Goitre (goiter): symptoms, causes and treatment

The NHS says the main symptom of a goitre is a swelling at the front of the neck, which is usually painless. It usually appears at the lower front of the neck. Goitres may look and feel either smooth or lumpy, and the swelling may sometimes be just on one side of the neck.

You may also have other symptoms, including a cough that does not go away, a hoarse voice or voice changes, feeling like something is stuck in your throat, a wheezing noise when you breathe, and finding it hard to swallow or breathe. Some people also have symptoms of an underlying thyroid problem, which are described below.

• A visible or palpable swelling at the lower front of the neck.

• A cough that does not go away.

• A hoarse voice or voice changes.

• A feeling that something is stuck in the throat.

• A wheezing noise when you breathe, or difficulty swallowing or breathing.

A goitre happens when your thyroid gland is swollen. The NHS describes the thyroid as a small gland in your neck that makes hormones; the overactive thyroid page adds that it is a small butterfly-shaped gland in the neck, just in front of the windpipe, producing hormones that affect things such as your heart rate and body temperature.

The NHS says some reasons why your thyroid might be swollen include an overactive thyroid gland (hyperthyroidism), an underactive thyroid gland (hypothyroidism), harmless lumps (nodules) on the thyroid, hormone changes during puberty, pregnancy or the menopause, an inflamed thyroid gland (thyroiditis), a condition with your immune system such as Graves' disease, not enough iodine in your diet (this is rare in the UK), and thyroid cancer (this is rare).

The NHS says most goitres are small and do not cause any problems, and sometimes they do not need treatment. You will usually need tests to find out what is causing your goitre, such as blood tests, an ultrasound scan, and taking a small sample from the thyroid gland using a small needle (biopsy).

If it is caused by a health condition like an underactive or overactive thyroid, it can usually be treated with medicines. For an overactive thyroid the NHS lists medicine that stops the thyroid producing too much hormone, radioiodine treatment, and surgery to remove some or all of the thyroid. An underactive thyroid is usually treated with levothyroxine tablets, usually for the rest of your life, with regular blood tests to check the dose. If your goitre is making breathing and swallowing difficult, you may have surgery to remove some or all of your thyroid.

The NHS lists symptoms of an overactive thyroid as nervousness, anxiety and irritability, mood swings, difficulty sleeping, persistent tiredness and weakness, sensitivity to heat, swelling in your neck from an enlarged thyroid gland (goitre), an irregular or unusually fast heart rate, twitching or trembling, and weight loss.

Symptoms of an underactive thyroid include feeling extremely tired, feeling cold more than usual, putting on weight, constipation, difficulty concentrating, low mood, dry skin and hair or hair loss, a croaky voice, and irregular or heavy periods. The GP may examine your neck to find out if your thyroid gland is swollen, and blood tests check thyroid-stimulating hormone (TSH) and thyroxine (T4).

The NHS says to see a GP if you think you have a goitre. It is not usually serious, but it is best to get it checked.

Call 999 or go to A&E if you are finding it hard to breathe or have a wheezing noise when you breathe. Do not drive to A&E; ask someone to drive you or call 999 and ask for an ambulance, and bring any medicines you take with you.

The NHS lists hormone changes during puberty, pregnancy or the menopause among the reasons a thyroid might be swollen. If you are pregnant or planning a pregnancy and notice a swelling at the front of the neck, or you already have a thyroid condition, speak to your GP or midwife, because thyroid conditions are usually checked and managed with blood tests.

On the NHS the first step is a GP, who can arrange blood tests and an ultrasound scan and refer you to a specialist, such as an endocrinologist (a specialist in hormonal conditions), if needed.

Some people use a private endocrinologist or neck ultrasound service for quicker tests. It helps if the results are shared with your GP, particularly if levothyroxine or other thyroid medicines need regular monitoring.