What is a multinodular goitre?

A multinodular goitre is a swelling in the neck. It is caused by abnormal growth of the thyroid gland, plus one or more growths called "thyroid nodules." Thyroid nodules are round or oval shaped growths in the thyroid gland. The thyroid gland is in the middle of the neck. Thyroid nodules are common and not usually harmful to a person's health. But sometimes thyroid nodules are caused by a serious condition, such as cancer.

The thyroid gland makes a hormone called "thyroid hormone." Most thyroid nodules do not change the amount of thyroid hormone in the body. But some thyroid nodules cause the thyroid gland to make too much thyroid hormone. If a multinodular goitre has this type of thyroid nodules, it can cause symptoms.

What are the symptoms of a multinodular goitre?

Most people with a multinodular goitre do not have symptoms. The swelling might be found during an imaging test, such as an ultrasound, that is done for another reason. Or a blood test to check thyroid hormone levels might show that a person has too much thyroid hormone. Having too much thyroid hormone can be a sign of a multinodular goitre. Some people with a multinodular goitre feel or see a lump in their neck.

Or they have symptoms from having too much thyroid hormone, such as:

• Feeling worried or upset, or having trouble sleeping
• Feeling weak or tired
• Losing weight without trying
• Having a fast heartbeat
• Having frequent bowel movements
• Trouble breathing – especially during physical activity, at night, or when reaching or bending
• Wheezing
• Coughing
• A choking feeling
• Trouble swallowing

Will I need tests?

Yes, Dr Alzubaidy will want to make sure that the multinodular goitre is not going to harm your body. You need tests to find out if nodules in the goitre are causing your thyroid gland to make too much hormone. Dr Alzubaidy will also check the nodules to see how big they are and if they need to be taken out.

Tests usually include blood tests and an imaging test of the thyroid called an ultrasound. Sometimes, people need more tests. These include:

• Fine needle aspiration
• Thyroid scan

How is a multinodular goitre treated?

Many multinodular goitres do not need treatment. If the nodules are small and do not look harmful, Dr Alzubaidy might watch and wait to see if the swelling gets bigger or needs to be treated.

A multinodular goitre needs treatment if:

• It causes the thyroid gland to make too much hormone
• It causes problems with breathing, swallowing, or other body functions – or is very large
• It contains cancer

Treatments for multinodular goitre include:

• Anti-thyroid medicines - to control thyroid hormone levels until doctors can do other treatments.
• Surgery to remove the multinodular goitre
• Radioactive iodine