- Patients have diffuse enlargement of their thyroid gland during the early stages of their autoimmune condition.
- The disease can be diagnosed by blood tests that show antibodies to the protein produced by the thyroid gland called thyroglobulin.
- Ultrasound may show diffuse vascularity of the thyroid gland and pseudonodules of the thyroid. Pseudonodules are indiscreet nodules which may be an artifact of the disease and may be present on one ultrasound and in followup ultrasounds the pseudonodule may no longer be found.
Symptoms of Thyroid Goiters
Most thyroid goiters don't cause symptoms, but they will if the goiter continues to grow. In fact, small thyroid goiters may more commonly be detected by routine examination of the patient's neck by a doctor or by some type of screening x-ray or scan for some other reason. The symptoms occur as the goiter becomes big enough that it presses on other structures in the neck.
Larger thyroid goiters most commonly produce symptoms of
- A mass or lump in the neck.
- Uncomfortable pressure sensation on the breathing tube (trachea)
- A sense of feeling like you need to swallow something or difficulty swallowing
What Are The Potential Causes of Thyroid Goiter?
Several conditions may cause or predispose to the development of thyroid nodules including:
Diets deficient in iodine can predispose individuals for the development of thyroid goiters. Portions of the world continue to lack iodine in their diets however in the United States, the presence of iodine in our daily diets makes this an unlikely cause for thyroid nodules.
Overgrowth of normal thyroid tissue
The reason why these thyroid goiters occur is not well understood. This is a condition called follicular hyperplasia (the follicular cell is a normal appearing thyroid cell). Both follicular hyperplasia and follicular adenomas are clearly not cancerous and are not worrisome and do not require removal except if they are symptomatic due to their size.
Thyroid cysts are fluid filled cavities caused by degenerating thyroid adenomas, congenital cysts, or overproduction of a fluid produced by the thyroid called colloid.
Inflammatory diseases of the thyroid (called thyroiditis)
Hashimoto's thyroiditis or Hashimoto's disease is a chronic inflammatory condition of the thyroid gland caused by an autoimmune event where the patient develops antibodies to thyroglobulin (a normal protein produced by the thyroid gland). Long standing Hashimoto's thyroiditis is frequently associated with decreased thyroid hormone production call hypothyroidism. Hashimoto's thyroiditis may also be associated with thyroid pseudo-nodule formation. These pseudo nodules are not concerning thyroid nodules. Pseudo nodules found on ultrasound in thyroiditis patients will come and go based upon unknown issues.
Multinodular disease of the thyroid (also called Multinodular Goiter or just "Goiter"
Multinodular goiter is a thyroid gland which contains multiple thyroid nodules. The cause of multinodular goiter is not known but in some instances there may be a strong family history of goiters. Multinodular goiters can be quite massive and extend throughout the neck and well into the chest cavity.