Materiały źródłowe

• #1 Goiter – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/goiter/symptoms-causes/syc-20351829

  A goiter may be associated with no change in thyroid function or with an increase or decrease in thyroid hormones. […] Treatment depends on the cause of the goiter, symptoms, and complications resulting from the goiter. Small goiters that aren’t noticeable and don’t cause problems usually don’t need treatment. […] Changes in the production of thyroid hormones that may be associated with goiters have the potential for causing complications in multiple body systems.

• #2 Thyroid Goiter

  https://www.thyroidcancer.com/thyroid-goiter

  Goiter means „big thyroid”. Thyroid Goiter means the same thing–the thyroid has grown to a large size. […] This page discusses thyroid goiters, the symptoms of thyroid goiters, and surgery for thyroid goiters. […] The most common symptom from a thyroid goiter is a lump in the neck. Other symptoms from a large thyroid goiter may include a sense of a lump in the throat, difficultly swallowing, difficulty breathing and even in extreme cases, voice changes and even vocal cord paralysis. […] Today, in the United States, thyroid goiter is more commonly associated with too much production of thyroid hormone (hyperthyroidism), too little production of thyroid hormone (hypothyroidism), or multiple nodules within the thyroid gland itself (mulitnodular goiter). […] If the ultrasound with or without biopsy suggests that the patient has benign small thyroid goiter and there are little to no symptoms, the doctor may suggest simply watching the patient and the goiter.

• #3 Thyroid Goiter

  https://www.thyroidcancer.com/thyroid-goiter

  If you have hypothyroidism (low thyroid hormone), your doctor will prescribe you thyroid hormone in the form of a pill or capsule. […] If you have hyperthyroidism [high thyroid hormone and very low thyroid stimulating hormone (TSH)], your doctor will likely prescribe you a medication to control your hyperthyroidism. […] Radioactive Iodine Therapy is used in circumstances where the thyroid goiter is associated with excess thyroid hormone production. […] Sometimes clearly thyroid goiters and multinodular goiters are managed with surgery. Some potential indications for removing thyroid goiters include: The thyroid goiter is large (producing a visible mass in the neck), The thyroid goiter is producing symptoms on the breathing tube or swallowing tube, The thyroid goiter is producing excessive thyroid hormone, Thyroid nodules which have Indeterminate or suspicious for cancer FNAs.

• #4 Goiter – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/goiter/diagnosis-treatment/drc-20351834

  Goiter treatment depends on the size of the goiter, your signs and symptoms, and the underlying cause. If your goiter is small and your thyroid function is healthy, your health care provider may suggest a wait-and-see approach with regular checkups. […] Medications for goiters may include one of the following: […] An underactive thyroid is treated with a thyroid hormone replacement. The drug levothyroxine (Levoxyl, Thyquidity, others) replaces thyroxine (T-4) and results in the pituitary gland releasing less thyroid-stimulating hormone (TSH). The drug liothyronine (Cytomel) may be prescribed as a triiodothyronine (T-3) replacement. These treatments may decrease the size of the goiter. […] An overactive thyroid may be treated with an anti-thyroid drug that disrupts hormone production. The most commonly used drug, methimazole (Tapazole), may also reduce the size of the goiter.

• #5 Goiter – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562161/

  Patients with goiter commonly present to outpatient facilities with a variety of complaints. […] Accurate diagnosis is essential for the proper treatment approach. […] This activity reviews the evaluation and management of goiter, reviews different causes and types, and highlights the role of the interprofessional team from various specialties in evaluating and treating goiter. […] Describe the management options available for goiter. […] The aim of goiter treatment is to relieve compression and to restore euthyroidism. […] If there is any coexistent hypothyroidism, treatment includes thyroid hormone administration. Patients with toxic goiter require modalities that address thyroid enlargement and thyrotoxicosis. […] Today the main treatment options include monitoring without any treatment and thyroidectomy.

• #6 Euthyroid Goiter With and Without Nodules—Diagnosis and Treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3441105/

  Thyroid enlargement and thyroid nodules are common in the general population. This review concerns their proper diagnostic assessment and treatment. […] There have been very few randomized trials concerning the diagnosis and treatment of goiter. Nodular goiter can be managed by watchful waiting, drug treatment (initially with levothyroxine and iodide), radioactive iodine therapy, or surgery. […] Many patients with nodules need no treatment at all. Treatment is indicated, however, if the patient is symptomatic and/or has an autonomously functioning (hot) nodule, or if cancer is suspected. Potentially cancerous nodules must be operated on. If euthyroid nodular goiter is to be treated with the main goal of size reduction, either surgery or radioactive iodine therapy can be used. Drug treatment is an option for small nodules or goiters, but iatrogenic hyperthyroidism must be avoided at all costs. The type of follow-up that is required depends on the chosen treatment.

• #7 Euthyroid Goiter With and Without Nodules—Diagnosis and Treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3441105/

  There are hardly any evidence-based recommendations for the treatment of euthyroid diffuse goiter and nodular goiter. Potential management strategies include watchful waiting for asymptomatic patients, drug treatment, radioactive iodine therapy, and surgery. The choice among them is taken individually for each patient in view of the risks, benefits, and availability of the various techniques, the experience of the treating physicians, and the patients wishes. […] Iodine deficiency is the main cause of euthyroid diffuse goiter; accordingly, correction of the intrathyroid iodine deficiency is the main objective of treatment. […] Treatment is clearly indicated if there is a suspicion of cancer, or if the patient has mechanical symptoms. […] The definitive treatment of autonomously functioning thyroid nodules is with surgery or radioactive iodine therapy.

• #8 Goiter – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562161/

  Monitoring and observation are recommended initially if there are no compressive symptoms, as certain goiters can spontaneously regress with time. […] For patients that fall into this latter category, the treatment of choice is surgery. […] Surgery is also indicated when malignancy is suspected or diagnosed. […] When surgery is the treatment option, total or near-total thyroidectomy is preferred over subtotal thyroidectomy. […] For patients that need a treatment option besides monitoring, however, cannot undergo surgery due to personal preference or being poor surgical candidates, radioiodine therapy is the treatment of choice. […] In patients with toxic goiters, treatment options include surgery, radioiodine therapy, or antithyroid drugs. […] Surgery is a definitive treatment option and indications include goiters that are obstructive or large, malignancy, coexistent primary hyperparathyroidism, or need for immediate or definitive correction of hyperthyroidism.

• #9 Goiter Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/120034-treatment

  Small benign euthyroid goiters do not require treatment. The effectiveness of medical treatment using thyroid hormone for benign goiters is controversial. Large and complicated goiters may require medical and surgical treatment. Malignant goiters require medical and surgical treatment. […] The size of a benign euthyroid goiter may be reduced with levothyroxine suppressive therapy. The patient is monitored to keep serum TSH in a low but detectable range to avoid hyperthyroidism, cardiac arrhythmias, and osteoporosis. The patient has to be compliant with monitoring. Some authorities suggest suppressive treatment for a definite time period instead of indefinite therapy. Patients with Hashimoto thyroiditis respond better. […] Treatment of hypothyroidism or hyperthyroidism often reduces the size of a goiter.

• #10 Patient Journey Thyroid – Planning and Treatment – Goiter and Nodule | American Association of Clinical Endocrinology

  https://www.aace.com/patient-journey/thyroid/planning-and-treatment/goiter-nodule

  Goiter, Nodule, and Thyroid Cancer Treatment Options […] Goiter Treatment Options […] What are the treatment options for a goiter? […] Health care professionals typically treat a goiter only if it is causing symptoms or if it is related to thyroid disease. If your goiter requires treatment, the type of treatment recommended depends on whats causing it. Treatment options include the following: […] Watchful waiting: When goiter has no medical cause and no uncomfortable symptoms, your health care professional may monitor it over time to watch for changes. […] Medication: If your goiter is caused by a thyroid condition, such as hyperthyroidism or hypothyroidism, your health care professional will prescribe medication for your condition. Medication can provide additional thyroid hormones, slow down your bodys production of thyroid hormones, or block the effect of thyroid hormones on your body. […] Radioactive iodine therapy: Radioactive iodine is a capsule or liquid that destroys overactive thyroid cells over time. […] Surgery: A surgical procedure known as a thyroidectomy removes all or part of your thyroid.

• #11 Goiter – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/goiter/diagnosis-treatment/drc-20351834

  Goiter treatment depends on the size of the goiter, your signs and symptoms, and the underlying cause. If your goiter is small and your thyroid function is healthy, your health care provider may suggest a wait-and-see approach with regular checkups. […] Medications for goiters may include one of the following: […] An underactive thyroid is treated with a thyroid hormone replacement. The drug levothyroxine (Levoxyl, Thyquidity, others) replaces thyroxine (T-4) and results in the pituitary gland releasing less thyroid-stimulating hormone (TSH). The drug liothyronine (Cytomel) may be prescribed as a triiodothyronine (T-3) replacement. These treatments may decrease the size of the goiter. […] An overactive thyroid may be treated with an anti-thyroid drug that disrupts hormone production. The most commonly used drug, methimazole (Tapazole), may also reduce the size of the goiter.

