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Simple Nontoxic Goiter

(Goiter; Euthyroid Goiter)


Laura Boucai

, MD, Weill Cornell Medical College

Reviewed/Revised Feb 2024
Topic Resources

Simple nontoxic goiter is noncancerous enlargement of the thyroid gland that does not involve over- or underproduction of thyroid hormones.

  • Noncancerous thyroid enlargement can occur because of lack of iodine in the diet or ingestion of certain substances or medications.

  • People often have no symptoms.

  • Doctors do blood tests to determine how well the thyroid is working.

  • Doctors may treat the cause of the enlargement, and sometimes people need surgery to remove part of the enlarged thyroid.

The word goiter is sometimes used to describe any form of thyroid gland enlargement (for example, enlargement caused by inflammation or cancer). Simple, nontoxic goiter is a specific form of noncancerous enlargement.

The most common cause of simple nontoxic goiter in most of the world is

The Thyroid

The thyroid gland uses iodine to make thyroid hormone. When there is not enough iodine, the thyroid gland grows larger in an attempt to compensate. However, in the United States, most salt is fortified with iodine, so lack of iodine is not a common cause of goiter.

Other causes of simple nontoxic goiter include

  • Using certain medications (such as amiodarone or lithium)

  • Eating certain foods in unusually large amounts (such as cassava, broccoli, cauliflower, and cabbage)

Sometimes a goiter forms temporarily during puberty, pregnancy, or menopause.

In people with simple, nontoxic goiter, the thyroid gland produces normal amounts of thyroid hormones, so the thyroid is neither underactive nor overactive.

Symptoms of Simple Nontoxic Goiter

People typically notice a swelling at the base of the neck but have no other symptoms. Sometimes the goiter presses on nearby tissue and causes cough, hoarseness, or difficulty breathing or swallowing.

Diagnosis of Simple Nontoxic Goiter

  • Thyroid function blood tests

  • Ultrasonography and a thyroid scan

Doctors usually do blood tests to determine how the gland is functioning (thyroid function blood tests Thyroid function blood tests The thyroid is a small gland, measuring about 2 inches (5 centimeters) across, that is located just under the skin in the neck. The two halves (lobes) of the gland are connected in the middle... read more ). They measure blood levels of the thyroid hormones thyroxine (T4, or tetraiodothyronine) and triiodothyronine (T3) and thyroid-stimulating hormone (TSH). Sometimes doctors also look for antibodies that attack the thyroid gland (antithyroid antibodies) in the blood, which are a sign of an immune reaction to the thyroid, which causes inflammation.

Doctors do ultrasonography, which uses sound waves to create an image of the thyroid gland, to identify any nodules that could be cancerous.

Treatment of Simple Nontoxic Goiter

  • Sometimes iodine supplements

  • Sometimes thyroid hormone replacement

  • Sometimes surgery

Treatment depends on the size and cause of goiter.

In iodine-deficient areas, people are given iodine supplements. Iodine may be added to salt, water, or crops to eliminate iodine deficiency in the area.

People should stop eating foods that inhibit thyroid hormone production, for example, cassava, broccoli, cauliflower, and cabbage.

When diet is not a cause, some people may be given thyroid hormone replacement with levothyroxine. This medication blocks production of thyroid-stimulating hormone and may shrink the goiter.

People with very large goiters may need surgery to remove part of the thyroid or may be given radioactive iodine to shrink the gland enough to prevent interference with breathing or swallowing or to correct cosmetic problems.

Drugs Mentioned In This Article

Generic Name Select Brand Names
Cordarone, Nexterone, Pacerone
Eskalith, Eskalith CR, Lithobid
Ermeza, Estre , Euthyrox, Levo-T, Levothroid, Levoxyl, Synthroid, Thyquidity, Thyro-Tabs, TIROSINT, TIROSINT-SOL, Unithroid
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