what are the symptoms of a goitre?

 

A goitre is simply the term for an enlarged thyroid gland. There are a number of  causes of a goitre including:

 

  • physiological goitre of iodine deficiency – commonly seen in young people in living in an iodine deficient society

  • diffuse goitre from autoimmune thyroid disease (Graves’  or Hashimoto’s) – these are autoimmune disorders associated with either increased or reduced thyroid hormone production from the thyroid

  • benign multinodular goitre – this is due to the development of multiple colloid or jelly-like lumps in the thyroid and commonly runs in families

  • neoplastic goitre – the thyroid may become enlarged because of the development of tumours, either benign (adenomas) or malignant (thyroid cancer)

 

A goitre may cause symptoms of disordered function, with either too much (hyper-) or too little (hypo-) thyroid hormone being produced. This is explained further in symptoms of hyperthyroidism and hypothyroidism.  A goitre may also cause symptoms of disordered structure  due to pressure on adjacent organs and other structures. Commonly a goitre will cause pressure on:

 

  • the trachea or windpipe – this leads to an irritating cough, followed by a sensation of choking, and eventually difficulty breathing

  • the oesophagus or swallowing tube – this leads to difficulty swallowing with solid food or tablets getting “stuck” on the way down

  • the recurrent laryngeal nerves or nerves to the voicebox – this leads to a change in the voice which eventually becomes husky and weak

  •  the major draining blood vessels or jugular vein – this causes the face to become red and bloated, especially with the arms raised

  • a malignant goitre may also spread beyond the local region and involve more distant structures such as lymph nodes, major nerves, bones or the lungs.