• #12 Goiter Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/120034-treatment

  Small benign euthyroid goiters do not require treatment. The effectiveness of medical treatment using thyroid hormone for benign goiters is controversial. Large and complicated goiters may require medical and surgical treatment. Malignant goiters require medical and surgical treatment. […] The size of a benign euthyroid goiter may be reduced with levothyroxine suppressive therapy. The patient is monitored to keep serum TSH in a low but detectable range to avoid hyperthyroidism, cardiac arrhythmias, and osteoporosis. The patient has to be compliant with monitoring. Some authorities suggest suppressive treatment for a definite time period instead of indefinite therapy. Patients with Hashimoto thyroiditis respond better. […] Treatment of hypothyroidism or hyperthyroidism often reduces the size of a goiter.

• #13 Goiter – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/goiter/diagnosis-treatment/drc-20351834

  Goiter treatment depends on the size of the goiter, your signs and symptoms, and the underlying cause. If your goiter is small and your thyroid function is healthy, your health care provider may suggest a wait-and-see approach with regular checkups. […] Medications for goiters may include one of the following: […] An underactive thyroid is treated with a thyroid hormone replacement. The drug levothyroxine (Levoxyl, Thyquidity, others) replaces thyroxine (T-4) and results in the pituitary gland releasing less thyroid-stimulating hormone (TSH). The drug liothyronine (Cytomel) may be prescribed as a triiodothyronine (T-3) replacement. These treatments may decrease the size of the goiter. […] An overactive thyroid may be treated with an anti-thyroid drug that disrupts hormone production. The most commonly used drug, methimazole (Tapazole), may also reduce the size of the goiter.

• #14 Goiter | American Thyroid Association

  https://www.thyroid.org/goiter/

  HOW IS A GOITER TREATED? The treatment will depend upon the cause of the goiter. If the goiter was due to a deficiency of iodine in the diet (not common in the United States), you will be given iodine supplementation given in preparations to take by mouth. This will lead to a reduction in the size of the goiter, but often the goiter will not completely resolve. […] If the goiter is due to Hashimotos Thyroiditis, and you are hypothyroid, you will be given thyroid hormone supplement as a daily pill. This treatment will restore your thyroid hormone levels to normal, but does not usually make the goiter go completely away. While the goiter may get smaller, sometimes there is too much scar tissue in the gland to allow it to get much smaller. However, thyroid hormone treatment will usually prevent it from getting any larger.

• #15 Goiter – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/goiter/diagnosis-treatment/drc-20351834

  Goiter treatment depends on the size of the goiter, your signs and symptoms, and the underlying cause. If your goiter is small and your thyroid function is healthy, your health care provider may suggest a wait-and-see approach with regular checkups. […] Medications for goiters may include one of the following: […] An underactive thyroid is treated with a thyroid hormone replacement. The drug levothyroxine (Levoxyl, Thyquidity, others) replaces thyroxine (T-4) and results in the pituitary gland releasing less thyroid-stimulating hormone (TSH). The drug liothyronine (Cytomel) may be prescribed as a triiodothyronine (T-3) replacement. These treatments may decrease the size of the goiter. […] An overactive thyroid may be treated with an anti-thyroid drug that disrupts hormone production. The most commonly used drug, methimazole (Tapazole), may also reduce the size of the goiter.

• #16 Toxic Nodular Goiter – Endocrine Surgery | UCLA Health

  https://www.uclahealth.org/medical-services/surgery/endocrine-surgery/patient-resources/patient-education/endocrine-surgery-encyclopedia/toxic-nodular-goiter

  Toxic nodular goiter involves an enlarged thyroid gland that contains a small rounded mass or masses called nodules, which produce too much thyroid hormone. […] Treatment: Radioactive iodine, surgery, or antithyroid drugs (propylthiouracil, methimazole) are the treatments used for toxic nodular goiter. […] Beta-blockers, such as propranolol, can control some of the symptoms of hyperthyroidism until thyroid hormone levels in the body are under control. […] To prevent toxic nodular goiter, treat hyperthyroidism and simple goiter as your health care provider recommends.

• #17 Goiter Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/120034-treatment

  Emergency surgical treatment of a goiter in a thyrotoxic patient requires antithyroid medications, beta blockers, and glucocorticoids at stress doses. Suppressive doses of iodine are helpful. […] An endocrinologist should assess a patient at least once, and assessment should be even more frequent if the goiter is complicated by thyroid dysfunction or malignancy or if the patient is being considered for surgical management. […] Nutrition plays a role in the development of endemic goiters. Dietary factors include iodine deficiency, goitrogens, protein malnutrition, and energy malnutrition. […] If it is practical, treat endemic goiters in iodine-deficient regions with iodine supplementation in the diet and avoidance of goitrogens. Treatment with iodine supplementation or levothyroxine may reduce goiter size. […] Goiter prevention is based on etiology. Correct iodine deficiency and avoid dietary or iatrogenic goitrogens if practical. Goiters due to autoimmune thyroiditis may be controlled with careful use of levothyroxine and, when indicated, anti-inflammatory medication.

• #18 Toxic Nodular Goiter – Endocrine Surgery | UCLA Health

  https://www.uclahealth.org/medical-services/surgery/endocrine-surgery/patient-resources/patient-education/endocrine-surgery-encyclopedia/toxic-nodular-goiter

  Toxic nodular goiter involves an enlarged thyroid gland that contains a small rounded mass or masses called nodules, which produce too much thyroid hormone. […] Treatment: Radioactive iodine, surgery, or antithyroid drugs (propylthiouracil, methimazole) are the treatments used for toxic nodular goiter. […] Beta-blockers, such as propranolol, can control some of the symptoms of hyperthyroidism until thyroid hormone levels in the body are under control. […] To prevent toxic nodular goiter, treat hyperthyroidism and simple goiter as your health care provider recommends.

• #19 What is Goiter? Symptoms and Treatment Methods | DocHospitals

  https://dochospitals.com/en/goiter-atc6/

  If thyroid inflammation results in pain, various painkillers can be prescribed. In case of severe pain, it is treated with steroids. […] Goiter surgery is the recommended treatment method if the following conditions are seen in patients. […] Depending on the amount of thyroid removed, patients may be given thyroid hormone replacement after surgery. […] Goiter surgeries performed under general anesthesia vary according to the procedure to be performed and the tissue to be removed. Goiter surgeries take 1 to 3 hours on average. After the surgery, the hospitalization period of the patients varies between 1 and 2 days. A rest period of 1 to 2 weeks is required for patients to return to their daily lives. […] Goiter surgeries are called thyroidectomies. These operations involve the removal of all or part of the thyroid gland.

• #20 Goiter > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/goiter

  Medication. If a person has a goiter because their body doesn’t produce enough thyroid hormone, their doctor may prescribe thyroid hormone supplementation if there is underlying iodine deficiency. If a goiter is caused by inflammation, a doctor may prescribe anti-inflammatory medications or steroids. When a person has an overactive thyroid due to Graves disease, they may be prescribed anti-thyroid medications (methimazole, or propylthiouracil) to reduce the amount of hormone that the thyroid produces. […] Most goiters can be treated successfully, helping people resolve their symptoms and improve their appearance, as well as their quality of life. It is important that a goiter be recognized early so that any potentially reversible causes may be addressed. […] At the Smilow Endocrine Neoplasia Center and other Yale network locations, we have a multidisciplinary team of highly trained specialists, including endocrinologists, thyroid surgeons and nuclear medicine specialists, who provide comprehensive care for the management of goiter and associated diagnoses, says Dr. Mekala.

• #21 NONSURGICAL TREATMENT OF GOITER

  https://www.thyroid-goiter.com/goiter

  What is goiter? Goiter is the enlargement of the thyroid, which is a butterfly-shaped gland in front of the neck. […] In conclusion, scientific studies suggest that the risk of MNG patients having thyroid cancer seems to be similar to those of normal individuals. Surgery is an important treatment in MNG, but systematic surgical operation of all MNG patients just for the small risk of cancer is not based on any scientific data. Therefore, this approach should be abandoned. […] In simple goiter, the treatment must be to replace what is lacking. If there is iodine deficiency, iodine must be taken with diet or medications. If there is hormonal deficiency due to autoimmune thyroiditis, then the thyroid hormone pills must be taken. […] In nodular goiter, first we must investigate whether the nodules are benign or malignant.

• #22 Goiter – simple Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/goiter-simple

  A goiter only needs to be treated if it is causing symptoms. […] Treatments for an enlarged thyroid include: […] Thyroid hormone replacement pills if the goiter is due to an underactive thyroid […] Small doses of Lugol’s iodine or potassium iodine solution if the goiter is due to a lack of iodine […] Radioactive iodine to shrink the gland if the thyroid is producing too much thyroid hormone […] Surgery (thyroidectomy) to remove all or part of the gland.

