What is a thyroid goitre?
A thyroid goitre is an enlargement of the thyroid gland, which is located at the front of your neck. The thyroid is responsible for producing hormones that regulate metabolism, energy levels, and overall body function. A goitre can range in size from a small, barely noticeable swelling to a large lump that causes discomfort or difficulty swallowing.
Goitres are often benign (non-cancerous), but they can sometimes indicate an underlying thyroid condition, such as hormonal imbalance, thyroid nodules, or, in rare cases, thyroid cancer.
What causes a thyroid goitre?
Several factors can lead to an enlarged thyroid, including:
- Iodine deficiency – iodine is essential for thyroid hormone production, but deficiency is rare in the UK
- Hormonal imbalances – both hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid) can cause goitre
- Autoimmune thyroid disease – conditions like Hashimoto’s thyroiditis (leading to hypothyroidism) or Graves’ disease (causing hyperthyroidism)
- Thyroid nodules – lumps within the thyroid gland that may be benign or, in rare cases, cancerous
- Thyroid cancer – though uncommon, an enlarged thyroid can sometimes be a sign of cancer
- Pregnancy – hormonal changes can temporarily enlarge the thyroid
- Thyroiditis – inflammation of the thyroid due to infection or autoimmune conditions
What are the symptoms of a thyroid goitre?
The symptoms of a thyroid goitre depend on its size, location, and effect on thyroid function. Many people with a small goitre experience no symptoms, while others may notice:
- A visible lump or swelling in the neck – which may gradually increase in size
- Difficulty swallowing or breathing – if the goitre presses on the windpipe or oesophagus
- Hoarseness or voice changes – due to pressure on the vocal cords
- A tight or uncomfortable feeling in the throat
- Persistent coughing or choking sensation – especially when lying down
If the goitre affects thyroid function, you may also experience symptoms of hypothyroidism (underactive thyroid) or hyperthyroidism (overactive thyroid).
How is a thyroid goitre diagnosed?
If you have a lump or swelling in your neck, your doctor may perform the following tests:
- Physical examination – feeling for swelling, nodules, or tenderness in the neck
- Blood tests – to check thyroid hormone (T3, T4) and thyroid-stimulating hormone (TSH) levels
- Thyroid ultrasound – to assess the size, shape, and structure of the thyroid and detect nodules
- Fine needle aspiration biopsy (FNA) – if a suspicious nodule is found, a biopsy may be taken to rule out thyroid cancer
- CT or MRI scan – for large goitres that may be pressing on the airway
How is a thyroid goitre treated?
The treatment for a goitre depends on its size, symptoms, and underlying cause. Options include:
Watchful waiting
If the goitre is small, not causing symptoms, and thyroid function is normal, no immediate treatment may be needed. Regular monitoring ensures it does not grow or cause problems.
Medication
- Levothyroxine (thyroid hormone replacement) – used if hypothyroidism is the cause
- Anti-thyroid medication (carbimazole, propylthiouracil) – used if hyperthyroidism is the cause
- Radioactive iodine therapy – helps shrink the thyroid gland in cases of hyperthyroidism
Surgery (thyroidectomy)
A thyroidectomy (partial or total removal of the thyroid gland) may be necessary if the goitre:
Thyroid surgery is performed under general anaesthesia, and most patients require an overnight hospital stay before being discharged. If the entire thyroid is removed, lifelong thyroid hormone replacement therapy (levothyroxine) will be required.
- Causes difficulty breathing or swallowing
- Presses on the vocal cords, affecting speech
- Is suspected to be cancerous
- Continues to grow despite medication
What are the risks of goitre treatment?
As with any medical treatment, there are some potential risks:
- Medication side effects – thyroid hormone replacement or anti-thyroid medication may require dose adjustments
- Surgical risks – including bleeding, infection, or voice changes if the vocal cord nerves are affected
- Temporary or permanent low calcium levels (hypocalcaemia) – if surgery affects the parathyroid glands
Can a thyroid goitre be prevented?
While not all goitres can be prevented, you can reduce your risk by:
- Maintaining a balanced diet – including iodine-rich foods like fish, dairy, and eggs
- Managing thyroid conditions – ensuring thyroid hormone levels remain stable
- Attending regular health check-ups – especially if you have a family history of thyroid disease
Why choose Birmingham ENT Clinic?
At Birmingham ENT Clinic, we provide expert assessment and treatment for thyroid conditions, including goitre diagnosis and management. Our specialist team offers:
- Advanced thyroid imaging and diagnostic tests
- Personalised treatment plans tailored to your symptoms and condition
- Minimally invasive and surgical options for goitre removal when necessary
Contact us
If you have noticed a swelling in your neck or have concerns about a thyroid goitre, our team is here to help.
