Do you or your loved ones have an enlarged neck? Well, it can be thyromegaly (goiter). You need not worry much. It is a curable medical condition. Goitre is due to the enlargement of the thyroid gland.

The thyroid gland is a butterfly-shaped organ present in our neck below Adam’s apple. You may have a cough, swelling, etc. as symptoms. You may ask if you should have a concern. If so, read on.

You see, the size of the goiter differs. Larger the size of the goiter, the greater is the risk. Pain is not felt at most times. But, there may be difficulty in breathing and swallowing.

Anyone can have a goiter. But if you are above 50 and a woman, then the chances are higher. Women are most likely affected by it.  It can be caused by many factors like iodine deficiency, hereditary, etc. Thus, it is essential to know what it is, the causes and its treatment.

If you have an interest thyromegaly and related queries, you came to the right place. Here, you will get to know everything about it; symptoms, causes, treatment, etc.

First of all, many of you are familiar with hormones. Hormones play a vital role in our life. It helps us to maintain our body. The thyroid is one of the glands that produce hormone When the function or the state of the thyroid is not healthy, complications such as thyromegaly occurs. Swelling of the neck is a warning sign.

The thyroid is one of the glands that produce hormone When the function or the state of the thyroid is not healthy, complications such as thyromegaly occurs. Swelling of the neck is a warning sign.

In some severe cases, it is most likely that you cannot reverse the damage and have to undergo hormone replacement therapy. Hence, early diagnosis and treatment is the key to finding relief.

Now, let’s see thyromegaly in details.

What Is Thyromegaly?

Thyromegaly is a disorder of the thyroid gland. It occurs when the gland enlarges from its standard size. It is commonly known as goiter and may occur due to high or level of thyroid hormone or due to lack of iodine in the body.

First of all, thyroid is a gland that is a butterfly in shape. It is present below Adam’s apple. It has two lobes; right lobe and left lobe. Each lobe lies on either side of the windpipe and a muscle called isthmus joins them.  The pituitary gland in the brain controls them. It prompts the thyroid gland to release the thyroid hormones (T3 and T4) by sending out stimulating thyroid hormone (TSH).

The peculiarity of the thyroid hormone is that you must have exactly the right amount. Any increase or decrease can create trouble in your body. It is because many organs need these hormones to work properly.

The enlargement of the thyroid gland occurs if your thyroid is not functioning well or if you have an iodine deficiency. Most of the time, it is due to lack of iodine. It can affect you regardless of your age.

Besides, it may be due to auto-immune diseases too. It may not be life-threatening, but it affects life.

And also, treatment is based on the causes. Hence, early diagnosis and treatment are essential. So, visit your doctor to avoid damage.

Types Of Thyromegaly

Thyromegaly types can be classified based on thyroid function, growth pattern, and size.

1. Thyroid Function

i) Hyperthyroid Goitre

In this form of goiter, excessive circulation of thyroid hormone is present. It causes eyelid dryness and swelling of eyes apart from the goiter.

ii) Euthyroid Goitre

This is the type of goiter which is independent of thyroid hormone. Your thyroid produces the right amount of hormones. But there are other factors like a cyst within the gland. It usually grows below the breastbone.

iii) Hypothyroid Goitre

In this type of goiter, there is less or no production of thyroid hormone. The goiter grows below the collarbone.

2. Growth Pattern

i) Diffuse Goitre

The goiter grows all throughout the thyroid. It is smooth to touch. Therefore, the whole thyroid appears to be enlarged.

ii) Nodular Goitre

In this type, there are lumps or cysts present in the thyroid gland. The lumps may be solid or fluid-filled and are called thyroid nodules. They may be toxic or non-toxic. The number of nodules varies too.

  • Unimodular- if the nodule is single, it is unimodular
  • Multinodular- if the nodule is more than one, it is multinodular. If it is toxic, then it is a toxic multinodular goiter.

