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Can you reduce the size of a goiter?
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Can you reduce the size of a goiter?

I have a goiter that I swear fluctuates in size, but I don't know if that's really possible, or is it?  My question is, without surgery, is there a way I can either naturally or with medication reduce the size of my goiter?  
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31 Comments Post a Comment
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929504_tn?1332589534
When I asked about doing this (thyroid hormone/synthroid), the surgeon that evaluated me, told me that "he" doesn't use any method of shrinking the goiter because it doesn't help. Before i had my surgery (TT) due to a multi-nodular goiter, i tried a product online that "did" shrink the goiter from 3.7cm to 3.3cm (which is the size it remained at the time of surgery).

Goiters can definitely increase in size.

Lots of people (including myself) are skeptical of trying online products but i figured why not try it..and i did! Due to the nodules, i had to have the thyroid removed regardless.

Before self medicating, speak to your endo about using "thyroid hormone replacement" to reduce the size. Do keep in mind that you will develop side effects from the medication.

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1013194_tn?1296463081
My goiter and nodual did shrink with thyroid meds quite considerably, but i was put on these for Hypothyroidism.Im not sure how it would work if the thyroid levels are in range to start with, maybe a small dose could work,
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Avatar_m_tn
I had my TSH, T3 and T4 tested and was told they were normal.  I have been doing some reading and am wondering if maybe I should request to get my thyroid antibodies tested??  I have also been thinking of getting a second opinion.  I was diagnosed with my multinodular goiter just a little over 2 months ago, so I don't know if it's too soon or not, or if I should just wait.  I was told to come back in a year.
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929504_tn?1332589534
Did you have a fna (fine needle biopsy) on the nodules???
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Avatar_f_tn
The very first thing you should do is get a copy of your lab report for FT3, FT4 and TSH.  Too often we hear doctors saying "normal" when testing was inadequate or reference ranges used were obsolete.  If you get them, post with reference ranges and members will help you decipher them.

Yes, have TPOab and TGab tested at the same time.  If you are dealing with autoimmune disease, you want to know it.

After you have the above, you'll know whether your doctor is a good thyroid doctor or not,  If not, you can decide on the second opinion then.

Your thyroid is enlarged and you have nodules for a reason.  Don't wait a year to find out what's causing this.  If you do have an autoimmune disease, you'll want to decide when to start treatment.  

Depending on size and composition, etc., many nodules do not require FNA.  Many of us with Hashi's have nodules, which are periodically monitored (ultrasound) for significant changes.  
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Avatar_m_tn
I did have a FNA of one of the nodules and they said it was benign and consistent with a multinodular goiter.  My TSH was 4.472 (normal 0.320-5.500 uIU/mL), free T4 1.30 (normal 0.70-1.80 ng/dL), and free T3 3.57 (normal 2.30-4.20 pg/mL).  What exactly is an autoimmune disease and how is it treated?
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Avatar_f_tn
Currently accepted range for TSH is 0.3-3.0.  Your lab, like most of them, is still using an obsolete range.  So, your TSH is a bit on the high side, which usually indicates hypo.  However, your FT4 is right where it belongs, somewhere around midrange, and your FT3 looks really good.  It's just into the upper third of the range, also right where it belongs.

Autoimmune diseases include Hashimoto's thyroiditis (hypo) and Grave's (hyper).  In these diseases, your immune system has "decided" that your thyroid tissue is a foreign protein and is attacking it, just like it attacks truly foreign substances that get into your body, like viruses and bacteria.  This causes your thyroid to malfunction.  

