Diffuse goiter and diffuse changes of the thyroid gland

Goiter is an enlargement of the thyroid gland that manifests as a swelling on the front surface of the neck. Ultrasound reports sometimes contain the wording "diffuse changes," and it requires clarification. In this article we will explain what goiter is, what examinations are performed, and when you should see a doctor.

What is diffuse goiter

Goiter is an enlargement of the thyroid gland. It is located on the front surface of the neck, just above the place where the collarbones meet, and produces the hormones T4 and T3, which control metabolism, mood, weight, and energy levels. The main symptom of goiter is a painless swelling in the lower part of the front of the neck; it may be smooth or lumpy and is sometimes noticeable only on one side. Goiter is usually not dangerous, but it is checked by a doctor.

Diffuse changes of the thyroid gland on ultrasound: what they mean

Ultrasound examination is part of the evaluation for goiter. The causes of thyroid enlargement can vary: iodine deficiency, autoimmune conditions, inflammation, nodules, hormonal changes. The doctor decides which examinations are needed.

Nontoxic and euthyroid goiter: what is specific about them

Nontoxic (simple) goiter is an enlargement of the thyroid gland that is usually not a tumor or cancer. It can be endemic or colloid. Such a goiter may disappear on its own or may enlarge over time. Sometimes the gland eventually stops producing enough hormone — hypothyroidism develops. In some cases the goiter becomes toxic and begins to produce hormone on its own, which leads to hyperthyroidism.

Why the thyroid gland enlarges

The most common cause is iodine deficiency: the body needs it for hormones, and the gland enlarges to capture more iodine. Other causes: increased or decreased gland function, benign nodules, hormonal changes during puberty, pregnancy, and menopause, inflammation of the gland, autoimmune conditions, use of certain medications, smoking, infections (rarely), very large amounts of soy, peanuts, and cruciferous vegetables, thyroid cancer (rarely). Simple goiter is more common in people over 40, in women, with a family history of goiter, and in those born and raised in regions with iodine deficiency.

What examinations are needed for diffuse changes

The doctor examines the neck by palpating it during swallowing. Then thyroid function tests are ordered — free T4 and TSH. To look for altered areas, thyroid scanning and ultrasound examination are used. If nodules are found on ultrasound, a biopsy may be needed — taking a small tissue sample with a fine needle to rule out cancer.

• examination and palpation of the neck during swallowing
• blood tests: free T4 and TSH
• thyroid ultrasound
• scanning and uptake measurement
• biopsy if nodules are found

When to see an endocrinologist

You should see a doctor if you have noticed a swelling in the front of the neck or other symptoms of goiter. These include a cough that does not go away, hoarseness or voice change, a feeling of a lump in the throat, a whistling sound when breathing, difficulty swallowing or breathing. With a very large goiter, pressure on the trachea and esophagus is possible: then breathing becomes difficult when lying on the back or with raised arms, and cough, hoarseness, difficulty with solid food, and pain in the area of the gland appear. With arms raised above the head, dizziness may occur due to pressure on the neck veins.

Goiter itself is not a reason to call an ambulance. Call 103 or 112 if it is difficult to breathe or a whistling sound is heard when breathing.

A line in an ultrasound report is not a diagnosis but a reason to see a doctor and have tests done. This material is for reference and does not replace a doctor's consultation.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer