The term goiter, which is the British/European variant of goiter, refers to the swelling of the thyroid. The thyroid is located at the front of the neck, just below the Adam’s apple. This small, butterfly-shaped gland produces the hormones T4 (thyroxine) and T3 (triiodothyronine).
Most T4 hormone is converted to T3 in the liver and the gut. T3 thyroid hormone is the hormone the body can use. These hormones regulate many body functions, such as body temperature, heart rate, mood, digestion, and energy levels.

Symptoms of goiter include:

Swelling, just below the Adam’s apple.

Tightness in the throat area.

Scratchy voice (Hoarseness)

Neck vein swelling.

Dizziness when the arms are raised

Unexplained coughing

Unusual weight gain or loss

Mood swings

What causes goiter?

Common causes of goiter are autoimmune disease, iodine deficiency, and thyroid nodules.

However, goiters have different causes and different types.

• Simple goiters will develop when the thyroid gland does not make enough hormones to support the body, causing the thyroid gland to make up for this shortage by growing more prominent. These are called simple or smooth goiters due to the absence of nodules. 
• Endemic goiters are most common in people in parts of the world who do not have sufficient iodine in their diet (iodine is needed to make thyroid hormone). For example, the lack of iodine is still a common problem in parts of central Asia and Africa. Iodine is added to table salt in modern countries like the United States, so this type of goiter is rare in these countries. However, since more people cook at home and many home cooks use sea salt instead of the more processed, iodine-enriched table salt, there has been an increase in thyroid issues since sea salt does not have added iodine.
• Sporadic goiter has no known cause. However, for some, certain drugs can cause this type of goiter. Lithium is one example of a drug used to treat certain mental health conditions and other medical conditions that can cause this type of goiter.
•  Multinodular goiter- The patient or an observant friend or family member often notices a multinodular goiter due to a visible lump. Many are discovered during a physical exam by a healthcare provider. These nodules can be nodular, smooth, localized or diffused, hard, soft, fixed, mobile, painful, or not bothersome.

Additional risk factors for goiter include:

• Hereditary (family history)
• Female gender
• Age over 40

These diseases and conditions may cause a goiter

Graves’ disease: This autoimmune disease causes your immune system to attack your thyroid gland causing it to grow larger and produces too much thyroid hormone.

Symptoms of Graves’ disease include:

• Increased resting pulse rate
• Rapid heartbeat
• Nausea, diarrhea, vomiting
• Sweating or feeling warm 
• Hand tremors
• Irritable 

Hashimoto’s disease: This autoimmune disease causes thyroid gland inflammation, resulting in the thyroid producing fewer hormones. Many times adding thyroid hormone will ease the inflammation.

Symptoms of Hashimoto’s disease include:

• Fatigue (feeling tired)
• Weight gain
• Dry skin
• Constipation
• Menstrual irregularities

Nodular goiter: Growths called nodules will occur on one or both sides of the thyroid, causing it to enlarge.

Thyroid cancer: Thyroid cancer will often result in swelling or nodules.

Pregnancy:  A hormone called human chorionic gonadotropin, which a woman produces during pregnancy, can cause goiter.

Thyroiditis: Inflammation caused by a virus or after a woman gives birth can cause goiter to develop.

Radiation exposure: A person who has undergone medical radiation treatments to the head or neck is more at risk of developing goiter.

Diagnosing Goiter

There are several tests used to diagnose goiter. They include:

Physical exam: Your doctor can tell if the thyroid gland has swollen by feeling the thyroid for nodules and tenderness.

Hormone test: The TSH test checks thyroid hormone levels and if the thyroid is functioning correctly.

Antibody test: This blood test checks for antibodies produced by some goiters; it also checks for antibodies associated with thyroid autoimmune diseases Hashimoto’s thyroiditis and Graves’ disease.

Thyroid ultrasound: An ultrasound sends high-frequency sound waves through the body’s tissues. These echos are recorded and developed into photos or videos revealing the thyroid’s size and the presence of any nodules.

Thyroid scan: This imaging test provides information on the function and size of the thyroid gland. For this test, a small amount of radioactive material is injected into the bloodstream producing an image on a computer screen of the thyroid. This test is often done when diagnosing Graves’ disease.

