Diagnosing goitre 

If you think you have a goitre, see your GP. They can examine your neck to see if there's any evidence of thyroid gland swelling.

Blood tests to check how well your thyroid gland is working may also be carried out.

Physical examination

Your GP will examine your neck to assess the size and extent of any swelling and determine whether it's:

  • a diffuse goitre  where your entire thyroid gland swells up and feels smooth
  • a nodular goitre  where solid or fluid-filled nodules develop within the thyroid, making the thyroid gland feel lumpy

They may ask you to swallow, to see whether the lump moves up and down.

Your GP may also arrange for you to have a thyroid function test to determine the underlying cause of your goitre.

Thyroid function test

A thyroid function test measures the level of certain hormones (chemicals produced by the body) in your blood.

The test can show if you have an underactive or overactive thyroid gland, both of which are associated with goitre.

The thyroid gland produces two hormones – thyroxine and triiodothyronine. An excessive amount of these two hormones indicates an underlying condition that's making your thyroid gland overactive, such as Graves' disease (an autoimmune condition that causes antibodies to stimulate the thyroid gland).

If your thyroid gland is underactive, your pituitary gland (a pea-sized gland that sits below the brain) will produce a hormone called thyroid stimulating hormone (TSH).

TSH is released by your body to stimulate your thyroid gland. A high level of TSH in your blood indicates that your thyroid gland is underactive.

Further tests

If you're referred to a specialist, you may have further tests in hospital. These are described in more detail below.

Radioactive iodine scan

This involves a small amount of radioactive iodine being injected into your vein. The iodine builds up in your thyroid gland, which can then be studied using a special camera.

The scan can provide useful information about the structure and function of your thyroid gland. As the amount of radiation used is very small, it's perfectly safe for most people. However,it may not be suitable if you're pregnant.

Ultrasound scan

An ultrasound scan uses high-frequency sound waves to create an image of part of the inside of your body. It can be used to:

  • build up a picture of the inside of your thyroid gland
  • assess the size of your thyroid gland
  • check whether there are any enlarged nodules in your thyroid gland not found during the physical examination

Fine-needle aspiration

Fine-needle aspiration is a procedure where a sample of the goitre is extracted, so that the cells inside it can be tested. This procedure is often known as a biopsy

During the procedure, a fine needle on the end of a syringe will be inserted into the goitre in your throat. A sample of the fluid or tissue inside the goitre will be sucked through the needle and into the syringe. The sample will be examined under a microscope to determine what kind of cells are inside the goitre. 


Referral

Your GP may refer you to a specialist thyroid clinic or an endocrinologist (a specialist in hormone-related conditions), if you have a thyroid swelling and:

  • it's getting bigger
  • you have a family history of thyroid cancer
  • you've had radiation treatment to your neck 
  • you have swollen lymph nodes in your neck
  • you're a child or teenager
  • you're 65 or over
  • your voice has changed
  • you're making a high-pitched noise as you breathe (stridor)
  • you're having difficulty breathing or swallowing

Page last reviewed: 07/05/2014

Next review due: 07/05/2016