Goitre

Also indexed as: Iodine Deficiency Hypothyroidism

Illustration

Stop the swelling in your neck by getting to the root of your thyroid problem. According to research or other evidence, the following self-care steps may help reduce or eliminate your goitre:

What you need to know

  • Get a check-up
  • Visit your doctor to find out if the swelling in your neck is caused by a treatable medical condition
  • Ask about iodine
  • Ask your doctor if your goitre may be caused by too little or too much iodine in your body

These recommendations are not comprehensive and are not intended to replace the advice of your doctor or chemist. Continue reading the full goitre article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful.

About goitre

Goitre is an enlargement of the thyroid gland that often produces a noticeable swelling in the front of the neck.

This enlargement can be caused by iodine deficiency, inability of the body to use iodine correctly, or a variety of thyroid disorders, including infection, tumours, and auto-immune disease. Some environmental pollutants, heavy metal poisonings, and certain drugs can also contribute to goitre formation.1 2 3 Both iodine deficiency and inability to use iodine properly make the thyroid gland unable to produce thyroid hormone, a hormone that helps to regulate the body’s metabolic rate. This state is called hypothyroidism and the symptoms include fatigue, weight gain, heavy menstrual bleeding in women, dry skin and hair, as well as goitre.

Iodine-deficiency goitre can be common in regions where the soils and foods have insufficient iodine. Preschool children, adolescent girls, pregnant women, and the elderly are most vulnerable to goitre and other iodine-deficiency disorders.4 Areas where iodine supplies are inadequate see high rates not only of goitre but also of birth defects and retardation of both mental and physical development.5 While iodine deficiency is the leading cause of goitre worldwide, it is a rare cause of goitre in the developed world. For this reason, any goitre that occurs in the developed world must be evaluated by a doctor and its cause determined before any treatment is given.

Top

Product ratings for goitre

Science Ratings Nutritional Supplements Herbs
3Stars

Iodine

  
1Star

Manganese (if deficient)

Vitamin A

Vitamin E

Zinc (if deficient)

  
3Stars Reliable and relatively consistent scientific data showing a substantial health benefit.
2Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
1Star For a herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health benefit.
Top

What are the symptoms?

People with goitre may notice a soft swelling in the front of the neck.

Top

Dietary changes that may be helpful

The most important dietary concern in treating iodine-deficiency hypothyroidism and preventing goitre is ensuring adequate intake of iodine. Iodine is found naturally in foods from the ocean, such as fish and seafood, kelp, and sea vegetables, and in plant and animal products produced in areas where soil and water contain sufficient iodine.6 7 In developed countries, commercial table salt has been fortified with iodine since the 1920s to prevent deficiency.8 Iodized salt contains approximately 100 micrograms of iodine per gram of salt. This fortified salt is used directly and is incorporated into animal feeds and processed foods making it easy to achieve the Recommended Dietary Allowance (RDA) of 150 mcg for adolescents and adults and 200 mcg daily for pregnant and breast-feeding women.9 Iodized salt has proven so effective it is recommended as the intervention of choice to eliminate iodine deficiency worldwide.10 11 Iodized oils, given as an annual injection or as food by mouth, have also been used effectively to treat iodine-deficiency goitre.12 13

Although iodine deficiency and goitre are now quite uncommon in developed countries, recent studies have found that the average dietary iodine intake in the United States has fallen below RDA guidelines.14 Long-term excessive dietary intake of iodine (1,000 to 2,000 micrograms daily), while less common than iodine deficiency, can occur in people who eat large amounts of kelp and other sea vegetables and can also cause goitre.15 16

A number of commonly eaten foods have been shown to interfere with the use of iodine by the thyroid, thus reducing production of thyroid hormone and causing goitre. These foods, known as goitrogens, include vegetables in the Brassica family such as broccoli, cabbage, kale and mustard,17 millet,18 soybeans,19 pine nuts20 and some seed meals used in animal feeds.21 22 These foods can be safely eaten in moderate amounts by people who consume adequate iodine.23 A combination of low iodine intake and high intake of goitrogenic foods increases the likelihood of goitre.24 25

Nutrient deficiencies, including zinc,26 manganese27 and vitamin A,28 29 and severe protein malnutrition30 also contribute to an inability to use iodine well and to the development of goitre.31 32 In the presence of adequate iodine supplies, it is less common for such factors to cause goitre;33 34 however, when iodine intake becomes deficient, even mild malnutrition can have such a negative impact on thyroid function.35 36 High levels of minerals such as calcium and magnesium, and certain bacteria in drinking water, have also been shown to be goitrogenic.37 38 Therefore, proper nutrition and a healthy water supply are crucial in the prevention and treatment of goitre.

Top

Other therapies

Other treatment includes the use of iodized table salt and the avoidance of goitre promoting (goitrogenic) foods, such as cabbage, Brussel sprouts, and soya. Surgical removal or radioactive iodine treatments may be necessary for cosmetic reasons or in individuals with large goiters that interfere with breathing or swallowing.

Top

Vitamins that may be helpful

Iodine supplementation can be an effective treatment of iodine deficiency hypothyroidism and can halt the growth of goitre if the cause is not complicated by malnutrition or environmental and dietary goitrogens.39 40 Iodine supplements will help to shrink goiters during early stages, but they have no effect in later stages.41 Ingestion of 2,000 to 6,000 mcg of iodine daily over long periods of time can be toxic to the thyroid and can be a cause of goitre.42 43

Blood levels of vitamin A are lower in people with goitre than in similar people without goitre.44 45 The same relationship has been found for vitamin E and goitre.46 Animal research has found that, in iodine-deficient conditions, a supplement combination of vitamin C, vitamin E, and beta-carotene prevented goitre formation (though hypothyroidism was not improved), and vitamin E alone had a similar effect.47 No studies have been done to investigate this benefit in humans.

When iodine deficiency is present, other nutrient levels become important in the development of goitre. Deficiencies of zinc48 and manganese49 can both contribute to iodine-deficiency goitre; however, an animal study found that manganese excess can also be goitrogenic.50 It has been suggested that selenium deficiency may contribute to goitre.51 However, when selenium supplements were given to people deficient in both iodine and selenium, thyroid dysfunction was aggravated, and it has been suggested that selenium deficiency may provide some protection when there is iodine deficiency.52 53 A study of the effects of selenium supplementation at 100 mcg daily in women without selenium deficiency but with slightly low iodine intake found no effect on thyroid function.54 The authors concluded that selenium supplementation seems to be safe in people with only iodine deficiency but not in people with combined selenium and iodine deficiencies. In those cases, iodine supplementation has been shown to be most useful.55 No studies have been done to evaluate the usefulness of supplementation with zinc or manganese to prevent or treat goitre.

Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.

Top
References
(To view, roll mouse over the "References" heading; to hide, click on the heading)