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Treatments and drugs
By Mayo Clinic staffGoiter treatment depends on the size of the goiter, your signs and symptoms, and the underlying cause. Your doctor may recommend:
- Observation. If your goiter is small and doesn't cause problems, and your thyroid is functioning normally, your doctor may suggest a wait-and-see approach.
- Medications. If you have hypothyroidism, thyroid hormone replacement with levothyroxine (Levothroid, Synthroid) will resolve the symptoms of hypothyroidism as well as slow the release of thyroid-stimulating hormone from your pituitary gland, often decreasing the size of the goiter. For inflammation of your thyroid gland, your doctor may suggest aspirin or a corticosteroid medication to treat the inflammation. For goiters associated with hyperthyroidism, you may need medications to normalize hormone levels.
- Surgery. Removing all or part of your thyroid gland (total or partial thyroidectomy) is an option if you have a large goiter that is uncomfortable or causes difficulty breathing or swallowing, or in some cases, if you have nodular goiter causing hyperthyroidism. Surgery is also the treatment for thyroid cancer. You may need to take levothyroxine after surgery, depending on the amount of thyroid removed.
- Radioactive iodine. In some cases, radioactive iodine is used to treat an overactive thyroid gland. The radioactive iodine is taken orally and reaches your thyroid gland through your bloodstream, destroying thyroid cells. The treatment results in diminished size of the goiter but eventually may also cause an underactive thyroid gland. Hormone replacement with the synthetic thyroid hormone levothyroxine then becomes necessary, usually for life.
References
- Goiter. American Thyroid Association. http://www.thyroid.org/patients/brochures/Goiter_brochure.pdf. Accessed Oct. 1, 2008.
- Simple nontoxic goiter. The Merck Manuals Online Medical Library: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec12/ch152/ch152i.html. Accessed Oct. 1, 2008.
- Jameson JL, et al. Disorders of the Thyroid Gland. In: Fauci AS, et al. Harrison's Online. 17th edition. The McGraw-Hill Companies Inc.; 2008. http://www.accessmedicine.com/content.aspx?aID=2877579&searchStr=goiter. Accessed Nov. 28, 2008.
- LaFranchi S. Goiter and thyroid cancer in children. http://www.uptodate.com/home/index.html. Accessed Oct. 1, 2008.
- LaFranchi S. Clinical manifestations and diagnosis of hyperthyroidism in children and adolescents. http://www.uptodate.com/home/index.html. Accessed Oct. 1, 2008.
- Endocrinology update: Imaging the thyroid nodule. MayoClinic.org. http://www.mayoclinic.org/mcitems/mc5800-mc5899/mc5810-1207.pdf. Accessed Oct. 1, 2008.
- Iodine. The Merck Manuals Online Medical Library: Home Edition for Patients and Caregivers. http://www.merck.com/mmhe/sec12/ch155/ch155f.html. Accessed Oct. 2, 2008.
- Bauer DC, et al. Thyroid Disease. In: McPhee SJ, et al. Pathophysiology of Disease: An Introduction to Clinical Medicine. 5th edition. The McGraw-Hill Companies Inc.; 2006. http://www.accessmedicine.com/content.aspx?aID=2091040&searchStr=goiter. Accessed Nov. 28, 2008.
- Nontoxic goiter: Diffuse and nodular. In: Kronenberg HM, et al. Williams Textbook of Endocrinology. 11th edition. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/112198375-3/778390960/1555/77.html. Accessed Nov. 28, 2008.
