The term GOITER is simply an enlargement of your thyroid gland. The thyroid gland is at the base of your neck right below the Adam’s Apple. It is butterfly-shaped and surrounds the trachea/esophagus. Goiters are mostly unnoticed by people and sometimes caught accidentally during other routine visits to your primary care or ENT.  Sometimes they are caught by an MRI or CT of other areas of the body. Goiters if enlarged, however, can cause some coughing, and make it difficult for you to swallow or breathe.

I am pretty sure you have heard of the most common cause of a goiter in the entire world? It is a lack of iodine in our diet. Here in the United States, our government made sure our table salt contains iodine… ionized NA+CL-. So here goiters are commonly caused by an over or underproduction of thyroid hormones  (thyroxin). Nodules form and swelling occurs. There are a few reasons outside of the iodine issue that causes the over or underproduction of thyroxin.  We can look at a few of these later in the blog.

Treatment options range from doing nothing, taking prescription medications and even a surgical intervention… So what are the symptoms?


Again many times you do not show signs of goiter however if you do they may be:

Remember the last blog where most all of these symptoms above were also in the Silent Reflux? Yes, very similar. Further studies are warranted here. Let us go deeper into the causes:



  • Pituitary gland and hypothalamus.  A normal thyroid gland will produce two important hormones — thyroxine AKA (T-4) and triiodothyronine  AKA (T-3). Metabolism is regulated by these hormones as they circulate in your blood. Fat storage and usage, carbohydrate usage, Protein usage, and temperature regulation come from these hormones

Calcium (CA++) is also regulated by hormone calcitonin… also produced by the thyroid.

What controls the thyroid? The pituitary and hypothalamus regulate the thyroid release of thyroxine (T-4/T-3)

The hypothalamus is the beginning of the regulation and is called the “thermostat” of the body. The hypothalamus by the use of biochemical signaling sends a signal to the pituitary gland to produce TSH or stimulating hormone. The pituitary… a different organ works in a concerted effort with the hypothalamus-ALSO can release TSH, which is dependent upon T-3 amounts in your blood. Basically the thyroid gland, in turn, regulates the production of TSH by a biofeedback mechanism between the hypothalamus and pituitary gland. Yes, these are very intricate systems that can get out of balance by different pathologies...  

Goiters do not necessarily mean the thyroid is not working properly and can be enlarged with normal hormone levels. However if  T-3 production increases or decreases this can cause certain problems AND there may or may not be a goiter present.

Common factors can cause your thyroid gland to enlarge.

Risk factors

Everyone is susceptible to Goiters. They may be present from birth to a geriatric death. We have mentioned many of the risks but here are common ones:


Again most of the time you do not notice a goiter however the ones that enlarge enough to cause breathing problems are at risk.

Other complications are weight loss and gain, emotional changes, and skin changes. 


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