Dear doctor;

I have been sent for investigations for a suspected goitre on the left side of my neck. It was never very large and now seems to have moved lower down and is harder to feel. Does this mean it has gone down and should I still go for my scans?

Nyirasafari.

Dear Nyirasafari,

A goitre occurs due to enlargement of thyroid gland. Thyroid gland lies in front of the neck over the wind pipe. It produces hormones that help in body metabolism in various ways. Goitre can form both due to overactive and under active thyroid gland. Sometimes it can be in a normal functioning gland as well.  Usually enlargement occurs in front and generalised. This may be due to hormonal causes, iodine deficiency, Grave’s disease, chronic inflammation auto immune disorder or hereditary. Tumours (benign as well as malignant), cysts on the thyroid can cause goiter. This may be one sided. It can be hard or soft to feel depending on the cause.

Mostly the thyroid gland grows below. It can compress wind pipe and cause breathing trouble, compression of the food pipe can cause difficulty in swallowing. There can be chest pain or sense of heaviness as well. Cause of a goitre is known by assessing thyroid hormone levels in the blood, ultrasound and a biopsy.

Treatment depends on the underlying cause. If there is not much problem associated with it, drugs can help. But in case of symptoms of compression like breathlessness or painful swallowing, surgery is done. In case of tumours, if not advanced, removing part of thyroid surgically is done. In advanced tumour, radiotherapy is used.