlarged thyroid and nodules. One, a blood test may be performed to see if the nodules are producing hormones. Nodules are not supposed to produce the thyroid hormone. This may be an indicator of hyperthyroidism, and the nodules could have developed from the condition.

Your thyroid may also be scanned via a radioactive iodine test. The patient is given a small amount of iodine which makes the thyroid more visible. The iodine levels in the thyroid and nodules will indicate to the doctor whether there is a more serious problem. Only a small number of nodules turn out to be cancerous, but it is important to rule out any indication of thyroid cancer. A needle aspiration test, or needle biopsy, could also be performed by a doctor to determine if the nodule is benign (not cancerous); malignant (cancerous); suspicious (not conclusive, but possibility of cancer); and inconclusive (additional biopsy probably needed).

To remedy the nodules and shrink an enlarged thyroid, often hormone therapy works to reduce the inflammation. Depending on the results of the nodule testing and whether it’s dangerous and possibly cancerous, surgery may be recommended to remove the nodules. Surgery may also be needed if hormone treatments or other non-surgical methods do not work to reduce the size of the enlarged thyroid.