Madison, Wis. — Some people in the United States may remember taking iodine pills or hearing their parents describe taking daily iodine pills. A few generations ago, these pills were a common remedy to reduce the risk of goiters. They were especially important in regions like the Midwest, where we are far from an ocean coastline and our soil is not rich in sea salt. When table salt began to be fortified with iodine in the 1920s, iodine pills were no longer necessary.
Goiters do still occur, but they are less frequent in the United States. As with all thyroid disorders, women are much more likely to experience a goiter than men.
What is a Goiter?
A goiter is an enlarged thyroid gland. The thyroid gland is a butterfly-shaped gland in the neck, slightly below the Adam’s apple. Hormone changes or other symptoms can cause the gland to swell and become enlarged. When this gland is swollen, it can result in a bump, sometimes even noticeable to the eye. A goiter is often painless, but it can cause hoarseness, a cough, a feeling of tightness in the throat, difficulty swallowing, or even difficulty breathing.
Causes of Goiters
An enlarged thyroid is not necessarily the same as thyroid cancer. An enlarged thyroid can be caused by many different factors, including:
Iodine deficiency – Iodine is essential to the production of hormones and a functioning thyroid. If a person is not able to consume iodine in their daily diet, their thyroid may swell. This is most common in regions where iodine is not added to table salt or other daily foods, and where the area is geographically far from a coastline.
Underactive or Overactive Thyroids – A thyroid that is overactive or underactive may produce hormones or antibodies that cause the thyroid gland to swell.
Thyroid Nodules – Lumps or bumps in the thyroid, called nodules, may develop and cause the thyroid to swell. In some cases, these nodules may be cancerous.
Pregnancy – In some cases, a hormone common in pregnancy may cause the thyroid to swell.
Thyroiditis – This is an inflammatory condition in the thyroid. It may be caused by the overproduction of a hormone. In this condition, the thyroid becomes inflamed and it can cause pain and swelling. In rare cases, the swelling can be a substernal goiter, which is a goiter that spreads down into the chest.
Dr. Kristin Long, UW Health Endocrine Surgeon, said it’s important for people to know there are many different reasons a thyroid gland can become swollen. In many cases, the person may not notice other symptoms.
“Any time you’re feeling an enlarged thyroid, you should have your doctor take a look at it,” she said. “Occasionally people will say, ‘But I didn’t notice anything until I felt it.’ For thyroid diseases especially, we think it’s important to see a specialist for proper evaluation.”
The past several years, Dr. Long has traveled to sub-Saharan Africa to treat people with thyroid disorders, especially goiters. In some countries in Africa that are elevated or far from an ocean, local foods are not iodine-rich and people do not have access to iodized table salt. As a result, goiters are far more common. She travels to both Ethiopia and Kenya to help perform thyroid surgery and treatments and to work with local surgeons.
“It’s a passion in my life,” she said. “It does make me grateful to remember everything we do have here.”