• #23 Simple Nontoxic Goiter – Endocrine and Metabolic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/thyroid-disorders/simple-nontoxic-goiter

  Simple nontoxic goiter, which may be diffuse or nodular, is noncancerous hypertrophy of the thyroid gland without hyperthyroidism, hypothyroidism, or inflammation. […] Treatment is directed at the cause, but partial surgical removal may be required for very large goiters. […] In iodine-deficient areas, eliminate iodine deficiency by these means: iodine supplementation of salt, oral administration of iodized oil, intramuscular administration of iodized oil yearly, iodination of water, crops, or animal fodder. […] In other instances, suppression of the hypothalamic-pituitary axis with thyroid hormone blocks thyroid-stimulating hormone (TSH) production (and hence stimulation of the thyroid). […] Moderate doses of levothyroxine (100 to 150 mcg orally once a day depending on the serum TSH) are useful in younger patients to reduce the serum TSH to the low-normal range.

• #24 Goiter Symptoms, Causes, Diagnosis, and Treatment

  https://www.verywellhealth.com/goiters-overview-4013767

  If your TSH is suppressed, this indicates that the thyroid gland is overactive, and RAI may be indicated. With this treatment, you are given a dose of radioactive iodine, which shrinks the thyroid gland. […] If your goiter continues to grow while on thyroid treatment, symptoms are debilitating, or you feel the goiter is cosmetically undesirable, your doctors may recommend surgery to remove part or all of the thyroid. […] If your goiter is due to an iodine deficiency, you will be given iodine supplementation. This will usually slow or stop growth, and it may reduce the size of the goiter somewhat, but often not completely. […] Once the underlying reason for a goiter is identified, your healthcare provider can treat the condition with medication. In some cases, surgery or radioactive iodine may be needed.

• #25 Become a member

  https://www.btf-thyroid.org/treatment-of-an-over-active-or-enlarged-thyroid-gland-with-radioactive-iodine

  Radioactive iodine (I-131) has been used to treat overactive thyroid disorders (hyperthyroidism) since the early 1940s. It is an effective method of treatment and is now being offered as first-line definitive treatment rather than surgery. Radioactive iodine is taken up by the thyroid, and destroys the cells in the thyroid gland. This has the effect of reducing the amount of thyroxine made by the thyroid gland and may also reduce the size of the gland. […] As treatment for Graves disease either because the disease fails to settle after antithyroid medication, or returns after stopping antithyroid medication, or if patients do not tolerate antithyroid medication. It can also be considered early after diagnosis of Graves disease should patients wish to have the treatment at this stage […] To shrink the gland when there is a goitre (enlarged thyroid).

• #26 Become a member

  https://www.btf-thyroid.org/treatment-of-an-over-active-or-enlarged-thyroid-gland-with-radioactive-iodine

  Radioactive iodine (I-131) has been used to treat overactive thyroid disorders (hyperthyroidism) since the early 1940s. It is an effective method of treatment and is now being offered as first-line definitive treatment rather than surgery. Radioactive iodine is taken up by the thyroid, and destroys the cells in the thyroid gland. This has the effect of reducing the amount of thyroxine made by the thyroid gland and may also reduce the size of the gland. […] As treatment for Graves disease either because the disease fails to settle after antithyroid medication, or returns after stopping antithyroid medication, or if patients do not tolerate antithyroid medication. It can also be considered early after diagnosis of Graves disease should patients wish to have the treatment at this stage […] To shrink the gland when there is a goitre (enlarged thyroid).

• #27 Hyperthyroidism: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0301/p363.html

  Hyperthyroidism caused by overproduction of thyroid hormones can be treated with antithyroid medications (methimazole and propylthiouracil), radioactive iodine ablation of the thyroid gland, or surgical thyroidectomy. […] The choice of treatment modality for hyperthyroidism caused by overproduction of thyroid hormones depends on the patient’s age, symptoms, comorbidities, and preference. […] Toxic multinodular goiter is the second most common cause of hyperthyroidism in the United States and the most common cause in older persons living in iodine-deficient areas. […] Antithyroid medications can control hyperthyroidism, but do not induce remission of hyperthyroidism associated with toxic adenoma or toxic multinodular goiter. Therefore, radioactive iodine ablation and thyroidectomy are the main treatment options for these conditions.

• #28 Hyperthyroidism: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0301/p363.html

  Thyroidectomy is favored if a nodule or goiter causes compressive symptoms. […] Painless thyroiditis and subacute thyroiditis are self-limiting conditions that usually resolve spontaneously within six months. There is no role for antithyroid medications or radioactive iodine ablation in the treatment of thyroiditis. […] Graves disease requires one of the three treatment options: an antithyroid medication (methimazole [Tapazole] or propylthiouracil), radioactive iodine (I-131) ablation of the thyroid gland, or surgical thyroidectomy. The choice of treatment depends on the benefits vs. risks in a specific clinical situation and on the patient’s preference.

• #29 Become a member

  https://www.btf-thyroid.org/treatment-of-an-over-active-or-enlarged-thyroid-gland-with-radioactive-iodine

  Radioactive iodine (I-131) has been used to treat overactive thyroid disorders (hyperthyroidism) since the early 1940s. It is an effective method of treatment and is now being offered as first-line definitive treatment rather than surgery. Radioactive iodine is taken up by the thyroid, and destroys the cells in the thyroid gland. This has the effect of reducing the amount of thyroxine made by the thyroid gland and may also reduce the size of the gland. […] As treatment for Graves disease either because the disease fails to settle after antithyroid medication, or returns after stopping antithyroid medication, or if patients do not tolerate antithyroid medication. It can also be considered early after diagnosis of Graves disease should patients wish to have the treatment at this stage […] To shrink the gland when there is a goitre (enlarged thyroid).

• #30 Fixed-dose radioactive iodine therapy reduces goiter size and treats hyperthyroidism in most patients with toxic multinodular goiter

  https://www.thyroid.org/patient-thyroid-information/ct-for-patients/september-2020/vol-13-issue-9-p-13-14/

  HYPERTHYROIDISM Fixed-dose radioactive iodine therapy reduces goiter size and treats hyperthyroidism in most patients with toxic multinodular goiter […] Definitive treatment for both causes of hyperthyroidism includes radioactive iodine therapy and surgery. […] Radioactive iodine therapy is better tolerated in older people who have additional medical problems that result in an increased surgical risk. […] One year after the radioactive iodine therapy, the size of the thyroid was reduced by about 30%. […] The treatment of toxic multinodular with a fixed dose of radioactive iodine (15 mCi) was effective in resolving hyperthyroidism in almost 90% of patients and significantly reducing the size of the goiter by more than half. […] The treatment was well tolerated and safe. […] This suggests that fixed dose radioactive iodine therapy is effective in treating hyperthyroidism.

• #31 Euthyroid Goiter With and Without Nodules—Diagnosis and Treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3441105/

  Euthyroid patients with nodular goiter have been treated medically in Germany for many years, yet the state of the evidence from studies performed across the world still leaves room for debate. […] Radioactive iodine therapy is an effective means of reducing the volume of goiters, even if they are large or very large (100 to 300 mL), by 35% to 40% in one year and by 40% to 60% in two years, with resulting improvement of airway function. […] Thyroid surgery is obligatory whenever cancer is suspected; it rapidly relieves the mechanical symptoms of benign nodular goiter. Other indications include retrosternal or mediastinal extension of a goiter and uni- or multifocal autonomy of thyroid function. […] Treatment is obligatory only when cancer is suspected, when the patient has symptoms, or when autonomous thyroid function is present. Asymptomatic, benign changes of the thyroid generally require no treatment. […] Patients who have undergone radioactive iodine therapy need lifelong clinical follow-up, as they may develop hypothyroidism.

• #32 Fixed-dose radioactive iodine therapy reduces goiter size and treats hyperthyroidism in most patients with toxic multinodular goiter

  https://www.thyroid.org/patient-thyroid-information/ct-for-patients/september-2020/vol-13-issue-9-p-13-14/

  HYPERTHYROIDISM Fixed-dose radioactive iodine therapy reduces goiter size and treats hyperthyroidism in most patients with toxic multinodular goiter […] Definitive treatment for both causes of hyperthyroidism includes radioactive iodine therapy and surgery. […] Radioactive iodine therapy is better tolerated in older people who have additional medical problems that result in an increased surgical risk. […] One year after the radioactive iodine therapy, the size of the thyroid was reduced by about 30%. […] The treatment of toxic multinodular with a fixed dose of radioactive iodine (15 mCi) was effective in resolving hyperthyroidism in almost 90% of patients and significantly reducing the size of the goiter by more than half. […] The treatment was well tolerated and safe. […] This suggests that fixed dose radioactive iodine therapy is effective in treating hyperthyroidism.

• #33 Radioactive Iodine Therapy for Thyroid Nodules & Cancers | NYU Langone Health

  https://nyulangone.org/conditions/thyroid-nodules-cancers/treatments/radioactive-iodine-therapy-for-thyroid-nodules-cancers

  NYU Langone doctors may prescribe radioactive iodine therapy to manage some toxic, or overactive, nodules and some types of thyroid cancers. […] They may prescribe it for people with a toxic nodule or a toxic multinodular goiter, which produce high levels of thyroxine and can lead to a condition called hyperthyroidism. […] The therapy is especially beneficial for people with toxic nodules that do not respond to other medications or who need medication throughout their lifetime. Radioactive iodine therapy may also help shrink a large toxic multinodular goiter. […] In this treatment, doctors give you a pill or liquid containing radioactive iodine. Iodine is a mineral found in table salt, seafood, and dairy products that the thyroid absorbs from the bloodstream and converts into thyroid hormone. Radioactive iodine travels to the thyroid, where it is absorbed and gradually destroys overactive thyroid tissue, along with other thyroid tissue.

• #34 Become a member

  https://www.btf-thyroid.org/treatment-of-an-over-active-or-enlarged-thyroid-gland-with-radioactive-iodine

  Radioactive iodine is also used in higher doses in the treatment of thyroid cancer. […] Radioactive iodine treatment is not given to: Pregnant women – radioiodine crosses the placenta and can affect the thyroid gland developing in the unborn baby […] People with active thyroid eye disease as it may worsen the eye disease unless steroids are given at the same time. […] For some patients who are treated with radioactive iodine to reduce the size of a goitre, there is also a small risk that they may develop Graves disease. […] Radioactive iodine is an effective and safe treatment option for children and teenagers with an overactive thyroid gland, but will usually be given as a second-line treatment after a reasonably long course of antithyroid medication. This is particularly the case for younger children.

• #35 Radioactive Iodine Therapy for Thyroid Nodules & Cancers | NYU Langone Health

  https://nyulangone.org/conditions/thyroid-nodules-cancers/treatments/radioactive-iodine-therapy-for-thyroid-nodules-cancers

  Risks include damage to the salivary glands, which may cause dry mouth and make swallowing difficult. It can also damage the tear ducts, causing dry eye. These side effects can be temporary or permanent. Our doctors can prescribe medications or recommend over-the-counter products or lifestyle changes to help manage them. […] There is also a slight risk of developing a secondary cancer, such as breast, gastrointestinal, or blood cancer. This is why doctors carefully weigh the decision to prescribe radioactive iodine. […] Radioactive iodine is not given to women who are pregnant or nursing a child. Generally, women who have received radioactive iodine should not get pregnant for about a year after the treatment. You and your doctor can discuss the risks involved and any precautions you need to take.

• #36 Euthyroid Goiter With and Without Nodules—Diagnosis and Treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3441105/

  Euthyroid patients with nodular goiter have been treated medically in Germany for many years, yet the state of the evidence from studies performed across the world still leaves room for debate. […] Radioactive iodine therapy is an effective means of reducing the volume of goiters, even if they are large or very large (100 to 300 mL), by 35% to 40% in one year and by 40% to 60% in two years, with resulting improvement of airway function. […] Thyroid surgery is obligatory whenever cancer is suspected; it rapidly relieves the mechanical symptoms of benign nodular goiter. Other indications include retrosternal or mediastinal extension of a goiter and uni- or multifocal autonomy of thyroid function. […] Treatment is obligatory only when cancer is suspected, when the patient has symptoms, or when autonomous thyroid function is present. Asymptomatic, benign changes of the thyroid generally require no treatment. […] Patients who have undergone radioactive iodine therapy need lifelong clinical follow-up, as they may develop hypothyroidism.

• #37 Become a member

  https://www.btf-thyroid.org/treatment-of-an-over-active-or-enlarged-thyroid-gland-with-radioactive-iodine

  Radioactive iodine has been used for several decades to treat an overactive thyroid gland safely. […] After radioactive iodine you should keep babies, children under five and pregnant women at arms length for two to three weeks (or longer if advised by your clinical team). […] You will need a blood test four to six weeks after the treatment and every one to three months until stable and once a year after that to check your thyroid hormone levels.

• #38 Euthyroid Goiter With and Without Nodules—Diagnosis and Treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3441105/

  Euthyroid patients with nodular goiter have been treated medically in Germany for many years, yet the state of the evidence from studies performed across the world still leaves room for debate. […] Radioactive iodine therapy is an effective means of reducing the volume of goiters, even if they are large or very large (100 to 300 mL), by 35% to 40% in one year and by 40% to 60% in two years, with resulting improvement of airway function. […] Thyroid surgery is obligatory whenever cancer is suspected; it rapidly relieves the mechanical symptoms of benign nodular goiter. Other indications include retrosternal or mediastinal extension of a goiter and uni- or multifocal autonomy of thyroid function. […] Treatment is obligatory only when cancer is suspected, when the patient has symptoms, or when autonomous thyroid function is present. Asymptomatic, benign changes of the thyroid generally require no treatment. […] Patients who have undergone radioactive iodine therapy need lifelong clinical follow-up, as they may develop hypothyroidism.

• #39 Goiter – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562161/

  Monitoring and observation are recommended initially if there are no compressive symptoms, as certain goiters can spontaneously regress with time. […] For patients that fall into this latter category, the treatment of choice is surgery. […] Surgery is also indicated when malignancy is suspected or diagnosed. […] When surgery is the treatment option, total or near-total thyroidectomy is preferred over subtotal thyroidectomy. […] For patients that need a treatment option besides monitoring, however, cannot undergo surgery due to personal preference or being poor surgical candidates, radioiodine therapy is the treatment of choice. […] In patients with toxic goiters, treatment options include surgery, radioiodine therapy, or antithyroid drugs. […] Surgery is a definitive treatment option and indications include goiters that are obstructive or large, malignancy, coexistent primary hyperparathyroidism, or need for immediate or definitive correction of hyperthyroidism.

• #40 Goiter Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/120034-treatment

  Thyroid hormone replacement is often required following surgical and radiation treatment of a goiter. Use of radioactive iodine for the therapy of nontoxic goiter has been disappointing and is controversial. […] Goiters with primary thyroid malignancy require levothyroxine replacement after surgery and radioactive iodine ablation. Metastatic lesions to the thyroid gland require treatment of the primary malignancy. Granulomatous and infectious etiologies for goiter require specific treatment depending on the underlying cause. […] Surgery is reserved for the following situations: Large goiters with compression, Malignancy, When other forms of therapy are not practical or are ineffective. […] Preoperatively, establish euthyroid state prior to surgical treatment. Evaluation must include the stability of the airway. This must be secured immediately if ventilatory status appears tenuous. Emergency surgical treatment of a goiter in a patient with hypothyroidism requires intravenous levothyroxine and glucocorticoids at stress doses.

• #41 Nontoxic Goiter Treatment & Management: Medical Care, Surgical Care, Further Outpatient Care

  https://emedicine.medscape.com/article/120392-treatment

  Thyroidectomy or surgical decompression causes rapid relief for obstructive symptoms. […] The American Association of Endocrine Surgeons recommends consideration of thyroidectomy for patients with a goiter associated with local compressive symptoms or progressive enlargement. […] After bilateral subtotal thyroidectomy, all patients require thyroid hormone replacement therapy. […] The use of total thyroidectomy to treat benign multinodular goiter has met with some concern, owing to the risk of parathyroid function damage and laryngeal nerve injury posed by the procedure. […] The incidence of transient hypoparathyroidism in the above study, as well as that of transient and permanent laryngeal nerve injuries, was greater in total thyroidectomy than in the other types of surgery. Nonetheless, the authors concluded that, owing to the fact that following total thyroidectomy there was a reduced incidence of goiter recurrence requiring repeat thyroidectomy, total thyroidectomy should be considered the procedure of choice for patients with nontoxic multinodular goiter.

• #42 Nontoxic Goiter Treatment & Management: Medical Care, Surgical Care, Further Outpatient Care

  https://emedicine.medscape.com/article/120392-treatment

  Thyroidectomy or surgical decompression causes rapid relief for obstructive symptoms. […] The American Association of Endocrine Surgeons recommends consideration of thyroidectomy for patients with a goiter associated with local compressive symptoms or progressive enlargement. […] After bilateral subtotal thyroidectomy, all patients require thyroid hormone replacement therapy. […] The use of total thyroidectomy to treat benign multinodular goiter has met with some concern, owing to the risk of parathyroid function damage and laryngeal nerve injury posed by the procedure. […] The incidence of transient hypoparathyroidism in the above study, as well as that of transient and permanent laryngeal nerve injuries, was greater in total thyroidectomy than in the other types of surgery. Nonetheless, the authors concluded that, owing to the fact that following total thyroidectomy there was a reduced incidence of goiter recurrence requiring repeat thyroidectomy, total thyroidectomy should be considered the procedure of choice for patients with nontoxic multinodular goiter.

