Goiter is the enlargement of the thyroid gland characterized by swelling on the front and sides of the neck. Two types are simple and exophthalmic goiter.

Simple goiter has largely been eliminated thanks to the use of iodized salt. It is common in women, especially in areas away from the sea or mountainous regions where there is lack of iodine.

“The possible causes are numerous. In the past, the most common cause of goiter was a shortage of iodine in the diet in areas where the soil was deficient in iodine. Without enough dietary iodine, your thyroid can't make and release enough of the two essential iodine-containing hormones. Goiter became rare in the United States after iodized salt was introduced. In some parts of the world, however, goiter is still common because of iodine deficiency,” revealed the Mayo Clinic.

Symptoms are gradual enlargement of the thyroid gland, coughing, and difficulty swallowing or breathing.

Simple goiter can be prevented by eating sea foods. If there is swelling in the neck, the doctor may administer thyroid hormones to correct this condition.

Exophthalmic goiter or Graves’ disease is caused by the overactivity of the thyroid gland. It is characterized by swelling in the back, bulging eyes, nervousness, rapid pulse, excessive appetite, weight loss, fatigue and a fine tremor of outstretched fingers.

It is not know why the thyroid gland becomes overactive but the disease appears to run in families.

“This disease, an autoimmune disorder, is the most common cause of an overactive thyroid (hyperthyroidism). In Graves' disease, antibodies produced by your immune system stimulate the thyroid to produce too much thyroxine. Normally, your immune system uses antibodies to help protect against viruses, bacteria and other foreign substances that invade the body. In Graves' disease, antibodies mistakenly attack your thyroid gland and occasionally the tissue behind your eyes and the skin of your lower legs. The overstimulation of your thyroid in Graves' disease results in uniform and nonpainful swelling of the gland,” said the Mayo Clinic.

Small doses of iodine may offer temporary relief and are usually given in preparation for thyroid surgery. Certain drugs may correct thyroid gland overactivity.

Whether or not you need surgery depends on the kind of goiter you have. If the thyroid gland continues to enlarge despite the use of antithyroid drugs or radioactive iodine, an operation may be necessary. The same is true if the goiter compresses the trachea (windpipe), causes persistent hoarseness and one or more isolated lumps are present.

Surgery is also performed if the doctor thinks the growth is malignant or cancerous. Untreated, complications of exophthalmic goiter include heart failure and thyroid crisis, a sudden onset of symptoms following neck injury or a thyroid operation.

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