Goitre | Symptoms & Causes | Diagnosis

What this section contains?


What is Goitre?

Iodine is an important trace element. It is required for synthesis of thyroid hormone (thyroxine) which controls normal heart function, nerve impulse and rate of body growth and metabolism.
The requirement of Iodine is met through food (cereals and grains). If, enough Iodine is not available it directly affects the thyroid gland function. Deficiency of iodine leads to goiter (enlargement of thyroid gland).

The Iodine deficiency disorders form spectrum of abnormalities which include goiter, mental retardation, deaf mutism, squint, difficulties in standing and walking normally and stunting of limbs.

In India, a population of over 167 million people are at a risk of Iodine deficiency disorders. 44 million actually have goiter and 2.2 million suffer from cretinism (stunted physical and mental growth). With every passing hour 10 children are born who will not attain their optimal mental and physical growth, due to iodine deficiency.
Tools for screening: RBSK mobile health teams would look for visible swelling in the neck region in children suggestive of swelling of the thyroid gland. They would also ask some specific questions suggestive of this deficiency.


Worldwide, the most common cause for goitre is iodine deficiency, usually seen in countries that do not use iodized salt. Selenium deficiency is also considered a contributing factor. In countries that use iodized salt, Hashimoto's thyroiditis is the most common cause. Goitre can also result from cyanide poisoning; this is particularly common in tropical countries where people eat the cyanide-rich cassava root as the staple food.

Diagnosis & Tests

Goitre may be diagnosed via a thyroid function test in an individual suspected of having it.

Prevention & Risk Factors

Iodization of table salt greatly reduces the pre-valance of goitre in many countries. The iodized salt must contain 76 kg of iodine/gm. salt and daily consumption of salt is between 2 and 6 gm. Lower levels of iodization are used in most other coun?tries and are effective. Potassium iodide is used for the iodization of the crude moist salt consumed in many countries.

Treatments & Therapies

Goitre is treated according to the cause. If the thyroid gland is producing an excess of thyroid hormones (T3 and T4), radioactive iodine is given to the patient to shrink the gland. If goitre is caused by iodine deficiency, small doses of iodide in the form of Lugol's iodine or KI solution are given. If the goitre is associated with an underactive thyroid, thyroid supplements are used as treatment. Sometimes a partial or complete thyroidectomy is required.