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.