• #43 Goiter Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/120034-treatment

  Thyroid hormone replacement is often required following surgical and radiation treatment of a goiter. Use of radioactive iodine for the therapy of nontoxic goiter has been disappointing and is controversial. […] Goiters with primary thyroid malignancy require levothyroxine replacement after surgery and radioactive iodine ablation. Metastatic lesions to the thyroid gland require treatment of the primary malignancy. Granulomatous and infectious etiologies for goiter require specific treatment depending on the underlying cause. […] Surgery is reserved for the following situations: Large goiters with compression, Malignancy, When other forms of therapy are not practical or are ineffective. […] Preoperatively, establish euthyroid state prior to surgical treatment. Evaluation must include the stability of the airway. This must be secured immediately if ventilatory status appears tenuous. Emergency surgical treatment of a goiter in a patient with hypothyroidism requires intravenous levothyroxine and glucocorticoids at stress doses.

• #44 Goiter Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/120034-treatment

  Emergency surgical treatment of a goiter in a thyrotoxic patient requires antithyroid medications, beta blockers, and glucocorticoids at stress doses. Suppressive doses of iodine are helpful. […] An endocrinologist should assess a patient at least once, and assessment should be even more frequent if the goiter is complicated by thyroid dysfunction or malignancy or if the patient is being considered for surgical management. […] Nutrition plays a role in the development of endemic goiters. Dietary factors include iodine deficiency, goitrogens, protein malnutrition, and energy malnutrition. […] If it is practical, treat endemic goiters in iodine-deficient regions with iodine supplementation in the diet and avoidance of goitrogens. Treatment with iodine supplementation or levothyroxine may reduce goiter size. […] Goiter prevention is based on etiology. Correct iodine deficiency and avoid dietary or iatrogenic goitrogens if practical. Goiters due to autoimmune thyroiditis may be controlled with careful use of levothyroxine and, when indicated, anti-inflammatory medication.

• #45 Goiter Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/120034-treatment

  Emergency surgical treatment of a goiter in a thyrotoxic patient requires antithyroid medications, beta blockers, and glucocorticoids at stress doses. Suppressive doses of iodine are helpful. […] An endocrinologist should assess a patient at least once, and assessment should be even more frequent if the goiter is complicated by thyroid dysfunction or malignancy or if the patient is being considered for surgical management. […] Nutrition plays a role in the development of endemic goiters. Dietary factors include iodine deficiency, goitrogens, protein malnutrition, and energy malnutrition. […] If it is practical, treat endemic goiters in iodine-deficient regions with iodine supplementation in the diet and avoidance of goitrogens. Treatment with iodine supplementation or levothyroxine may reduce goiter size. […] Goiter prevention is based on etiology. Correct iodine deficiency and avoid dietary or iatrogenic goitrogens if practical. Goiters due to autoimmune thyroiditis may be controlled with careful use of levothyroxine and, when indicated, anti-inflammatory medication.

• #46 Nontoxic Goiter Treatment & Management: Medical Care, Surgical Care, Further Outpatient Care

  https://emedicine.medscape.com/article/120392-treatment

  Thyroidectomy or surgical decompression causes rapid relief for obstructive symptoms. […] The American Association of Endocrine Surgeons recommends consideration of thyroidectomy for patients with a goiter associated with local compressive symptoms or progressive enlargement. […] After bilateral subtotal thyroidectomy, all patients require thyroid hormone replacement therapy. […] The use of total thyroidectomy to treat benign multinodular goiter has met with some concern, owing to the risk of parathyroid function damage and laryngeal nerve injury posed by the procedure. […] The incidence of transient hypoparathyroidism in the above study, as well as that of transient and permanent laryngeal nerve injuries, was greater in total thyroidectomy than in the other types of surgery. Nonetheless, the authors concluded that, owing to the fact that following total thyroidectomy there was a reduced incidence of goiter recurrence requiring repeat thyroidectomy, total thyroidectomy should be considered the procedure of choice for patients with nontoxic multinodular goiter.

• #47 Nontoxic Goiter Treatment & Management: Medical Care, Surgical Care, Further Outpatient Care

  https://emedicine.medscape.com/article/120392-treatment

  Thyroidectomy or surgical decompression causes rapid relief for obstructive symptoms. […] The American Association of Endocrine Surgeons recommends consideration of thyroidectomy for patients with a goiter associated with local compressive symptoms or progressive enlargement. […] After bilateral subtotal thyroidectomy, all patients require thyroid hormone replacement therapy. […] The use of total thyroidectomy to treat benign multinodular goiter has met with some concern, owing to the risk of parathyroid function damage and laryngeal nerve injury posed by the procedure. […] The incidence of transient hypoparathyroidism in the above study, as well as that of transient and permanent laryngeal nerve injuries, was greater in total thyroidectomy than in the other types of surgery. Nonetheless, the authors concluded that, owing to the fact that following total thyroidectomy there was a reduced incidence of goiter recurrence requiring repeat thyroidectomy, total thyroidectomy should be considered the procedure of choice for patients with nontoxic multinodular goiter.

• #48 Goiter Causes & Treatment in Utah – ENT Center of Utah

  https://entcenterutah.com/adult-care/thyroid-salivary/goiter/

  Surgical removal of all or part of your thyroid gland (total or partial thyroidectomy) is an option if you have a large goiter that is uncomfortable or causes difficulty breathing or swallowing, or in some cases, if you have nodular goiter causing hyperthyroidism. […] Surgery is also the treatment for thyroid cancer. […] In some cases, radioactive iodine is used to treat an overactive thyroid gland. The radioactive iodine is taken orally and reaches your thyroid gland through your bloodstream, destroying thyroid cells. The treatment results in diminished size of the goiter, but eventually may also cause an underactive thyroid gland. […] If enough of the thyroid is removed or no longer working then hormone replacement often becomes necessary, usually for life.

• #49 NONSURGICAL TREATMENT OF GOITER

  https://www.thyroid-goiter.com/goiter

  Although surgery is frequently offered for such patients, percutaneous ablation and embolization are increasingly preferred because of their important advantages. […] Classic treatments of multinodular goiter (MNG) include oral medications, radioactive iodine and surgery. […] In conclusion, each classic goiter treatment has specific disadvantages and side effects. Therefore, new treatment options that preserve thyroid gland and have little side effects are necessary. […] In MNG patients, new options such as percutaneous ablation and embolization has been increasingly used in the last 2 decades. […] In MNG, if the nodules are few, percutaneous ablation must be the first line treatment. However, if the nodules are too many, ablation may take too long and become impractical. […] Embolization is especially beneficial in plunging goiters that extends into the chest cavity and compress the trachea (windpipe) causing shortness of breath.

• #50 What is Non-Surgical Goiter Treatment? Prices | Doç.Dr. Bülent Çekiç

  https://bulentcekic.com/en/ameliyatsiz-guatr-tedavisi

  Non-surgical goiter treatment has gained great interest in recent years and offers effective solutions for many patients without the need for surgical intervention. […] Yes, although the word goiter often immediately brings surgery to mind, surgery is not required for every case, and goiter can be treated without surgery. […] The most commonly used non-surgical goiter treatments are thyroid ablation therapies. Among these, Microwave Ablation and Radiofrequency Ablation methods provide effective results in most cases. […] Non-surgical goiter treatment is generally preferred for individuals with benign nodules or those whose nodules do not show significant growth. […] If thyroid nodules are benign and not growing rapidly, non-surgical options like microwave ablation, radiofrequency ablation, or radioactive iodine therapy can yield successful results.

• #51 NONSURGICAL TREATMENTS OF THYROID NODULES AND GOITER

  https://www.thyroid-goiter.com/

  Some thyroid disorders can be treated with simple nonsurgical interventions. In parallel with these developments in diagnosis, several nonsurgical treatments have been introduced in the last 15 years, including ablations and embolizations. Ablations have allowed the destruction of cystic and solid as well as hot and cold nodules through tiny needles, and embolization has made it possible to treat huge goiters with a simple angiography. This web site has been prepared by Prof Saim Yilmaz, MD, and is aimed at providing objective information on these new treatment options, which have a huge therapeutic potential in many thyroid disorders. […] Giant goiter, plunging goiter: we can treat them with a simple angiography. […] Alcohol ablation is the ideal treatment for cystic thyroid nodules.