There is no treatment for either.  The SYMPTOMS of both can be treated by thyroid replacement hormones (Hashi's) or anti-thyroid meds, RAI and surgery (Grave's).  When to start treating Hashi's is a controversial area with some saying it's better to start before symptoms appear, and others saying to wait until they appear.  If you have the antibody tests, you can make the decision on when you want to start treatment. Your FT3 and FT4 levels are fine at the moment, but something is causing your goiter and nodules, and if I were you I'd like an explanation.  Your thyroid is working too hard (thus the goiter and nodules).  If you test positive for antibodies, it will indicate what you can expect in the future.  
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139126_tn?1255040591
I had a multinodule goiter which was quite noticeable for 40+ years with no symptoms whatsoever.   It would get a little larger, get a little smaller, stay the same...no big deal.   Tried a few times to shrink it with synthroid but that didn't work.  Periodically did the FNA to make sure there were no cancer cells.  Had my thyroid levels checked every year with my physical and they were always fine.    I went to see a very good endo Dr down at Yale about 10 years ago who told me that some people have goiters for no apparent reason and live very long, healthy lives without having any issues.   He told me that a goiter is not necessarily indicative of a problem and to just make sure I had it checked out once a year. That was the case most of my life until last year when it decided to act up (thyroid toxicosis) and I would up having it removed.   So just make sure you watch it, pay attention to how you feel and have all the right tests done every year.
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Avatar_m_tn
Thank you all for your words of advice.  My mom is hypothyroid and has wondered if maybe I am as well.  I think I am going to get a second opinion from another endo and bring up some of the points you all mentioned.  I figure it couldn't hurt any.  The endo I am going to make an appt with I have never seen before, but have talked to in e-mails and I really liked him.  I'll e-mail him again and see if he can order the thyroid antibody blood work, as well as maybe repeat TSH, FT3 and FT4 as well, so the results are in when I see him.  Thanks again!!
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Avatar_m_tn
Okay, I have an appt for March 24.  I am to get some repeat blood work the week before, and I requested thyroid antibodies as well, but I guess the endo has to approve that, so we'll see.  Since I'm still new to all of this thyroid stuff, I am wondering what kinds of questions I should ask the endo.  Any suggestions?
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Avatar_m_tn
Hi. I just want to share my experience. My mom used to have a goiter before and she underwent an operation twice. I'm having the same problem now at 26 y.o. I've been diagnosed with U thyroid/ colloidal thyroid. Thank God that my biopsy result is fine. I really don't want to undergo an operation before so I insisted my Doctor to take chances in taking Eltroxin 5mcg to reduce the size. Yes indeed it helped in shrinking a few mm, but after 6mos, my FT4 became high. It used to be normal before. My TSH and FT3 are still normal now though. It was my right thyroid that has a goiter back then, and now, my left thyroid is also swollen. I'm planning to have an operation in a month because the doctor/surgeon advised me that there are no other better solution than to have it removed before it cause anything bad to my health.
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649848_tn?1357751184
This is a very old thread and mymeow74 hasn't participated in the forum for a very long time, so it's unlikely she will respond.

You have only one thyroid that consists of 2 lobes and an isthmus.  Goiter is a swollen/inflamed thyroid.  

Have you been diagnosed with Hashimoto's Thyroiditis? or Graves Disease?

Are you planning to have the entire thyroid removed or just the left lobe? I wish you the best of luck with your surgery.  
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Avatar_f_tn
hi..i want to ask something..i am 24...i have a normal goiter in my left neck
after the fna the doctor said that it was a normal goiter(hypothyroid)..the doctor gave me a med levothyroxine euthyrox(150mg)...but after a few 2 months i stop taking it bcoz my hearts beats faster that i cant even control it...so what should i do? i did not take the until now...i didnt even go to doctor bcoz i dont have money any more...can someone give me an advise....plzzzz help me...thnx
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Avatar_f_tn
Was 150 mcg the first dosage your doctor started you on, or dd you work up to that?

Tachycardia is a symptom of overmedication.  It sounds like you needed less meds, but perhaps didn't need to stop altogether.

How do you feel?  Do you have a lot of hypo symptoms?
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Avatar_f_tn
thats the first med that my doctor gave me....at first i take 15omcg, but since we live in urban less medicine here...since the pharmacy here only have 100mcg..then i have no choice is to buy only not to stop take med...is that ok that i take 100mcg the same brand? now i feel ok since i stop taking levothyroxine..my heart beat is normal...is hair fall a symptom of hypothyroid?

what can i do now?? i did not go to doctor bcos we are poor....any recommended med?..but my neck is not bigger..its the same since i discover it..thx for the reply
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Avatar_f_tn
150 mcg is a very large starting dose.  Many people don't need that much.  Your doctor should have started you on a lower dose and worked up.

