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Nontoxic Nodular Goiter

Nontoxic Nodular Goiter

A goiter is an enlargement of the thyroid gland, located on the front of the neck. It produces hormones that help regulate your body’s metabolism. Goiters are seldom painful, as they tend to grow slowly.

Nontoxic or sporadic goiter is a type of simple goiter that may be:

  • Diffuse — an enlargement of the whole thyroid gland
  • Nodular — an enlargement caused by nodules, or lumps on the thyroid



The exact causes of nontoxic goiter are unknown. In general, goiters may be caused by too much or too little thyroid hormones. There is often normal thyroid function with a nontoxic goiter. Some possible causes of nontoxic goiter include:

  • Family history of goiters
  • Regular use of medications such as lithium, propylthiouracil, phenylbutazone or aminoglutethimide
  • Eating foods that inhibit production of thyroid hormone, including cabbage, turnips, brussel sprouts, seaweed and millet
  • Iodine deficiency 


The following factors increase your chance of developing nontoxic goiter:

  • Sex: female (nontoxic goiter is more common in women than men)
  • Age: over 40 years
  • A diet low in iodine


Nontoxic goiters usually do not have noticeable symptoms, unless they become very large. Symptoms may include: 

  • Swelling on the neck
  • Breathing difficulties, coughing or wheezing with large goiter
  • Difficulty swallowing with large goiter
  • Feeling of pressure on the neck
  • Hoarseness
If you experience any of these symptoms, do not assume it is due to this condition. These may be caused by other, less serious health conditions. 


Your doctor will ask about your symptoms and medical history and perform a physical exam.

Tests may include the following:

  • Examination of the neck 
  • Ultrasound 
  • Blood tests 
  • Thyroid scan (scintigraphy) 
  • Fine needle aspiration biopsy 
  • Barium swallow 
  • X-ray of neck and chest for large goiters


You may need treatment for goiters that grows rapidly and affect your neck or obstruct your breathing. If a nontoxic goiter progresses to the nodular stage and the nodule is found to be cancerous, you will need treatment. 

Hormone Suppression Therapy

Thyroid hormone medication suppresses the secretion of thyrotropin (TSH). TSH is the thyroid-stimulating hormone that causes growth. This therapy is most effective for early stage goiters that have grown due to impaired hormone production. It's less effective for goiters that have progressed to the nodular stage.

Radioactive Iodine

Radioactive iodine treatment reduces the size of large goiters. It is used in the elderly when surgical treatment is not an option.


Thyroidectomy is a surgery to remove a portion or all of the thyroid gland. This treatment is particularly effective if the goiter is so large it causes difficulty in breathing or swallowing.


Call us at 434.243.3675.


Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.

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