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Well - the goiter swells in general, never getting back to original size (ie - before I knew it was there) and makes my whole neck tight, but, I have noticed that it get bigger than usual after sitting outside in the 100 degree weather we are having. (Gotta love the Louisiana heat). After a day in the heat, it does get a little funny prickly feeling, but that part goes away after cooling off for a couple of hours. It also swells when I am cleaning, mowing, etc, basically when I am active.