Goitre - Treatment 

Treating goitre 

Treatment for goitre can include medication, hormone therapy 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 conditions, such as an overactive thyroid gland (hyperthyroidism) or an underactive thyroid gland (hypothyroidism)

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

If you have a problem with your thyroid gland, however, it will be treated. Surgery may be needed if your condition doesn't improve with treatment. A study has estimated that up to one in seven people with goitres may eventually require surgery. 

Underactive thyroid gland

If tests reveal that you have an underactive thyroid gland, treatment could include using a synthetic hormone to replicate your normal thyroid function (hormone therapy).

The synthetic hormone is levothyroxine and is taken orally, usually once a day.

Side effects of levothyroxine, which usually occur when too much has been taken, can include:

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

Read more about treating hypothyroidism.

Overactive thyroid gland

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

Thionamides

Thionamides are a type of medication that help reduce the amount of hormones your thyroid gland is producing.

Thionamides are usually taken orally. They work 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
  • joint pain
  • nausea (feeling sick)
  • itchy skin

In very rare cases, thionamides can cause a serious condition called a sudden drop in the number of white blood cells (agranulocytosis). This usually occurs within the first three months of treatment.

Signs to look out for include:

If you notice any of the above, see your GP.

You may need to take thionamides for two to four months before the overactive thyroid gland is controlled.

Radioactive iodine

Radioactive iodine is another treatment for an overactive thyroid gland that's taken orally. When the iodine reaches your thyroid gland, it destroys the thyroid cells and reduces the goitre's size.

However, the treatment may cause your thyroid gland to become underactive. If this happens, you may need hormone therapy (see above).

Read more about treating hyperthyroidism.

Iodine supplements

well-balanced diet usually provides all the iodine your body needs, and iodine supplements aren't usually required in developed countries like the UK. Your GP can give more advice about extra supplements, if needed.

Iodine supplements are available in many health food shops without a 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 it hasn't responded to other forms of treatment, you may need surgery to remove part or all of your thyroid gland. This procedure is known as a thyroidectomy.

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

During surgery, the surgeon will make an incision in the front of your neck so they can see your thyroid gland.

How much of the thyroid gland is removed will depend on the underlying condition causing the goitre. The procedure will reduce the size of your goitre and the amount of thyroid hormones being produced.

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,  if this isn't possible, you may require hormone therapy after surgery.

Surgery to remove the thyroid gland is usually safe, but as with all surgical procedures there's a risk of complications, such as post-operative infection.

The risks of complications occurring after thyroid gland surgery are estimated to be 1-2%. Before having the procedure, you should discuss the risks with your surgeon.

Nerve damage and parathyroid gland damage are two other possible complications of thyroid gland surgery. These are briefly described below.

Nerve damage

The thyroid gland is very close to the two laryngeal nerves, which 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 to 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 help regulate the amount of calcium in your body. If the parathyroid glands are damaged, you will probably need to take calcium supplements for the rest of your life.

Page last reviewed: 07/05/2014

Next review due: 07/05/2016

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Comments

The 2 comments posted are personal views. Any information they give has not been checked and may not be accurate.

helenv0786 said on 02 September 2014

I was end of last year diagnosed with an extremely large thyroid nodule and having read online only negative comments initially refused surgery and waited and watched for 6 months as I was so terrified- they would become the most anxious and stressful months of my life.
After 6 months I could no longer cope with not knowing what was growing and while terrified of becoming underactive having read all the negativity online I agreed to the surgery. This was the best decision I ever made, the moment you wake up and it has been removed it is like the biggest weight has been lifted, no more worrying you can move on with your life. Looking back if I had known what I know now I would have done it as soon as possible.
I was terrified after reading all the negative scary articles online and dreaded the decision I had made. Not everyone is as lucky granted as there is a 50% chance of becoming underactive but I have been one of the lucky ones and apart from my minor scar that I wear proudly you wouldn’t know half of my thyroid is missing. I am happier than ever knowing it’s gone and cannot come back.
You can never find online the success stories but they do happen, if you get referred to a specialist they will tell you most of what is written online is to scare and accounts for around 5% of sufferers views.
You have to want the surgery to make it work, when I was ready I couldn’t have had a smoother journey and having known 4 people in the same boat who have had the same procedure some 60 years ago they are perfectly happy and healthy and have never had an issue since.

it really isn't all doom and gloom, it can be a positive experience.

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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

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