There are two main hormones produced in the thyroid glands. These hormones are called T3 and T4 or triiodothyronine and thyroxine, respectively. Both of these hormones flow throughout the bloodstream and are responsible for regulating the body’s metabolism. They also control how the body uses lipids (or fats) and carbohydrates. T3 and T4 are also responsible for regulating body temperature and protein production. The thyroid gland also has another hormone called calcitonin. This hormone is responsible for regulating how much calcium is in your blood.

The pituitary gland and the hypothalamus regulate the rate that the above hormones (calcitonin, T3 and T4) are being made and at what rate they are being released.

The hypothalamus is located at the base of the brain. It behaves like a thermostat for your entire system. The hypothalamus signals the pituitary gland to produce a hormone called TSH, which simply stands for thyroid stimulating hormone. Your pituitary gland is also located at the base of the brain. Depending on how much thyroxine or T4 you already have in your blood, the pituitary gland will release amounts into the bloodstream. Based on the amount of TSH the pituitary gland releases, the thyroid gland will regulate production of the afore-mentioned hormones T3 and T4.

The existence of a goiter does not conclusively signify that the thyroid gland is malfunctioning. An enlarged thyroid can still produce normal amounts of hormones. It is possible that your thyroid could be producing and insufficient amount of thyroxine and triiodothyronine. The opposite can also be true in that there may be overproduction of these hormones.

What factors can cause the thyroid gland to enlarge? Here are some common ones:

  • Iodine deficiency. Iodine is essential for the production of thyroid hormones. It can be found in seawater or in the soil of coastal regions. Statistics show that persons living at geographically high elevations or perhaps inland are often deficient in iodine. As a result, they are at risk for developing goiter. What typically happens is that the thyroid gland begins to get larger in an effort to absorb more iodine. Iodine deficiency can worsen for someone who maintains a diet that is high in hormone-inhibiting foods. Such foods are cabbage, cauliflower and even broccoli. Since iodine is routinely added to table salt in first world countries such as the U.S., dietary iodine can be rules out as the main reason for the development of goiter.
  • Graves’ disease. An overproduction of thyroid hormone as in hyperthyroidism can also cause goiters. Graves’ disease, where antibodies created by the immune system instead attack your thyroid gland, the result will be an overproduction of T4 or thyroxine. This causes the thyroid gland to become enlarged.
  • Hashimoto’s disease. An underactive thyroid or hypothyroidism is another likely culprit. As in Graves’ disease, Hashimoto’s disease is a disorder of the immune system as well. Hashimoto’s damages your thyroid so that it produces insufficient thyroid hormone. In turn, your pituitary gland, sensing the low hormone level, produces TSH to compensate and stimulate the thyroid. The result is that the gland becomes enlarged.
  • Multinodular goiter. This is a condition where there are not one, but several solid or fluid-filled nodules, which are lumps that have developed inside of the lobes of the thyroid gland. This too causes the gland to become enlarged.
  • Solitary thyroid nodules. This is when a single nodule is found in one of the lobes of the thyroid. These are generally not malignant.
  • Thyroid cancer. Cancerous nodules in the thyroid often appear as a large swelling on one side of the thyroid gland.
  • Pregnancy. Chorionic gonadotropin (HCG) is a hormone produced during pregnancy. It is possible for this hormone to enlarge the thyroid to some degree.
  • Inflammation. Thyroiditis is the inflammatory condition in the thyroid gland. It often causes much swelling and appears as enlarged in the neck area.

Risk Factors

No one is really exempt from developing goiters. Sometimes people are born with them but they can occur at anytime. Statistically speaking, they are more commonly seen after the age of 50. Here are some risk factors:

  • A lack of dietary iodine. Insufficient iodine in the diet can lead to its development.
  • Your sex. Studies show that women are more likely to develop a thyroid disorder. Therefore, they are more at risk for developing a goiter.
  • Your age. Persons over 50 are generally at a higher risk.
  • Medical history. If anyone in your family has a history of thyroid disease, goiter or dysfunction of the immune system, then that will increase your risk.
  • Pregnancy and menopause. It has been shown that thyroid dysfunction is most likely to occur after pregnancy or menopause.
  • Certain medications. It has been shown that immunosuppressants, antiretrovirals, amiodarone and lithium can increase your risk.
  • Radiation exposure. If you’ve had radiation treatments to your neck or chest area as a child or live near a nuclear facility where an accident has occurred, then you may also be at risk.

Complications

Small goiters are not as much of a concern as large ones. Large goiters make it a challenge to swallow or breathe. They also cause coughing and hoarseness. There are associated symptoms such as fatigue, inexplicable weight loss or insomnia.

Preparing For Your Appointment

If it has been determined that you have a goiter, you may need further testing done. It is recommended that you make a list of questions in preparation for your doctor’s visit. Here are some questions you may want to ask:

  • What is the cause of my goiter?
  • How serious is my condition?
  • How do I treat the underlying cause?
  • What are the treatment alternatives?
  • Will the goiter continue to grow or will it stop if left alone?
  • Is there a treatment option that will reduce the appearance of the enlargement?
  • Will I need medication?
  • How long will I be required to take medication if needed?
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