Yes, it's okay if you take 100 mcg of the same brand.  Are you saying that you can only buy 100 mcg tablets at your pharmacy?  Of course, that's a lower dose, but you might be able to take it without geting tachycardia, etc.

Hair loss is a symptom of hypo.

Being hypo is a little like being diabetic.  Your condition has to be monitored with regular blood work so meds can be adjusted as necessary.  Is there a free clinic you could go to?  What about a government health service?

There's really nothing else you can take.  I think you'd do fine on a smaller dose, but you really do have to see a doctor and keep monitoring your levels.
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Avatar_f_tn
ok thanks!..yes its only 100mcg available in our pharmacy here!..is normal goiter have a chance to be cancerous one?...i was not able to ask here if their was government services here in free..i try to ask first..can be a normal goiter be larger as i expected? can i maintain a 100mcg levothyroxine even if i cant go to doctor as of now? can i give you my thyroid panel test and can u give me a med take to? how about that?..thank you so much for answering my questions...i hope you could help me..
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Avatar_f_tn
It's possible to develop thyroid cancer, but it's rare.  Most of us with thyroid disease have a goiter and/or nodules, and they're just monitored for changes.  The harder your thyroid has to try to work, the more inflamed (goiter gets bigger) it becomes.  Often, thyroid meds will make it shrink.

You really should try to have blood work done.  Without it, it's impossible to tell you if you can maintain 100 mcg or not.  However, your doctor did prescribe 150 mcg, but that seemed like too much.  I'd strongly encourage you to see a doctor.

I'm not a doctor, so no, I can't tell you what to take.  That has to be based not only on labs, but on further examination by your doctor.  Medical history, other conditions, other tests can all have bearing on what your doctor does.  We all react differently to meds, so there is no "formula" for how much to take.  No one can look at your labs and say "you need to take X mcg of meds".

Your doctor should choose a starting dose for you, which is usually based on weight somewhat.  He should order labs again in 4-6 weeks to see what that dose has done to your levels.  Then, you should discuss your symptoms with him.  He will then make an adjustment, if necessary, and you have to repeat that process until you feel well and your dose is stable.  At that point, you can go longer between lab work.

It's pretty complicated.  I think the best thing you could do is try to find a free clinic.  

Best of luck...  
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Avatar_f_tn
I have been arguing in relation to my thyroid for some 20+ years because of my enlarged neck area and regular neck pain; hoarseness of voice (happens for approx 2 weeks every 6-8 weeks) and just general swelling.  I have also had problems of fatigue; breathing issues; multiple tendonitis issues; constant rapid heart rate; "foggy" spells of concentration and mysterious fainting spells...  but these have all been explained away as "stress" by doctors.

I keep getting told its a multinodular goitre and it isnt pressing on the windpipe so there is nothing to do....    

I demanded and have since had another CT scan today which has confirmed that it has grown by at least 1cm on the right and 0.5cm on the left (so is now 5.5 & 6cm long) and 0.3cm (now being 1.3cm) in the isthmus.  Even though they say it isnt pressing on anything, theyre not the ones that have to swallow twice to get "spit" down.  In some cases I have had to physically push stuff down my throat from the outside (hopefully that makes sense)

So I'm prepared for my doctors appointment...  if my bloods come back supposedly as "normal" again, what should I do?

This is about the 8th doctor I have seen and I have been laughed out of 2 Endocrinologists office already over the years.

My only argument so far has been:
A thyroid works, for it to make nodules to increase its productivity there has to be something wrong otherwise it wouldnt make the nodules.  And now I have proof it is growing!!!! so as far as Im concerned this proves THERE IS SOMETHING WRONG!!!   but how do I get them to listen to me??

Just totally confused! and bewildered its taken this long.
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649848_tn?1357751184
Sometimes, nodules leak hormones independently, of the thyroid, but, typically, they don't "increase it's productivity".  

Have you been tested for thyroid antibodies?  Nodules are typical with autoimmune thyroid diseases.  Many/most of us with Hashimoto's have multinodular goiters. Inflammation can cause nodules to swell.

What blood work are you having done?  You should be getting TSH, Free T3 and Free T4, along with the antibody tests, Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab).  These antibody tests are necessary for the diagnosis of Hashimoto's Thyroiditis.

