Treatment for a goitre can include medication, hormone therapy and surgery.
The treatment you receive will depend on:
- the size of the goitre
- the symptoms the goitre is causing
- whether you have any underlying thyroid condition
Your condition may just be monitored if tests reveal your thyroid gland is working normally and the goitre is small.
If your goitre is interfering with your breathing or swallowing and it hasn't responded to other forms of treatment, you may need surgery to remove part or all of your thyroid gland. This procedure is known as a thyroidectomy.
Treating thyroid gland problems
If tests reveal a problem with your thyroid gland, you may receive treatment for:
- an overactive thyroid gland (hyperthyroidism) – which may include taking a type of medication known as thionamides or a type of radiotherapy called radioiodine treatment
- an underactive thyroid gland (hypothyroidism) – which usually involves taking a synthetic hormone called levothyroxine to replicate your normal thyroid function (hormone therapy)
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A well-balanced diet usually provides all the iodine your body needs, and iodine supplements aren't usually required in developed countries like the UK. Your GP can give more advice about extra supplements, if needed.
Iodine supplements are available in many health food shops without a prescription. However, always consult your GP before taking them as the amount of iodine needed varies from person to person.
Taking too much iodine may cause other health problems, and it could also have toxic effects.
Before a thyroidectomy, you'll be given a general anaesthetic so you're unconscious and unable to feel anything.
During surgery, the surgeon makes a cut (incision) in the front of your neck so they can see your thyroid gland.
How much of the thyroid gland is removed depends on the underlying condition causing the goitre. The procedure reduces the size of your goitre and the amount of thyroid hormones being produced.
The surgeon will attempt to remove enough of your thyroid gland to relieve your symptoms, while leaving enough so normal thyroid hormone production can continue.
However, if this isn't possible, you may require hormone therapy after surgery.
Surgery to remove the thyroid gland is usually safe, but as with all surgical procedures there's a risk of complications, such as postoperative infection.
Complications of a thyroidectomy
The risks of complications occurring after thyroid gland surgery are estimated to be 1-2%. Before having the procedure, you should discuss the risks with your surgeon.
Nerve damage and parathyroid gland damage are two other possible complications of thyroid gland surgery. These are briefly described below.
The thyroid gland is very close to the two laryngeal nerves, which control your vocal cords. If these are accidentally damaged during surgery, your voice and breathing could be affected.
Permanent damage to the laryngeal nerves affects 1-2 people in every 100 who have this type of surgery. Temporary damage may affect up to 5 people in every 100.
Parathyroid gland damage
The parathyroid glands help regulate the amount of calcium in your body. If the parathyroid glands are damaged, you'll probably need to take calcium supplements for the rest of your life.