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The month of January marks Thyroid Awareness Month. To help bring about that awareness, we’ve teamed up with doctors of color to keep you better informed about the conditions impacting our thyroid and overall health. 

Swelling in the neck is a common sign of an issue with the thyroid. We talked about the swelling that accompanies thyroid nodules last week. However, the swelling of a goiter is a different type of beast.

A goiter (also spelled goitre) is the sign of an enlarged thyroid. Around the world, they are caused by a deficiency in iodine, which is a major issue in developing countries. In the United States and other countries that do have access to foods with and sources of iodine, they are often attributed to Hashimoto’s thyroiditis, as well as Graves’ disease, and having multiple nodules in the thyroid (multinodular goiter). Melynda Barnes, MD, associate clinical director at Ro, also notes that too much iodine can even increase your risk for a goiter. And iodine, which we often attribute to the iodized table salts we use, can also be found in other things you may not have realized you shouldn’t overdo it on.

“If you have sufficient iodine in your diet, then adding more iodine will not prevent a goiter; in fact too much iodine can cause a goiter and can even cause thyroid inflammation,” she said via e-mail. “In the American diet, salt is fortified with iodine and other natural sources of iodine are tuna, cod, shrimp and other shellfish, milk, yogurt, cheese and grains like breads and cereals.”

But outside of thyroid conditions and chemical elements, Barnes says that certain medications, including lithium and amiodarone, can increase your risk. Other factors also include radiation exposure, a family history of autoimmune disease, and surprisingly, “being a woman, being over 40, being pregnant or in menopause.”

And while goiters can grow to an alarming size, making them easier to diagnose, not every one looks like the one pictured above. There are actually different size classes for swelling, and goiters in class I aren’t often noticed until they are felt by a doctor. When that is the case, a diagnosis may come through a hormone test, an ultrasonography, thyroid scan, biopsy or antibody test.
As for treatment, in many cases, goiters are painless, so they may just require observation, medication (if due to hypothyroidism), and in some cases, radioactive iodine when the goiter is caused by an overactive thyroid gland.
But some goiters are so big that they can impact your standard of living. For example, a large one can cause a cough, hoarseness, tightness of the throat, dizziness, and interrupt your ability to swallow and breathe. In those cases, surgery is the best option.
A goiter, how it will be treated, and how it can impact your life, depends on the size of it. If you want to do your best to avoid having to deal with one, then you have to walk a fine line between ensuring that you have enough iodine, while also avoiding consuming excessive levels of it.
Experts recommend getting about 150 micrograms of iodine a day. It’s encouraged that you use iodized salt a couple of times a week, and if you’re a sushi lover, cap those meals at about twice a week. If you’re pregnant and lactating, having the proper amounts of iodine is especially important. But if you do end up overdoing it, ditch the salts fortified with iodine, as well as iodine supplements, seaweed and other sources of the element until your doctor tells you otherwise.
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