Even though your CT shows that the nodule has grown, blood work will, most likely, have to indicate a problem in order to get treatment, though it's not unusual for symptoms to appear long before labs indicate an issue.

If you have Hashi's, at some point, you will need to be put on thyroid replacement hormones, because your thyroid is constantly being destroyed by the antibodies and eventually, will there will be no healthy tissue to produce hormones.

I had that choking sensation for a long time; most of it was caused by anxiety.  I get it now, when swallowing, if I take too large bites; feels like whatever I'm eating is getting stuck; it's not a thyroid thing.  

Of course, when nodules grow, there's something "wrong".  Do you have other symptoms of thyroid condition, such as unexplained weight gain/loss, constipation/diarrhea, fatigue, slow/rapid heart rate, muscle/joint aches/pain, foggy thinking, etc?  
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Avatar_f_tn
Hi Barb135

All that was written on the pathology form was TSH T3 T4 with cholestorol, iron studies and blood sugar levels.

"Have you been tested for thyroid antibodies?"
I dont believe so.

"Do you have other symptoms of thyroid condition, such as unexplained weight gain/loss, constipation/diarrhea, fatigue, slow/rapid heart rate, muscle/joint aches/pain, foggy thinking, etc?  "

I have had the same systems for those 20 odd years but they are becoming MORE extreme....  
regular neck pain; hoarseness of voice (happens for approx 2 weeks every 6-8 weeks) and just general swelling.  I have also had problems of fatigue; breathing issues; multiple tendonitis issues; constant rapid heart rate; "foggy" spells of concentration and mysterious fainting spells...

I have also had issues of diarrhea, bloating, having trouble breathing (such as taking a breath every 2nd or 3rd word.  My arms and shoulders always have that weak feeling.

In one instance a few years ago, I was feeling on top of the world and the next day I couldnt lift a finger without it taking my entire energy....    A whole heap of blood tests later I was told two things...   "Youre fighting something but we have no idea what" and "People like you in the old days we put into sanitariums to rest".

I exercise on average 3-4 days per week and even my personal trainer is amazed I am not so much smaller....   even in some cases I have gotten bigger.

So ultimately I should say Im not interested in his test results and demand the Free T3 & T4 test along with a thyroid antibody blood test??

Thank you for your help :)
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649848_tn?1357751184
"So ultimately I should say Im not interested in his test results and demand the Free T3 & T4 test along with a thyroid antibody blood test??"  No, that's not what I'm saying; the tests that were run are all important, except total T3 and total T4, which are obsolete.

What were your cholesterol levels like?  What were the results of the iron panel?  Blood sugar levels?  

High cholesterol is a symptom of hypothyroidism.  Iron is essential for producing/metabolizing thyroid hormones.  Some of us with hypothyroidism have impaired fasting glucose levels (insulin resistance) that can lead to type II diabetes.  High tryglyceride levels and insulin resistance are components in metabolic syndrome.  

All of those tests are important; they just don't tell the whole story.  Without Free T3 and Free T4, you don't know what your thyroid is actually doing.  Without the antibody tests you have no idea whether or not, you have Hashimoto's, which could be an explanation as to why you feel badly.

Multi-nodular goiter is very common with Hashimoto's and it's not unusual to swing from hyper to hypo, with normal periods in between, which explains your symptoms of both hyper and hypo.

Don't discount any of the tests already done, but do be persistent about getting the FT3, FT4 and "both" of the antibody tests I mentioned above.  It's important that you get them both, or you could be misdiagnosed, because some people have one antibody, some have the other and still others have both....
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Avatar_f_tn
Thank you Barb135.

I havent got the results from tests yet but will update when I get them :)

Im glad you wrote you can go from one to the other and feel ok in between because it makes me feel reassured Im not going crazy
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649848_tn?1357751184
No, you aren't going crazy......  Will look forward to seeing the blood test results when you get them.  Be sure to include reference ranges, as those vary lab to lab and have to be posted with your results.

You might want to start a new thread of your own, so we can keep you separate from all the other posters on this thread.
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Avatar_f_tn
Hi Barb135...  

I can shed no more on this as yet..  (hence no new thread)

Saw doctor today and he would not give me print out and was just saying "youre tests are normal".  When I inquired and asked for further tests, I was once again told ALL my tests were normal and we wont be taking it out!.

