You might be familiar with a goiter as a bulge in the neck, but what is the true goiter definition? According to the American Thyroid Association, the term simply refers to the abnormal enlargement of the thyroid gland. This health phenomenon can occur when there’s an overproduction (hyperthyroidism), underproduction (hypothyroidism) or the correct production of the hormone (euthyroidism). No matter what, though, the presence of a goiter always means that there’s some condition present leading to abnormal enlargement of the thyroid gland.

What is the thyroid gland? The thyroid gland is a small, butterfly-shaped gland located in the neck, right below the Adam’s apple (which tends to be more prominent in men, but women have one as well). It’s an essential hormonal gland that produces two types of hormones, called triiodothyronine (T3) and thyroxine (T4), which help regulate blood circulation and metabolism, among other essential bodily functions. Goiters can occur when too much or too little of T3 and T4 hormone is produced and released.

There are actually three main types of goiters including, simple goiters, endemic goiters and sporadic goiters. Endemic goiters are also called colloidal goiters or colloid nodular goiters.

Goiter Symptoms

Thyromegaly, more commonly known as a goiter, is an enlarged thyroid, but what are enlarged thyroid symptoms exactly? First off, not every goiter causes symptoms. When symptoms do occur, they can include: (3)

  • An enlarged thyroid gland, which results in a visible swelling at the base of your neck that may be especially obvious when you shave or put on makeup
  • A tight feeling in your throat
  • Difficulty swallowing
  • Coughing
  • Hoarseness
  • Difficulty breathing

In rare cases, a large goiter can put pressure on the windpipe (trachea) and food tube (esophagus). When a goiter is this large, it can become particularly hard to breathe when lying flat on one’s back. Swallowing can also be especially difficult with solid food, and there might even be pain the thyroid area.

A large goiter can also cause neck vein distention and dizziness when the arms are raised above the head. (4)

Goiter Risk Factors

Some of the most common goiter risk factors are: (5)

  • Lack of dietary iodine — People who don’t get enough iodine in their diets are at greater risk for developing goiters.
  • Being female — Since women are more prone to thyroid disorders, they’re also more likely to develop goiters.
  • Age — Your chances of developing one increase with age, especially once you hit 40.
  • Medical history — A personal or family history of autoimmune disease increases your risk.
  • Pregnancy and menopause — For unclear reasons, thyroid problems are more likely to occur during pregnancy and menopause.
  • Certain medications — Some medical treatments, including immunosuppressants, antiretrovirals, the heart drug amiodarone (Cordarone, Pacerone, others) and the psychiatric drug lithium (Lithobid, others), increase your risk.
  • Radiation exposure — Your risk increases if you’ve had radiation treatments to your neck or chest area or you’ve been exposed to radiation in a nuclear facility, test or accident.


Goiter symptoms and risk factors - Dr. Axe


Goiter Causes 

The causes of goiters differ between the three different types. With a simple goiter, the thyroid gland does not produce enough of the appropriate hormones to meet the needs of the body. Due to this shortage of hormones, the thyroid gland tries to compensate for this deficit by growing larger, resulting in a simple goiter.

An endemic goiter is caused by an an iodine deficiency. When iodine intake becomes severely low, the thyroid compensates for the decreased levels by developing a swollen thyroid gland, known as a goiter, in order to absorb as much available iodine. Iodine has been added to table salt (in the form of potassium iodide) since 1924. Originally, iodization of salt was adopted to reduce goiter occurrence.