Goiter treatment

Determining the appropriate treatment for a goiter depends on a number of factors, including the size of the goiter, your signs and symptoms, and the underlying cause. Your provider may recommend:

• Watchful waiting: If your goiter is not causing significant problems and your thyroid is functioning normally, your provider may suggest a wait-and-see approach. This involves carefully monitoring your signs and symptoms for any changes.
• Medications: If you have underlying thyroid dysfunction, making your thyroid function at a normal level can often decrease the size of a goiter.

If you have a goiter associated with hypothyroidism (underactive thyroid), thyroid hormone replacement with levothyroxine (Levoxyl, Synthroid, Tirosint) will help relieve symptoms and slow the release of TSH from your pituitary gland.

If you have a goiter associated with hyperthyroidism¹⁷ (overactive thyroid), medications such as methimazole (generic Tapazole) can prevent your thyroid from producing excess amounts of hormones.

Your provider may suggest using aspirin or a corticosteroid medication if your thyroid is inflamed. If your goiter is associated with hyperthyroidism, you may be prescribed medications to help normalize your hormone levels.

• Surgery (thyroidectomy): If you have a goiter that is large and uncomfortable or obstructing breathing and swallowing, your provider may recommend a procedure to remove all or part of your thyroid gland (total or partial thyroidectomy). However, thyroid surgery is an option in only a few cases of goiter. It is more commonly used as a treatment for thyroid cancer.

Depending on the amount of your thyroid that is removed, you may need life-long treatment with levothyroxine to supply your body with normal amounts of thyroid hormone. If your parathyroid glands are also removed, you'll need medication to keep your blood calcium levels normal.

• Radioactive iodine: In some cases, radioactive iodine is used to treat an overactive thyroid. Radioactive iodine is taken by mouth and reaches your thyroid gland through your bloodstream, destroying thyroid cells.

Depending on the dose¹⁸, radioactive iodine can destroy a portion or all of your thyroid. Large doses of radioactive iodine are usually not needed unless they are for thyroid cancer cells.

Taking radioactive iodine helps diminish the size of a goiter, but eventually may also cause an underactive thyroid gland. If your thyroid becomes underactive, you may need to take medication to replace thyroxine.

Goiter medicine

Your healthcare provider might prescribe the following medications for goiter:

Goiter lifestyle and home remedies

If your diet contributed to the development of your goiter, your provider may suggest the following:

• Consume sufficient iodine: To ensure that you get enough iodine, use iodized salt or eat foods rich in iodine, such as shellfish, seaweed, cow’s milk, and yogurt.

The recommended daily serving of iodine is 150 micrograms per day. There are about 150 micrograms of iodine in a scant half teaspoon of iodized salt. It is especially important that pregnant and lactating women, infants, and children get enough iodine in their diets.

• Avoid excess iodine consumption: While uncommon, getting too much iodine can lead to a goiter. Thyroid dysfunction from too much iodine¹⁹ is more likely to occur in people with pre-existing thyroid disease, the elderly, and babies.

If excess iodine is a problem, avoid iodized salt, shellfish, seaweed, and iodine supplements.