Colloid Nodular Goiter

Definition

Colloid nodular goiter is the enlargement of an otherwise normal thyroid gland.

See also: Goiter

Endocrine glands
Thyroid enlargement - scintiscan
Thyroid gland

Alternative Names

Causes, incidence, and risk factors

Colloid nodular goiters are also known as endemic goiters. They are usually caused by inadequate iodine in diet.

Colloid nodular goiters tend to occur in certain geographical areas with iodine-depleted soil, usually areas away from the sea coast. An area is defined as endemic for goiter if more than 10 % of children aged 6 to 12 have goiters.

Certain things in the environment may also cause thyroid enlargement.

Small- to moderate-sized goiters are relatively common in the United States. The Great Lakes, Midwest, and Intermountain regions were once known as the "goiter belt." The routine use of iodized table salt now helps prevent this deficiency.

Risk factors for colloid nodular goiters include being female, being older than 40, not getting enough iodine in your diet, living in an endemic area, and having a family history of goiters.

Symptoms

• Thyroid swelling -- may be one small nodule to a very large mass
• Breathing difficulties (rare)
• Swallowing difficulties (rare)
• Enlarged neck veins
• Dizziness when the arms are raised above the head (large goiter)

Signs and tests

• Thyroid scan
• Thyroid ultrasound
• Blood tests to monitor thyroid function including thyroid stimulating hormone (high if underactive, low if overactive)
• Radioactive iodine uptake (normal or increased)
• Urinary excretion of iodine (low)

Treatment

Thyroid hormone replacement therapy is prescribed for iodine deficiency. If the iodine content of one's diet can be increased, a person may no longer need thyroid hormone replacement therapy.

Persons with a large goiter that persists despite treatment or that restricts swallowing and breathing may need surgery to remove all or part of the thyroid gland.

If the goiter is producing too much thyroid hormone, treatment with radioactive iodine, antithyroid medication, or surgery may be necessary.

Expectations (prognosis)

The outlook is good with treatment. A persistent goiter may become toxic, causing symptoms of excess thyroid hormones to develop. Sudden enlargement of a thyroid gland may mean there is internal bleeding or an immune disorder, and requires immediate medical attention.

Complications

• Thyroid malignancy (cancer)
• Toxic nodular goiter
• Thyrotoxicosis

Calling your health care provider

Call your health care provider if signs of thyrotoxicosis develop:

• Fever
• Increased pulse rate
• Palpitations
• Diarrhea
• Constipation
• Nausea
• Fatigue
• Dry skin
• Sweating
• Tremors
• Anxiety
• Shortness of breath

Prevention

Use iodized salt or foods supplemented with iodine.

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Review Date:2/8/2007
Reviewed By: Robert Hurd, MD, Department of Biology, College of Arts and Sciences, Xavier University, Cincinnati, OH. Review provided by VeriMed Healthcare Network.