• #52 Thyroid Goiters Embolization – Overview & Treatment Options

  https://cvithyroidcenter.com/thyroid-goiter-treatment-doctor-embolization/

  This non-surgical treatment uses a special probe that is inserted into the goiter tissue. The probe then heats up the tissue rendering it inactive, over time this tissue is reabsorbed by the body resulting in volume shrinkage. […] Embolization has been around for many decades as a treatment modality for cancer, tumors, bleeding, pain etc. This method involves injecting tiny beads into the goiter tissue. Over time, the body resorbs the tissue that has lost its blood supply resulting in volume shrinkage. […] Ignoring the potential long-term risks of untreated thyroid goiters can lead to progressive enlargement, compression complications, and an increased risk of thyroid nodules. Therefore, proactive medical intervention is essential for maintaining a healthy thyroid and overall well-being.

• #53 Thyroid Goiter Embolization Treatment | CVI Thyroid Center

  https://cvithyroidcenter.com/thyroid-goiter-embolization-treatment-tae/

  Thyroid artery goiter embolization, or TAE, is a non-surgical outpatient procedure that is an alternative treatment option to prevent total surgical removal and loss of the thyroid gland. […] Currently the gold standard treatment for a thyroid goiter is surgical removal called hemithyroidectomy or total thyroidectomy. […] The use of radioactive iodine is another option when patients do not wish to get surgery. […] Recently, non-surgical thyroid artery embolization (TAE) has become an effective, minimally invasive, and safer alternative for a thyroid goiter. […] Thyroid Artery Goiter Embolization, or TAE, is a non-surgical image-guided procedure that effectively treats an enlarged thyroid gland, or goiter. […] TAE is a minimally invasive, cost-feasible, effective, and a safer alternative to invasive surgical removal that would result in complete loss of thyroid function.

• #54 NONSURGICAL TREATMENT OF GOITER

  https://www.thyroid-goiter.com/goiter

  Although surgery is frequently offered for such patients, percutaneous ablation and embolization are increasingly preferred because of their important advantages. […] Classic treatments of multinodular goiter (MNG) include oral medications, radioactive iodine and surgery. […] In conclusion, each classic goiter treatment has specific disadvantages and side effects. Therefore, new treatment options that preserve thyroid gland and have little side effects are necessary. […] In MNG patients, new options such as percutaneous ablation and embolization has been increasingly used in the last 2 decades. […] In MNG, if the nodules are few, percutaneous ablation must be the first line treatment. However, if the nodules are too many, ablation may take too long and become impractical. […] Embolization is especially beneficial in plunging goiters that extends into the chest cavity and compress the trachea (windpipe) causing shortness of breath.

• #55 NONSURGICAL TREATMENT OF GOITER

  https://www.thyroid-goiter.com/goiter

  Following embolization, a 70-90% volume reduction of the goiter mass can be achieved. […] Surgically challenging goiters such as plunging or giant goiters can be easily and effectively treated with embolization, in which the feeding vessels of the goiter are occluded angiographically. After embolization, such goiters decrease in size substantially (around 80% volume reduction) in 6 months, which also continues thereafter for years.

• #56 Thyroid Goiter Embolization Treatment | CVI Thyroid Center

  https://cvithyroidcenter.com/thyroid-goiter-embolization-treatment-tae/

  TAE is a minimally invasive outpatient alternative with organ preservation. […] However, unlike surgery, TAE is not known to cause permanent hypothyroidism or hypoparathyroidism. […] If you are suffering from multinodular goiter, contact us today to discuss thyroid arterial embolization as a treatment option.

• #57 What is Non-Surgical Goiter Treatment? Prices | Doç.Dr. Bülent Çekiç

  https://bulentcekic.com/en/ameliyatsiz-guatr-tedavisi

  If symptoms such as mild swelling or discomfort do not require surgery, hormone therapy or iodine supplementation may be sufficient to alleviate the condition. […] Patients with other health conditions like heart disease or high blood pressure may not be suitable for surgery. In these cases, non-surgical treatment options offer a safer alternative. […] Some patients may avoid surgery due to concerns about complications, anesthesia, or surgical scars. Non-surgical thyroid nodule treatment offers lower risks and minimal invasiveness. […] For patients who want to quickly return to their daily activities, non-surgical treatment is an ideal option since it offers a faster recovery time compared to surgery. […] If you are looking for non-surgical goiter treatment, the first doctor you should consult is an endocrinologist.

• #58 Euthyroid Goiter With and Without Nodules—Diagnosis and Treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3441105/

  There are hardly any evidence-based recommendations for the treatment of euthyroid diffuse goiter and nodular goiter. Potential management strategies include watchful waiting for asymptomatic patients, drug treatment, radioactive iodine therapy, and surgery. The choice among them is taken individually for each patient in view of the risks, benefits, and availability of the various techniques, the experience of the treating physicians, and the patients wishes. […] Iodine deficiency is the main cause of euthyroid diffuse goiter; accordingly, correction of the intrathyroid iodine deficiency is the main objective of treatment. […] Treatment is clearly indicated if there is a suspicion of cancer, or if the patient has mechanical symptoms. […] The definitive treatment of autonomously functioning thyroid nodules is with surgery or radioactive iodine therapy.

• #59 Goiter Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/120034-treatment

  Small benign euthyroid goiters do not require treatment. The effectiveness of medical treatment using thyroid hormone for benign goiters is controversial. Large and complicated goiters may require medical and surgical treatment. Malignant goiters require medical and surgical treatment. […] The size of a benign euthyroid goiter may be reduced with levothyroxine suppressive therapy. The patient is monitored to keep serum TSH in a low but detectable range to avoid hyperthyroidism, cardiac arrhythmias, and osteoporosis. The patient has to be compliant with monitoring. Some authorities suggest suppressive treatment for a definite time period instead of indefinite therapy. Patients with Hashimoto thyroiditis respond better. […] Treatment of hypothyroidism or hyperthyroidism often reduces the size of a goiter.

• #60 Goiter | American Thyroid Association

  https://www.thyroid.org/goiter/

  If the goiter is due to hyperthyroidism, the treatment will depend upon the cause of the hyperthyroidism. For some causes of hyperthyroidism, the treatment may lead to a disappearance of the goiter. For example, treatment of Graves disease with radioactive iodine usually leads to a decrease or disappearance of the goiter. […] Many goiters, such as the multinodular goiter, are associated with normal levels of thyroid hormone in the blood. These goiters usually do not require any specific treatment after the appropriate diagnosis is made. If no specific treatment is suggested, you may be warned that you are at risk for becoming hypothyroid or hyperthyroid in the future. However, if there are problems associated with the size of the thyroid per se, such as the goiter getting so large that it constricts the airway, your doctor may suggest that the goiter be treated by surgical removal. […] Whatever the cause, it is important to have regular (annual) monitoring when diagnosed with a goiter.

• #61 Thyroid hormone suppressive therapy for thyroid nodules and benign goiter – UpToDate

  https://www.uptodate.com/contents/thyroid-hormone-suppressive-therapy-for-thyroid-nodules-and-benign-goiter

  Thyroid hormone suppressive therapy for thyroid nodules and benign goiter […] The efficacy of thyroid hormone suppressive therapy in euthyroid patients with solitary benign thyroid nodules or sporadic nontoxic multinodular goiters is controversial. Most studies have shown that few thyroid nodules regress in patients taking thyroid hormone. However, suppressive therapy does appear to interfere with goitrogenesis in many patients, and it has been proposed that it could reduce the risk of thyroid oncogenesis, as well. […] It is therefore important to review the evidence. […] The importance of TSH in goiter formation varies with the cause of the goiter. […] In contrast, most patients with thyroid nodules or sporadic nontoxic multinodular goiters have normal serum TSH concentrations. […] We do not routinely use levothyroxine (T4) suppression for euthyroid patients with goiter. However, in selected patients (history of external radiation exposure during childhood, iodine-deficient region, and younger patients with growing diffuse or nodular, nontoxic goiter who are concerned about growth of their goiter), a trial of T4 aiming either for minimal TSH suppression or a low-normal TSH is a reasonable intervention, pending further studies, especially those that assess the efficacy of suppressing serum TSH into the low-normal range, which would mitigate the adverse effects of treatment.

• #62 Goiter | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/22351

  The aim of goiter treatment is to relieve compression and to restore euthyroidism. By definition patients with nontoxic goiters are euthyroid or in lower frequency hypothyroid. If there is any coexistent hypothyroidism, treatment includes thyroid hormone administration. Patients with toxic goiter require modalities that address thyroid enlargement and thyrotoxicosis. […] Today the main treatment options include monitoring without any treatment and thyroidectomy. Levothyroxine suppression therapy is no longer recommended. […] Monitoring and observation are recommended initially if there are no compressive symptoms, as certain goiters can spontaneously regress with time. […] For patients that fall into this latter category, the treatment of choice is surgery. Surgery is also indicated when malignancy is suspected or diagnosed. When surgery is the treatment option, total or near-total thyroidectomy is preferred over subtotal thyroidectomy.

• #63 Goiter | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/22351

  In patients with toxic goiters, treatment options include surgery, radioiodine therapy, or antithyroid drugs. […] The most effective and preferred treatment option is radioiodine therapy for toxic goiters. […] Surgery is a definitive treatment option and indications include goiters that are obstructive or large, malignancy, coexistent primary hyperparathyroidism, or need for immediate or definitive correction of hyperthyroidism.