3. Size

The division is based on the size and the visibility of the goiter

i) Class I

It is palpation goiter.When you are in normal position, it cannot be seen. It can only be detected through palpation

ii) Class II

You can see this goiter enlargement. It can also be palpable.

iii) Class III

This type of goiter is huge. It can even leave compression marks.

Another way of the division is into an endemic and sporadic goiter.

i) Endemic Goitre

This is the type which develops in regions where there is iodine deficiency by nature. It accounts for 10% of the case.

ii) Sporadic Goitre

It occurs in the nonendemic regions for goiter. It may be due to positive family history or age if you are above 40, dietary iodine deficient and a female.

Causes Of Thyromegaly

Causes Of Thyromegaly
Causes Of Thyromegaly

As mentioned earlier, goiter has some causes. You are at the risk of having one based on your hereditary if you have thyroid function problems etc. Below I have listed some of the common causes of a goiter-

1. Iodine deficiency:

Iodine is one of the most important elements for the functionality of the thyroid gland. It is needed in the production of T3 and T4 hormone. When you lack iodine, the thyroid starts to swell during the production of the hormones. As it continues to produce the hormones, it swells more if iodine is not given.

It makes up 90% of the causes.

2. Heredity:

Some people may be genetically predisposed to develop the condition. If your family has anyone suffering or if anyone suffered from it, then you have a possibility. And you should take care of your diet.

3. Hyperthyroidism:

If your thyroid functions in an overactive manner, then you have a risk. Since the thyroid functions more than usual, it is prone to swelling.

4. Hypothyroidism:

Similar to hyperthyroidism if the thyroid produces less or no thyroid hormones, it too swells.

5. Auto-immune diseases:

Diseases like Grave’s disease and Hashimoto’s disease also alter the thyroid. These diseases make your antibodies and lymphocytes attack the thyroid.

6. Medications:

If you take medications that include cobalt or lithium can make the thyroid swell as a side-effect.

7. Thyroiditis:

It is the inflammation of the thyroid gland and may be due to germs like bacteria and viruses. It can also be due to auto-immune diseases. Even radiological treatment can cause thyroiditis.

8. Pregnancy:

Pregnancy can alter a lot of hormones. The thyroid can incorrectly process the signals sent by the pituitary gland. Thus, pregnant women have a higher risk for developing a goiter.

Hence, blood serum is done at the end of each trimester.

9. Nodules:

Nodules may be a cyst, an adenoma or a tumor. A cyst is a non-carcinogenic sac-like swelling filled with fluid. An adenoma is a single non-cancerous tumor. A carcinogenic tumor is rare.

10. Other medical conditions:

Conditions like congenital hypothyroidism, thyroid cancer, benign thyroid neoplasms and pituitary diseases can damage the thyroid over time.

What Are The Symptoms Of Thyromegaly?

An enlargement of the neck is the most common symptoms. However, it is not mandatory. The intensity of symptoms varies. At first, there may be a pain in the throat and difficulty in speaking or no symptoms at all.

Some of the common symptoms are-

1. Swelling

As we know from earlier, you neck tend to swell. The size of thyroid varies from tiny unnoticeable to huge lumps. But they are painless.

2. Hyperthyroidism

If you suffer from hyperthyroidism, the symptoms may include the following. You may have difficulty in breathing, high blood pressure, nervousness, heat intolerance and chest pain.

3. Hypothyroidism

You may gain weight despite your poor diet. You may also be intolerant to cold, constipation and lethargy. But, making a diagnosis from these is challenging. Hence, laboratory tests are needed.

4. Throat

There may be a pain in swallowing food and breathing in severe cases. It is because of the pressure of the swelling. Bad breath is also common.

5. Other symptoms

When the condition is critical, you may have a headache, dizziness and vomiting sensation. You may also have a hoarse voice. You may also be down with fever if an infection is a cause.

Many times, the initial stage of goiter goes unnoticed due to small size swelling of the thyroid gland and absence of other symptoms. You may, however, feel constriction in the throat, discomfort while breathing and swallowing along with a cough and hoarse voice.