I replied with leave it or take it out, doesn't the fact that it has grown constitute further investigation?  I was promptly told, it is not pressing on the trachea or any other part of the throat and it has not grown downwards; it is a case of wait and see.

I pushed and pushed and pushed....  the only concession I got was the next time I have a crackly voice he'll refer me to an ENT to look at my throat.

I pushed the fact that I feel weak at the moment and my neck is still sore and moving it is uncomfortable.  Of which his response was to ask if I was possibly a hypochondriac or should I see a psychologist.

So peeved right now and looks like I need to find another doctor UUGGHHH!!!  

FEELING SO FRUSTRATED AND BEATEN RIGHT NOW....  

Barb135, I will start a new thread "just n case"
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Avatar_n_tn
what did you do to make them shrink?
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Avatar_f_tn
I just had my thyroid out last week. It had been enlarged for years and my doctor would not take it out until I voiced concerns of snoring and wanting a sleep study. It had almost gotten too large. It had stretched one of my nerves. Both nerves shut down after surgery and I had to be on ventilator in ICU for 3 days!
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Avatar_n_tn
I just now found this forum, have read your writings and have some questions. I was diagnosed with hypothyroidism 20 years ago, been taking Synthroid ever since. over 3 years ago I noticed difficulty swallowing, breathing, hoarseness. General doc did a barium swallow, no findings, so it was dropped. It's worse, went to diff family doc, had an ultrasound that showed goiter w/ nodules. am now scheduled for thyroid scan, a 2 day deal in 6 weeks. I was told to stop my Synthroid now. I'm afraid that will wreak havoc with my body and also grow the goiter.
My research is saying I'll most likely have to have thyroid removed which I don't want to do!
Any advice from anyone?
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649848_tn?1357751184
This is an old thread and justfixit is no longer active on the forum, so I doubt you'll get a response.  

The test you're getting is a nuclear uptake and scan.  You will be given a small dose of radioactive material (tracer), the tracer will collect in the thyroid than a sensor records how much of the tracer your thyroid absorbed. The second day the tracer is injected into your arm and a scan of your thyroid is done.

It's typical to go off thyroid med, usually for 4 weeks to be sure they are all out of your system before you have this test.  It does wreak havoc with some people and they have to start all over, once they get back on the med.  Goiter is a swollen thyroid and it's unlikely that going off your med will affect it all that much.  This test is, typically, done on those with hyperthyroidism.

Were you ever tested for thyroid Antibodies to determine whether or not you have Hashimoto's?  Hashimoto's is the most common cause of hypothyroidism in the developed world.  

Do you have current thyroid hormone levels that you can post?
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Avatar_n_tn
thank you very much. Here is the lab history I have. I developed celiac disease, epilepsy and hypothryoidism at about the same time. There is a lot of autoimmune disease in the family. These were done at different labs and some were done to test epilepsy med levels. When I had those annually I just asked my neuro to add thyroid tests.
March '05  TSH 1.323 (.35-5.5)  T4 Free 1.44 (.67-1.76)
Aug '06  TSH .33 (.35-7)
Oct '07  TSH 1.47 (.35-5.5)
Jan '09  TSH  0.848 (.470-4.681)  ANA was very high 253 (0-99)
April '09 TSH .42 (.35-5.5), Thyroglobulin AB 68 (less than 20), Thyroid Peroxidase 73 (less than 35)
Sept '09  TSH 1.1 (there was no normal listed)
July '10 TSH 1.24 (3.5-5.5) T4 1.48 (.89-1.76)  T3 2.9 (2.3-4.2)
March '12 TSH 2.64 (.470-4.68)  T4 1.7 (.78-2.19)
Jan '14 TSH 1.23  (.47-4.68)

I will be off synthroid for 8 weeks before the scan! I have a lot of pressure in my neck, lots of trouble swallowing, breathing, hoarseness, cough. I need to be able to swallow my med for epilepsy.
The doc (family physician) said they'll try to shrink it first before surgery. Why doesn't he try to do that now?
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Avatar_m_tn
Yes, get the antibodies tested. My levels were all normal and finally they tested for those and turns out I have hashimoto's disease
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