• #64 Hyperthyroidism: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0301/p363.html

  Hyperthyroidism caused by overproduction of thyroid hormones can be treated with antithyroid medications (methimazole and propylthiouracil), radioactive iodine ablation of the thyroid gland, or surgical thyroidectomy. […] The choice of treatment modality for hyperthyroidism caused by overproduction of thyroid hormones depends on the patient’s age, symptoms, comorbidities, and preference. […] Toxic multinodular goiter is the second most common cause of hyperthyroidism in the United States and the most common cause in older persons living in iodine-deficient areas. […] Antithyroid medications can control hyperthyroidism, but do not induce remission of hyperthyroidism associated with toxic adenoma or toxic multinodular goiter. Therefore, radioactive iodine ablation and thyroidectomy are the main treatment options for these conditions.

• #65 Goiter | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/22351

  In patients with toxic goiters, treatment options include surgery, radioiodine therapy, or antithyroid drugs. […] The most effective and preferred treatment option is radioiodine therapy for toxic goiters. […] Surgery is a definitive treatment option and indications include goiters that are obstructive or large, malignancy, coexistent primary hyperparathyroidism, or need for immediate or definitive correction of hyperthyroidism.

• #66 Hyperthyroidism: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0301/p363.html

  Thyroidectomy is favored if a nodule or goiter causes compressive symptoms. […] Painless thyroiditis and subacute thyroiditis are self-limiting conditions that usually resolve spontaneously within six months. There is no role for antithyroid medications or radioactive iodine ablation in the treatment of thyroiditis. […] Graves disease requires one of the three treatment options: an antithyroid medication (methimazole [Tapazole] or propylthiouracil), radioactive iodine (I-131) ablation of the thyroid gland, or surgical thyroidectomy. The choice of treatment depends on the benefits vs. risks in a specific clinical situation and on the patient’s preference.

• #67 Hyperthyroidism: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0301/p363.html

  Thyroidectomy is favored if a nodule or goiter causes compressive symptoms. […] Painless thyroiditis and subacute thyroiditis are self-limiting conditions that usually resolve spontaneously within six months. There is no role for antithyroid medications or radioactive iodine ablation in the treatment of thyroiditis. […] Graves disease requires one of the three treatment options: an antithyroid medication (methimazole [Tapazole] or propylthiouracil), radioactive iodine (I-131) ablation of the thyroid gland, or surgical thyroidectomy. The choice of treatment depends on the benefits vs. risks in a specific clinical situation and on the patient’s preference.

• #68 Goiter | American Thyroid Association

  https://www.thyroid.org/goiter/

  If the goiter is due to hyperthyroidism, the treatment will depend upon the cause of the hyperthyroidism. For some causes of hyperthyroidism, the treatment may lead to a disappearance of the goiter. For example, treatment of Graves disease with radioactive iodine usually leads to a decrease or disappearance of the goiter. […] Many goiters, such as the multinodular goiter, are associated with normal levels of thyroid hormone in the blood. These goiters usually do not require any specific treatment after the appropriate diagnosis is made. If no specific treatment is suggested, you may be warned that you are at risk for becoming hypothyroid or hyperthyroid in the future. However, if there are problems associated with the size of the thyroid per se, such as the goiter getting so large that it constricts the airway, your doctor may suggest that the goiter be treated by surgical removal. […] Whatever the cause, it is important to have regular (annual) monitoring when diagnosed with a goiter.

• #69 Become a member

  https://www.btf-thyroid.org/treatment-of-an-over-active-or-enlarged-thyroid-gland-with-radioactive-iodine

  Radioactive iodine (I-131) has been used to treat overactive thyroid disorders (hyperthyroidism) since the early 1940s. It is an effective method of treatment and is now being offered as first-line definitive treatment rather than surgery. Radioactive iodine is taken up by the thyroid, and destroys the cells in the thyroid gland. This has the effect of reducing the amount of thyroxine made by the thyroid gland and may also reduce the size of the gland. […] As treatment for Graves disease either because the disease fails to settle after antithyroid medication, or returns after stopping antithyroid medication, or if patients do not tolerate antithyroid medication. It can also be considered early after diagnosis of Graves disease should patients wish to have the treatment at this stage […] To shrink the gland when there is a goitre (enlarged thyroid).

• #70 Hyperthyroidism: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0301/p363.html

  Thyroidectomy is favored if a nodule or goiter causes compressive symptoms. […] Painless thyroiditis and subacute thyroiditis are self-limiting conditions that usually resolve spontaneously within six months. There is no role for antithyroid medications or radioactive iodine ablation in the treatment of thyroiditis. […] Graves disease requires one of the three treatment options: an antithyroid medication (methimazole [Tapazole] or propylthiouracil), radioactive iodine (I-131) ablation of the thyroid gland, or surgical thyroidectomy. The choice of treatment depends on the benefits vs. risks in a specific clinical situation and on the patient’s preference.

• #71 Goiter | American Thyroid Association

  https://www.thyroid.org/goiter/

  HOW IS A GOITER TREATED? The treatment will depend upon the cause of the goiter. If the goiter was due to a deficiency of iodine in the diet (not common in the United States), you will be given iodine supplementation given in preparations to take by mouth. This will lead to a reduction in the size of the goiter, but often the goiter will not completely resolve. […] If the goiter is due to Hashimotos Thyroiditis, and you are hypothyroid, you will be given thyroid hormone supplement as a daily pill. This treatment will restore your thyroid hormone levels to normal, but does not usually make the goiter go completely away. While the goiter may get smaller, sometimes there is too much scar tissue in the gland to allow it to get much smaller. However, thyroid hormone treatment will usually prevent it from getting any larger.

• #72 Goiter | American Thyroid Association

  https://www.thyroid.org/goiter/

  If the goiter is due to hyperthyroidism, the treatment will depend upon the cause of the hyperthyroidism. For some causes of hyperthyroidism, the treatment may lead to a disappearance of the goiter. For example, treatment of Graves disease with radioactive iodine usually leads to a decrease or disappearance of the goiter. […] Many goiters, such as the multinodular goiter, are associated with normal levels of thyroid hormone in the blood. These goiters usually do not require any specific treatment after the appropriate diagnosis is made. If no specific treatment is suggested, you may be warned that you are at risk for becoming hypothyroid or hyperthyroid in the future. However, if there are problems associated with the size of the thyroid per se, such as the goiter getting so large that it constricts the airway, your doctor may suggest that the goiter be treated by surgical removal. […] Whatever the cause, it is important to have regular (annual) monitoring when diagnosed with a goiter.

• #73 Become a member

  https://www.btf-thyroid.org/treatment-of-an-over-active-or-enlarged-thyroid-gland-with-radioactive-iodine

  Radioactive iodine has been used for several decades to treat an overactive thyroid gland safely. […] After radioactive iodine you should keep babies, children under five and pregnant women at arms length for two to three weeks (or longer if advised by your clinical team). […] You will need a blood test four to six weeks after the treatment and every one to three months until stable and once a year after that to check your thyroid hormone levels.

• #74 Goiter Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/120034-treatment

  Emergency surgical treatment of a goiter in a thyrotoxic patient requires antithyroid medications, beta blockers, and glucocorticoids at stress doses. Suppressive doses of iodine are helpful. […] An endocrinologist should assess a patient at least once, and assessment should be even more frequent if the goiter is complicated by thyroid dysfunction or malignancy or if the patient is being considered for surgical management. […] Nutrition plays a role in the development of endemic goiters. Dietary factors include iodine deficiency, goitrogens, protein malnutrition, and energy malnutrition. […] If it is practical, treat endemic goiters in iodine-deficient regions with iodine supplementation in the diet and avoidance of goitrogens. Treatment with iodine supplementation or levothyroxine may reduce goiter size. […] Goiter prevention is based on etiology. Correct iodine deficiency and avoid dietary or iatrogenic goitrogens if practical. Goiters due to autoimmune thyroiditis may be controlled with careful use of levothyroxine and, when indicated, anti-inflammatory medication.

• #75 Euthyroid Goiter With and Without Nodules—Diagnosis and Treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3441105/

  Euthyroid patients with nodular goiter have been treated medically in Germany for many years, yet the state of the evidence from studies performed across the world still leaves room for debate. […] Radioactive iodine therapy is an effective means of reducing the volume of goiters, even if they are large or very large (100 to 300 mL), by 35% to 40% in one year and by 40% to 60% in two years, with resulting improvement of airway function. […] Thyroid surgery is obligatory whenever cancer is suspected; it rapidly relieves the mechanical symptoms of benign nodular goiter. Other indications include retrosternal or mediastinal extension of a goiter and uni- or multifocal autonomy of thyroid function. […] Treatment is obligatory only when cancer is suspected, when the patient has symptoms, or when autonomous thyroid function is present. Asymptomatic, benign changes of the thyroid generally require no treatment. […] Patients who have undergone radioactive iodine therapy need lifelong clinical follow-up, as they may develop hypothyroidism.