But, these can be overlooked as symptoms of a sore throat. Thus, you should not ignore any swelling, howsoever small it be and see your doctor.

Diagnosis

A specialist may be able to help you. He will proceed the diagnosis by taking a history of symptoms and performing a careful physical examination. He may also ask you to have a clinical examination based on his findings. The clinical tests may consist of blood tests, ultrasound, RAI, CT or MRIs and FNAC.

Well, the physical examination is done by a doctor. He examines the size of the gland, its tenderness, mobility, and firmness.

1. Blood Tests

A sample of your blood is taken. It is to check your thyroid hormone levels; T3, T4, and TSH.

2. Ultrasound

Ultrasound signals are used to determine the size and shape of the thyroid gland and its surrounding tissues.

3. Radioactive Iodine Uptake

You are injected with the specific amount of radioactive iodine. Then imaging proceeds. This test determines if your nodule is hot or cold. Hot nodules are hyperactive nodules that take up more iodine. Whereas, cold nodules are hypoactive that take up less iodine.

Cancerous nodules appear as cold nodules. It might be benign nodules too.

4. CT or MRIs

CT lets you check the level of iodine in your body. It is difficult to see if the soft mass is cancerous or not and so MRI is used.

5. FNAC

If your thyroid is larger than normal. But, you have normal hormone levels. Then, you might have to do FNAC (fine needle aspiration cytology). It is a biopsy of the thyroid tissue. It reveals the type and level of the nodule and tumor.

Natural Home Remedies To Get Rid Of Thyromegaly

If you have a goiter, don’t worry. Apart from the medications, you may also try home remedies. Some of the home remedies for pinched nerve are listed below.

1. Dandelion Leaves:

You need to make a paste of dandelion leaves. Mix clarified butter (ghee) to the leaves and heated the mixture until it becomes lukewarm. Apply it on your neck and leave for 15 to 20 minutes before washing it off. Use this every day for about two weeks, and you will notice a difference in the size of the goiter.

2. Flaxseeds:

Grind flaxseeds and make a paste with water. Apply on your neck and leave for 20 to 25 minutes. Wash and dry. It helps reduce the swelling because of the anti-inflammatory properties.

3. Barley Water:

Drink barley water once a day to reduce the swelling and ease other symptoms. Barley water also cleanses toxins from the body. Barley is rich in phytonutrients and antioxidants that build up the body’s immunity and help fight diseases.

4. Kachnar (Bauhinia variegate):

Kachnar is indigenous to India and is one of the herbal remedies for goiter and also treats several other ailments. Take two tablespoons of Kachnar bark powder and dissolve it in 160 ml water. Boil until it reduces by 40 percent. Strain and divide the concoction into two. Now, add ginger powder. Drink early in the morning and in the evening.

5. Cold Shower:

Take a cold shower twice a day. This stimulates the thyroid gland and helps it to work properly. This is one of the most effective home remedies for goiter.

6. Watercress:

Watercress is high in iodine and also has other vitamins, minerals, and antioxidants that help in curing goiter. Make a paste and apply it on your neck. Leave the paste for about 15 to 20 minutes before washing it off.

You can also crush the leaves to extract the juice. Now, dilute the juice with a little bit of water and drink it three times a day for about six weeks.

7. Pineapple:

Pineapple is rich in vitamins and minerals. It helps the symptoms of goiter, particularly the coughing.

8. Sorrel Leaves:

You should make a paste of sorrel leaves and add a little olive oil to it. Apply the paste on your neck and leave it for 15 to 20 minutes.

9. Garlic:

Garlic is known for its many medicinal properties. It stimulates the production of glutathione in the body, which is required for the healthy functioning of the thyroid. Chew 3-4 cloves of garlic daily in the morning. If you don’t want to have a garlicky breath, you can also make a salad with raw garlic, tomatoes, onions and olive oil.

10. Green Tea:

Well, we all know that green tea is great with antioxidants. Daily consumption of green tea can cure goiter and also prevent it. Green tea also has a high amount of natural fluoride, which helps in the healthy functioning of the thyroid.

