Over 90% of goiter cases is due to iodine deficiency. In countries that use iodized salt, the most common cause is Hashimoto's thyroiditis.
Other causes of a goiter includes Graves disease, nodules or cysts, tumours (both cancerous and benign), goitrogens (suppress thyroid function), smoking (thiocyanate in tobacco smoke interferes with iodine absorption), hormonal changes (pregnancy, puberty, and menopause (can affect thyroid function), lithium (psychiatric drug can interfere with thyroid function), overconsumption of iodine, radiation therapy (particularly when administered to the neck), selenium deficiency, injury or infections in the thyroid.