CT scan or MRI: These imaging tests are done if the goiter is large or has spread.

Treating goiter

Treatment is based on symptoms, the thyroid’s size, and what caused the goiter.

1. Watching and waiting with no treatment- When the goiter is small and not bothersome, your doctor may decide not to treat and monitor for changes.

• Medications- Levothyroxine (aka Levothroid, Synthroid) is prescribed if the goiter is caused by hypothyroidism (an underactive thyroid). Methimazole(Tapazole®) and propylthiouracil are prescribed if the goiter is caused by hyperthyroidism (an overactive thyroid). In addition, your doctor may prescribe aspirin or a corticosteroid medication if the goiter is due to inflammation.
• Radioactive iodine treatment (RAI)- Commonly used in cases of an overactive thyroid gland (Graves’ disease), this treatment involves taking a radioactive iodine pill by mouth. Since only the thyroid absorbs iodine, it is absorbed and destroys the thyroid cells, shrinking them and causing them to produce less thyroid hormone. After this treatment, most patients have to take thyroid hormone replacement for the rest of their life.
•  Biopsy- A biopsy is a tissue sample removed from the thyroid to be examined at a laboratory. For example, a biopsy is done if there are large nodules and must rule out cancer.
• Surgery- The removal of all or part of the thyroid. It may be necessary if the goiter is extensive, causing problems with swallowing and breathing. Surgery is also done to remove nodules and if cancer is present. As with RAI, most patients will need to take thyroid hormones for the rest of their lives.

The treatments I described above are how you will be treated when visiting a conventional medical doctor. These are the doctors that work in hospitals and clinics. They must follow the treatment plans the CDC and insurance companies set. Unfortunately, most patients are told that removal or treating the thyroid with RAI is the only treatment that works. Therefore, your doctor will tell you that you must take thyroid hormone replacement therapy for the rest of your life. However, they will also tell you that hormone therapy is just a little pill, and you will feel like yourself again once your dose is adjusted to your needs.

Unfortunately, the sad truth is that approximately 50% of surgical removal or RAI patients have ongoing symptoms after treatment. In medical school, our doctors are taught that thyroid issues are one test, one treatment, and one pill disease to treat, and nothing could be further from the truth. There will be some cases where the only choice will be thyroid removal or RAI, but most patients want to try to heal their thyroid before removing or destroying it.

Non-conventional goiter treatments

I mentioned earlier that most goiters are caused by iodine deficiency and thyroid nodules. But, nowadays, most thyroid diseases are caused by autoimmune diseases triggered by toxins in our environment, stress, and nutritional deficiencies. So, goiters are just one of the results of these factors.

So many products we use daily expose us to harmful and toxic chemicals. These chemicals mimic our hormones and disrupt them, causing problems in the communication between cells. The thyroid is a member of the endocrine system of glands; these glands produce hormones that send messages back and forth, regulating the functions of our bodies. The thyroid is in charge of regulating the speed of metabolism, so if your thyroid is not producing enough or too much thyroid hormone, you will have symptoms. One of those symptoms is goiter.

Many patients find that conventional treatments do not ease their symptoms, so they turn to holistic or functional medicine doctors for treatment. These doctors focus on treating the whole body, clearing out toxins that have built up within the body, and testing for nutritional deficiencies you may have. Then, using that information, they will set up a treatment plan based on the testing results of your body. 

These doctors will also recommend diets that help clear out toxins, boost energy, ease digestive issues, and improve mood.

These diet plans also help you give your thyroid the nutrition it needs to heal and function properly. 

Natural Treatments that can ease goiter

According to Dr. Farrah, MD., several natural treatments can help reduce your goiter.

Apple Cider Vinegar (ACV)

ACV is slightly acidic, helping detoxify your body and restore pH balance. In addition, by reducing toxins, the thyroid can increase its absorption of iodine and reduce swelling.

 Stir a teaspoon of apple cider vinegar and ½ teaspoon of honey into a glass full of warm water. Mix well and drink every morning on an empty stomach.