11. Kelp:

Kelp is a seaweed and helps to normalize the functioning of the thyroid gland. It is because of its high iodine content. You can buy kelp from a Japanese food store. It can be dry or pickled. As kelp is naturally salty, use it instead of salt. You can also add a tablespoon of dried kelp powder to smoothies.

12. Bugleweed:

Bugleweed (Lycopus virginicus) has been used to treat hyperthyroidism, breast pain, weak heart, and edema. It is high in flavonoid, phenolic acids, and tannins. It can inhibit stimulating thyroid hormone (TSH), but be sure to consult your doctor before using it. You can make tea and consume it with honey.

13. Lemon Balm:

Lemon balm tea is known to help treat goiter by slowing down the functioning of the pituitary gland and lowering TSH level. It is available in the form of a tincture. So, it can be brewed into a tea. Drink it three times a day. Be sure to keep the lid on while making the tea to prevent the aromatic oils of the balm from escaping.

14. Motherwort:

You may suffer from palpitations and fast heartbeat because of hyperthyroidism. These symptoms can be eased with motherwort. It is rich is flavonoid, tannins, and alkaloids and can help you to reduce the size of your goiter. Drink motherwort tea twice a day.

15. Coconut Oil:

Coconut oil contains high levels of lauric acid. When you eat it, the acid is converted into monolaurin, which has antibacterial, antiviral and anti-protozoa properties. You can use coconut oil for cooking to help treat goiter.

16. Water Spinach and Almonds:

This Indonesian and Malay vegetable has many names, including water morning glory, swamp cabbage. For this, extract a tablespoon juice from water cabbage. Boil 2 almonds in about a cup of water and strain. Now, grind the almonds and add the water cabbage juice to it. Consume this paste every day for nearly a month.

17. Bentonite Clay:

Bentonite clay can help treat goiter. Make a paste of the clay and apply it on your neck. Let the paste dry before washing it off. This helps to suck out the toxins and reduces the swelling.

18. Iodine-rich Diet:

If your goiter is due to iodine deficiency, you need to eat an iodine-rich diet. Try using iodized salt or consume more cabbage, kale, seafood, codfish, tuna, eggs, natural yogurt, milk, and cranberries. Adults should eat about 150 micrograms of iodine daily to keep goiter away.

19. Selenium-rich Food:

Your thyroid gland needs selenium to function at its optimum. Some foods are rich in this mineral-like Brazil nuts, mushrooms wheat germ, sunflower seeds, shellfish, onions, eggs, barley, meats, poultry and fatty fish. Have these foods as a part of your daily diet to help cure goiter.

20. Bladderwrack:

This seaweed is rich in iodine. You can make a tea with dried bladderwrack or in the form of capsules. Take the pills as recommended.

21. Oak Bark:

Prepare a paste of dried oak bark with some water. Apply it on your neck and let it stay overnight. It helps reduce the size of your goiter and eases many of the symptoms.

22. Limit Goitrogenic Foods:

Goitrogenic foods are those that hinder normal functioning of the thyroid gland. As a result, the gland is unable to synthesize iodine accurately. So, these are some foods that you should eat in moderation.

  • Cauliflower
  • Cabbage
  • Turnip
  • Brussels sprouts
  • Mustard greens
  • Spinach
  • Broccoli
  • Kale
  • Soya beans
  • Peanuts
  • Radish
  • Sweet potatoes
  • Strawberries

Cooking goitrogenic foods negates their effect on your thyroid. Well, it is not necessary to eliminate them from your diet, but you should consume in limited quantities.

23. Coleus Leaves:

In Asia, coleus leaves are used in salads even though it is an ornamental plant. It helps to reduce the size of your goiter and ease the symptoms.

24. Self-Heal Herb:

Self-heal’s scientific name is Prunella vulgaris. It is a perennial plant with anti-inflammatory properties. It regulates the functioning of the thyroid gland and is available as a tincture. So, you can brew it into a tea and drink to reduce the swelling.

