Nontoxic Nodular Goiter
(Sporadic Goiter; Simple Goiter; Nodular Enlargement of the Thyroid Gland)
by Michelle Badash, MS
A goiter is an enlargement of the thyroid. The thyroid is a gland. It produces hormones that help regulate your body’s metabolism. It is located on the front of the neck, right below the Adam’s apple. Goiters are seldom painful. They tend to grow slowly.
There are different types of goiters. This is about nontoxic goiters which may be:
The exact causes of nontoxic goiter are not known. In general, goiters may be caused by too much or too little thyroid hormones. There is often normal thyroid function with a nontoxic goiter. Some possible causes of nontoxic goiter include:
Nontoxic goiter is more common in women and in people over age 40.
Other factors that may increase your chances of nontoxic goiter:
Nontoxic goiters usually do not have noticeable symptoms, unless they become very large. Symptoms may include:
You will be asked about your symptoms and medical history. A physical exam will be done. Your doctor may recommend a specialist. An endocrinologist focuses on hormone related issues.
Your body fluids and tissues may be tested. This can be done with:
Images may be taken of your body structures. This can be done with:
Nontoxic goiters usually grow very slowly. They may not cause any symptoms. In this case, they do not need treatment.
Treatment may be needed if the goiter grows rapidly, affects your neck, or obstructs your breathing.
If a nontoxic goiter progresses to the nodular stage, and the nodule is found to be cancerous, you will need treatment. Talk with your doctor about the best plan for you. Treatment options include the following:
Hormone Suppression Therapy
Thyroid hormone medication is used to suppress secretion of thyroid-stimulating hormone (TSH). TSH causes growth of the thyroid. This therapy is most effective for early stage goiters that have grown due to impaired hormone production. It is less effective for goiters that have progressed to the nodular stage.
Radioactive iodine treatment is used to reduce the size of a large goiter. It is used when surgical treatment is not an option.
Thyroidectomy is done to remove part or all of the thyroid gland. It is the treatment of choice if the goiter is so large that it makes it difficult to breathe or swallow.
To help reduce your chances of a nontoxic goiter, be sure that your diet contains enough iodine. In the US, iodine can be found in table salt and a variety of foods. Iodine deficiency is more common in less developed countries.
American Thyroid Association
Hormone Health Network—Endocrine Society
The College of Family Physicians of Canada
Thyroid Foundation of Canada
Diehl LA, Garcia V, Bonnema SJ, et al. Management of the nontoxic multinodular goiter in Latin America: comparison with North America and Europe, an electronic survey. J Clin Endocrinol Metab. 2005;90(1):117-123.
Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016 Jan;26(1):1-133.
Freitas JE. Therapeutic options in the management of toxic and nontoxic nodular goiter. Seminars in Nuclear Medicine. 2000;30(2):88-97.
Gharib H, Papini E, Garber JR, et al; AACE/ACE/AME Task Force on Thyroid Nodules. American Association of Clinical Endocrinologists, American College of Endocrinology, and Associazione Medici Endocrinologi Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules. Endocr Pract. 2016 May;22(5):622-39.
Nontoxic Multinodular Goiter. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/nontoxic-multinodular-goiter. Accessed September 23, 2020.
Last reviewed September 2020 by EBSCO Medical Review Board Monica Zangwill, MD, MPH
Last Updated: 9/23/2020
EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
To send comments or feedback to our Editorial Team regarding the content please email us at firstname.lastname@example.org. Our Health Library Support team will respond to your email request within 2 business days.