• #76 Become a member

  https://www.btf-thyroid.org/treatment-of-an-over-active-or-enlarged-thyroid-gland-with-radioactive-iodine

  Radioactive iodine has been used for several decades to treat an overactive thyroid gland safely. […] After radioactive iodine you should keep babies, children under five and pregnant women at arms length for two to three weeks (or longer if advised by your clinical team). […] You will need a blood test four to six weeks after the treatment and every one to three months until stable and once a year after that to check your thyroid hormone levels.

• #77 Nontoxic Goiter Treatment & Management: Medical Care, Surgical Care, Further Outpatient Care

  https://emedicine.medscape.com/article/120392-treatment

  Nontoxic goiters usually grow very slowly over decades without causing symptoms. Without evidence of rapid growth, obstructive symptoms (eg, dysphagia, stridor, cough, shortness of breath), or thyrotoxicosis, no treatment is necessary. Therapy is considered if growth of the entire goiter or a specific nodule is present, especially if intrathoracic extension of the goiter, compressive symptoms, or thyrotoxicosis exists. The currently available therapies include thyroidectomy, radioactive iodine therapy, and levothyroxine (L-thyroxine, or T4) therapy. […] Radioactive iodine therapy for nontoxic goiters was reintroduced in the 1990s. Careful studies have shown a reduction in thyroid volume in nearly all patients after a single dose of therapy. […] Obstructive symptoms improved in most patients who received radioactive iodine.

• #78 Goiter Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/120034-treatment

  Thyroid hormone replacement is often required following surgical and radiation treatment of a goiter. Use of radioactive iodine for the therapy of nontoxic goiter has been disappointing and is controversial. […] Goiters with primary thyroid malignancy require levothyroxine replacement after surgery and radioactive iodine ablation. Metastatic lesions to the thyroid gland require treatment of the primary malignancy. Granulomatous and infectious etiologies for goiter require specific treatment depending on the underlying cause. […] Surgery is reserved for the following situations: Large goiters with compression, Malignancy, When other forms of therapy are not practical or are ineffective. […] Preoperatively, establish euthyroid state prior to surgical treatment. Evaluation must include the stability of the airway. This must be secured immediately if ventilatory status appears tenuous. Emergency surgical treatment of a goiter in a patient with hypothyroidism requires intravenous levothyroxine and glucocorticoids at stress doses.

• #79 Nontoxic Goiter Treatment & Management: Medical Care, Surgical Care, Further Outpatient Care

  https://emedicine.medscape.com/article/120392-treatment

  Thyroidectomy or surgical decompression causes rapid relief for obstructive symptoms. […] The American Association of Endocrine Surgeons recommends consideration of thyroidectomy for patients with a goiter associated with local compressive symptoms or progressive enlargement. […] After bilateral subtotal thyroidectomy, all patients require thyroid hormone replacement therapy. […] The use of total thyroidectomy to treat benign multinodular goiter has met with some concern, owing to the risk of parathyroid function damage and laryngeal nerve injury posed by the procedure. […] The incidence of transient hypoparathyroidism in the above study, as well as that of transient and permanent laryngeal nerve injuries, was greater in total thyroidectomy than in the other types of surgery. Nonetheless, the authors concluded that, owing to the fact that following total thyroidectomy there was a reduced incidence of goiter recurrence requiring repeat thyroidectomy, total thyroidectomy should be considered the procedure of choice for patients with nontoxic multinodular goiter.

• #80 Nontoxic Goiter Treatment & Management: Medical Care, Surgical Care, Further Outpatient Care

  https://emedicine.medscape.com/article/120392-treatment

  Thyroidectomy or surgical decompression causes rapid relief for obstructive symptoms. […] The American Association of Endocrine Surgeons recommends consideration of thyroidectomy for patients with a goiter associated with local compressive symptoms or progressive enlargement. […] After bilateral subtotal thyroidectomy, all patients require thyroid hormone replacement therapy. […] The use of total thyroidectomy to treat benign multinodular goiter has met with some concern, owing to the risk of parathyroid function damage and laryngeal nerve injury posed by the procedure. […] The incidence of transient hypoparathyroidism in the above study, as well as that of transient and permanent laryngeal nerve injuries, was greater in total thyroidectomy than in the other types of surgery. Nonetheless, the authors concluded that, owing to the fact that following total thyroidectomy there was a reduced incidence of goiter recurrence requiring repeat thyroidectomy, total thyroidectomy should be considered the procedure of choice for patients with nontoxic multinodular goiter.

• #81 Euthyroid Goiter With and Without Nodules—Diagnosis and Treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3441105/

  Thyroid enlargement and thyroid nodules are common in the general population. This review concerns their proper diagnostic assessment and treatment. […] There have been very few randomized trials concerning the diagnosis and treatment of goiter. Nodular goiter can be managed by watchful waiting, drug treatment (initially with levothyroxine and iodide), radioactive iodine therapy, or surgery. […] Many patients with nodules need no treatment at all. Treatment is indicated, however, if the patient is symptomatic and/or has an autonomously functioning (hot) nodule, or if cancer is suspected. Potentially cancerous nodules must be operated on. If euthyroid nodular goiter is to be treated with the main goal of size reduction, either surgery or radioactive iodine therapy can be used. Drug treatment is an option for small nodules or goiters, but iatrogenic hyperthyroidism must be avoided at all costs. The type of follow-up that is required depends on the chosen treatment.

• #82 Euthyroid Goiter With and Without Nodules—Diagnosis and Treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3441105/

  There are hardly any evidence-based recommendations for the treatment of euthyroid diffuse goiter and nodular goiter. Potential management strategies include watchful waiting for asymptomatic patients, drug treatment, radioactive iodine therapy, and surgery. The choice among them is taken individually for each patient in view of the risks, benefits, and availability of the various techniques, the experience of the treating physicians, and the patients wishes. […] Iodine deficiency is the main cause of euthyroid diffuse goiter; accordingly, correction of the intrathyroid iodine deficiency is the main objective of treatment. […] Treatment is clearly indicated if there is a suspicion of cancer, or if the patient has mechanical symptoms. […] The definitive treatment of autonomously functioning thyroid nodules is with surgery or radioactive iodine therapy.

• #83 Goiter – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562161/

  Patients with goiter commonly present to outpatient facilities with a variety of complaints. […] Accurate diagnosis is essential for the proper treatment approach. […] This activity reviews the evaluation and management of goiter, reviews different causes and types, and highlights the role of the interprofessional team from various specialties in evaluating and treating goiter. […] Describe the management options available for goiter. […] The aim of goiter treatment is to relieve compression and to restore euthyroidism. […] If there is any coexistent hypothyroidism, treatment includes thyroid hormone administration. Patients with toxic goiter require modalities that address thyroid enlargement and thyrotoxicosis. […] Today the main treatment options include monitoring without any treatment and thyroidectomy.

• #84 NONSURGICAL TREATMENT OF GOITER

  https://www.thyroid-goiter.com/goiter

  Although surgery is frequently offered for such patients, percutaneous ablation and embolization are increasingly preferred because of their important advantages. […] Classic treatments of multinodular goiter (MNG) include oral medications, radioactive iodine and surgery. […] In conclusion, each classic goiter treatment has specific disadvantages and side effects. Therefore, new treatment options that preserve thyroid gland and have little side effects are necessary. […] In MNG patients, new options such as percutaneous ablation and embolization has been increasingly used in the last 2 decades. […] In MNG, if the nodules are few, percutaneous ablation must be the first line treatment. However, if the nodules are too many, ablation may take too long and become impractical. […] Embolization is especially beneficial in plunging goiters that extends into the chest cavity and compress the trachea (windpipe) causing shortness of breath.

• #85 Goiter > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/goiter

  Medication. If a person has a goiter because their body doesn’t produce enough thyroid hormone, their doctor may prescribe thyroid hormone supplementation if there is underlying iodine deficiency. If a goiter is caused by inflammation, a doctor may prescribe anti-inflammatory medications or steroids. When a person has an overactive thyroid due to Graves disease, they may be prescribed anti-thyroid medications (methimazole, or propylthiouracil) to reduce the amount of hormone that the thyroid produces. […] Most goiters can be treated successfully, helping people resolve their symptoms and improve their appearance, as well as their quality of life. It is important that a goiter be recognized early so that any potentially reversible causes may be addressed. […] At the Smilow Endocrine Neoplasia Center and other Yale network locations, we have a multidisciplinary team of highly trained specialists, including endocrinologists, thyroid surgeons and nuclear medicine specialists, who provide comprehensive care for the management of goiter and associated diagnoses, says Dr. Mekala.

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