Goitre - Treatment 

Treating goitre 

Treatment for goitre can include medication and surgery. The treatment you receive will depend on:

  • the size of the goitre
  • the symptoms the goitre is causing
  • whether you have any underlying health conditions, such as an overactive or underactive thyroid gland (a gland in your neck that produces hormones)

If tests reveal your thyroid gland is working normally, and the goitre is small, no immediate treatment may be recommended. Your condition may just be monitored.

If you have a problem with your thyroid gland, it will be treated. If this does not improve your condition, you may need surgery. One study estimated that up to one-in-seven people with goitres may eventually require surgery. 

Underactive thyroid gland

If testing reveals an underactive thyroid gland, one treatment involves using a synthetic (man-made) hormone to replicate your normal thyroid function. This is called hormone therapy.

The synthetic hormone, which is called levothyroxine, is taken orally (by mouth), usually once a day.

Side effects of levothyroxine can include:

  • an irregular or rapid heartbeat
  • muscle cramps (when your muscles suddenly shorten, causing pain)
  • vomiting
  • diarrhoea
  • weight loss
  • problems sleeping
  • headaches
  • sweating

These side effects should pass in a few days as your body gets used to the hormone. However, if they continue you should speak to your GP because your dosage may need to be adjusted. In most cases, hormone therapy will need to be maintained for the rest of your life.

See treatment for hypothyroidism for more information.

Overactive thyroid gland

If you have an overactive thyroid gland, there are several recommended treatments. Some are described below.

Thionamides

Thionamides are drugs that help to reduce the amount of thyroid hormones your thyroid gland is producing.

Thionamides are usually taken orally (by mouth). The medicine works by gradually reducing levels of thyroid hormones, so it may be several weeks before you notice any effects.

Side effects of thionamides include:

  • a mild skin rash
  • pain in your joints
  • nausea (feeling sick)
  • itchy skin

In very rare cases, thionamides can cause a serious condition called agranulocytosis (a sudden drop in the number of white blood cells). If this occurs, it will usually be during the first three months of treatment. Signs to look out for include:

  • a high temperature (a fever) of 38C (100.4F) or above
  • sore throat
  • mouth ulcers

See your GP if you notice any of the above.

You may need to take thionamides for two-to-four months before your thyroid gland is under control.

Radioactive iodine

Radioactive iodine is another treatment for an overactive thyroid gland that is taken orally (by mouth). When the iodine reaches your thyroid gland, it destroys the thyroid cells and reduces the size of the goitre. However, the treatment may cause your thyroid gland to become underactive. If this happens, you may need hormone therapy (see above).

See treatment for hyperthyroidism for more information.

Iodine supplements

Your GP may recommend iodine supplements if your goitre is caused by an iodine deficiency.

Iodine supplements are also available in many health food shops without prescription. However, always consult your GP before taking them because the amount of iodine needed varies from person to person. Taking too much iodine may cause other health problems and it could also have toxic (poisonous) effects.

Surgery

If your goitre is interfering with your breathing, or swallowing, and has not responded to other forms of treatment, surgery may be required to remove part, or all, of your thyroid gland.

You will be given a general anaesthetic, so you will be unconscious and unable to feel anything. 

During surgery, the surgeon will make an incision (cut) in the front of your neck so they can see your thyroid gland. They will usually remove half of it. This should reduce the amount of thyroid hormones being produced and the size of your goitre.

The surgeon will attempt to remove enough of your thyroid gland to relieve your symptoms, while leaving enough so that normal thyroid hormone production can continue. However, you may require hormone therapy following surgery if this isn't possible.

Surgery to remove the thyroid gland is usually safe, but as with all surgical procedures there is a risk of complications, such as post-operative infection. other possible complications are briefly described below.

Nerve damage

The thyroid gland is very close to the two laryngeal nerves (the nerves that control your vocal cords). If these are accidentally damaged during surgery, your voice and breathing could be affected.

Permanent damage to the laryngeal nerves affects one or two people in every 100 who have this type of surgery. Temporary damage may affect up to five people in every 100.

Parathyroid gland damage

The parathyroid glands are glands that help to regulate the amount of calcium (a mineral that is needed for strong teeth and bones) in your body. If the parathyroid glands are damaged, you will probably need to take calcium supplements for the rest of your life.

The risks of complications occurring after thyroid gland surgery are estimated to be 1% to 2%.


Page last reviewed: 23/05/2012

Next review due: 23/05/2014

Ratings

How helpful is this page?

Average rating

Based on 108 ratings

All ratings

Add your rating

Comments

The 1 comments posted are personal views. Any information they give has not been checked and may not be accurate.

diandmag said on 24 March 2014

I have a small goiter, i am due to go and have a biopsy, but my anxiety is really bad. the goiter has no effects on my life, does,nt cause me no problems, i feel that going for this biopsy i am just going to stress me out so much, has anyone left theres and monitored it
Diane

Report this content as offensive or unsuitable

The Yellow Card Scheme

The MHRA has produced a video that explains how the Yellow Card Scheme can be used to report the side effects of medication

10 medical reasons for feeling tired

Any serious illness – and some minor ones – can make you tired. Here are 10 health conditions that can cause fatigue