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Think of your thyroid

Whether under- or overactive, this small gland can have big effect

Most of us don’t think about our thyroid—the small, butterfly-shaped gland located on the lower part of the neck—but it plays a big role in how the body functions. The thyroid produces the thyroid hormone that helps the body regulate its temperature and energy level, and keeps the brain, heart and other organs working as they should.

The term “goiter” refers to any abnormal enlargement of the thyroid gland. There are several causes of goiter formation. One is Hashimoto’s thyroiditis, a condition in which the thyroid is attacked by the body’s own immune system. As a result, the thyroid doesn’t produce enough thyroid hormone, leading to hypothyroidism. A person with an underactive thyroid will experience symptoms such fatigue, weight gain and hair loss. 

Another common condition that causes goiter is Graves’ disease, which causes an overactive thyroid gland. Too much thyroid hormone in the blood can lead to hyperthyroidism. Symptoms can include anxiety or nervousness, difficulty sleeping, excessive sweating and weight loss. 

Nodules on the thyroid are another common cause of goiters. In this condition, one or more nodules can form within the gland, causing it to increase in size. A multinodular goiter may not cause any symptoms, but if it grows large enough, it can be felt under the skin in a physical examination.

Aside from the symptoms of an over or underactive thyroid, goiters are usually painless. But a particularly large thyroid can lead to other issues, including difficulty swallowing, prolonged coughing or difficulty breathing, or a visible lump near the base of the neck.

A blood test can determine if your thyroid is underactive or overactive. If the blood test determines you have hypothyroidism or hyperthyroidism, your doctor may prescribe medication to help regulate your thyroid hormone. For treatment of Graves’ disease, your doctor may prescribe radioactive iodine that can shrink the goiter. For Hashimoto’s thyroiditis, the medication prescribed won’t reduce the goiter’s size, but it can prevent it from growing any larger. 

If the size of the goiter doesn’t respond to medication, or has grown too large, your doctor may recommend it be removed. Without it, you have to take a thyroid hormone supplement for the rest of your life.

If you suspect you have an enlarged thyroid, or are experiencing the symptoms of hypo- or hyperthyroidism, talk to you doctor about the next steps.

Dr. William B. Inabnet III is an endocrine surgeon and chair of the UK HealthCare department of surgery.

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