Virgin Coconut Oil

Virgin coconut oil has high levels of lauric acid. When consumed, this acid converts to monolaurin, which boosts metabolism and aids with iodine absorption from foods we eat. In addition, coconut oil has anti-inflammatory properties and can help reduce thyroid swelling. Coconut oil can be used when cooking and added to smoothies or hot drinks.

Green Tea

Green tea has antioxidants, is a stimulant, and is an energy booster.

Green tea also has high fluoride levels, which can slow an overactive thyroid. Try to drink 2-3 cups throughout the day.

Garlic

For years, garlic has been used to treat various illnesses. This is because it helps with glutathione production in our body and contains selenium. In addition, selenium is a mineral vital for the healthy functioning of our thyroid.

Crush 3-4 garlic cloves, add some honey and chew.

Moringa (Malunggay)

This earthy-tasting herbal has anti-inflammatory properties that help ease thyroid gland swelling. Consume a tea made by steeping a tablespoon of dried moringa leaves in a cup of hot water. Strain and enjoy this tea every morning.

Beets

Beetroots have betalain pigments that have anti-inflammatory and antioxidant properties. Boil fresh beetroots to enjoy or add to salads. You can also try drinking beetroot juice or adding it to a smoothie.

Turmeric

This superfood has anti-inflammatory and antioxidant properties that help to treat various diseases. In addition, these properties protect the body from free radicals and help reduce goiter swelling. To use this remedy, heat one cup of water in a pan and add 1/2 cup of turmeric powder. When it forms a thick paste, after about 5-10 minutes, add one and a half teaspoons of black pepper and 70 ml of cold-pressed olive oil to it. Store the paste in an airtight container. Consume one teaspoon of the paste daily.

Flax Seeds

Flax seeds also have anti-inflammatory properties that can help reduce swelling, relieving the symptoms of goiter.

Grind 2-3 teaspoons of flax seeds and mix with water to make a paste. Apply the paste to the neck and leave it on for 20-25 minutes. Rinse off with clear water and pat dry.

Garlic And Lemon

These two are anti-inflammatory and help clear toxins accumulated in the body. Mix a tablespoon of lemon juice, honey, and a crushed garlic clove to use this remedy, consuming the mixture on an empty stomach every morning.

Sorrel Leaves

These leaves contain high amounts of iodine and have anti-inflammatory properties, helping to reduce swelling and acting as a cooling agent.

Make a paste by adding a handful of crushed sorrel leaves to warm water. Apply the mixture to the neck and let rest for 25 to 30 minutes. Rinse off with clear water and repeat this process every day.

As I mentioned earlier, most thyroid diseases are caused by autoimmune diseases triggered by environmental toxins, stress, and nutritional deficiencies. I have written a post about the numerous toxins in our environment; you can read it here: https://knowyourthyroid.com/improving-your-thyroid-gland-function-17-toxins-to-avoid/.

Many patients I know and have talked to wish they had known this information before surgery or RAI. Taking steps to heal your body will result in much better health and renewed vitality. For many, if you clear the overwhelming amount of toxins from your life and support your body with better nutrition, you will find your thyroid function will improve, along with your health and a disappearing goiter. 

You can also follow one of the many programs to help heal your thyroid and improve your overall health. One of my reader’s favorites is this one: https://knowyourthyroid.com/recommends/hyposolution (If you purchase through the links in this post, we may receive a commission.)

This hormone-balancing program is popular with ladies going through menopause: https://knowyourthyroid.com/recommends/thyroidfactor/

Remember, taking care of yourself benefits everyone! Thyroid imbalances make life miserable! Start with small changes such as switching to a thyroid-friendly cooking oil like olive or coconut oil. You will want to continue to add thyroid healthy foods once you start to feel more energetic and healthier!

Take care,

Corri

References

https://my.clevelandclinic.org/health/diseases/12625-goiter

https://www.mayoclinic.org/diseases-conditions/goiter/symptoms-causes/syc-20351829

https://www.racgp.org.au/afp/2012/august/goitre

https://www.jove.com/v/10098/thyroid-exam

https://drfarrahmd.com/

https://drfarrahmd.com/2019/08/common-remedies-and-natural-ways-to/