Exercises To Get Rid Of Thyromegaly

Exercises To Get Rid Of Thyromegaly
Exercises To Get Rid Of Thyromegaly

One of the best ways to relieve the pain is through simple activities. Exercises help strengthen the damaged area. Not only do they relieve pain and help heal.

There are a few simple but effective exercises you can do to get relief. However, it might be a good idea to take the advice of a physical therapist. This is to check which exercise would be most appropriate for you.

1. Chin Extension

Sit on a chair and cross the fingers on both hands. Place them behind your head. Move your chin in a downward direction and to the right side simultaneously. Hold for 15 seconds, before looking forward again. Repeat on your left side. Perform five times in each direction.

2. Neck Rotation

Stand or sit in an upright position. Rotate your neck on the right 5 times and then on the left five times. If you have massive swelling, avoid it.

3. Shoulder Shrugs

Perform in a standing position. Keep both arms at your sides and shrug your shoulders backward in a rotating motion. Return to the original position by rotating from the opposite direction. Perform a set of 15. Take a break between each set.

4. Yoga

Yoga combines classic poses, breathing, and deep relaxation to condition and strengthens your body regardless of your current flexibility or other physical limitations.

These exercises help the muscle surrounding the thyroid to have more circulation.

Treatment To Get Rid Of Thyromegaly(Goiter)

Treatment To Get Rid Of Thyromegaly(Goiter)

The treatment of a goiter depends upon the location and the cause. Here are the medications used in common-

1. Hormone Replacement Therapy

The primary reason is either due to the low or high level of hormone. Therefore, it can be treated by replacing the hormone using radiation or surgery.

2. Levothyroxine Suppressive Therapy

This is a lengthy but effective procedure. You must be patient to undergo this therapy. It is targeted against non-toxic goiter.

3. Healthy Diet

A healthy diet is essential for living a healthy life. Make sure you have a balanced diet. A diet that is rich in iodine.

4. Medications

To stabilize the gland medication can be used. The common medicines are methimazole and PTU. These drugs help to reduce the swelling by reducing hormone level in your body.

5. Exercise

Exercise strengthens the muscles and supports you more. It further helps you lose and maintain weight.

7. Ethanol Infusion

This treatment is effective and reduces the size of non-cancerous lumps. In some cases, the lump can increase and cause great discomfort. If you experience this side effect, contact your doctor.

8. Surgery

If you have a severe case of goiter and you experience a lot of pain, you may also choose to undergo surgery. This is usually your last option so you can expect to try out a variety of other treatments before your doctor approves it. It involves partial and total removal of the thyroid known as thyroidectomy

  • Total thyroidectomy requires removal of the whole gland.
  • Near-total thyroidectomy involves the surgical removal of both lobes except for a small amount of thyroid tissue.
  • Subtotal thyroidectomy leaves 3‑5 g of the tissue on the less affected side of the gland.

A possible after-effect is recurrent nerve palsy as the nerve could be traumatized during surgery. Changes to the voice, difficulty swallowing or both may occur. If the parathyroid glands close to the thyroid are accidentally removed or injured, your blood calcium levels may drop resulting in tingling, muscle cramps, and numbness. A severely low calcium level can lead to throat spasm or a seizure.

Endoscopic techniques are used to remove the thyroid gland are minimally invasive, and the scars are invisible. The safety of the operation lies in the quality of the images captured on the endoscopic high-definition camera.

It is a must for you to take care of your body. Sometimes goiter may not be visible, but it doesn’t mean it isn’t there. You may need treatment to shrink the swollen gland. Hence, visit a doctor.

In severe cases, it may be necessary to remove the gland. It may also cause bronchocele.

Hence, it is advisable to get treated by a specialist in case symptoms starts. Having proper knowledge, taking precaution and healthy lifestyle is the best key.

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Dr. Abhishek Jain has wide stint of more than 13 years in the field of Spa & Wellness across Global and Indian hospitality.For his contributions, he was recognized as ‘Best Naturopath’ for the year 2003-04.