Treatment options for goiter - monitoring, medication, iodine and surgery

The treatment of goiter depends on the cause of the enlargement of the gland. The determination of the form of treatment also depends on the degree of the enlargement itself, clinical manifestations, medical history and health complications of the patient.

A specialist diagnosis and determination of treatment by an endocrinologist is necessary.

Conservative treatment and follow-up

Conservative treatment is based on regular outpatient monitoring of the thyroid gland. Follow-up without prescribing treatment is indicated if the goiter is unremarkable and the thyroid gland is functioning physiologically.

Conservative therapy includes lifestyle modification and the introduction of dietary measures. In the case of goiter arising from iodine deficiency, supplementation of the deficiency of this mineral is indicated.

Pharmacological treatment

The type of pharmacological treatment again depends on the cause of goiter. It is the most common form of treatment for thyroid disorders.

In hypothyroidism, synthetic thyroid hormone replacements are mainly used, which at the same time eliminate clinical symptoms. Often they can shrink the gland to its original size.

Conversely, in hyperthyroidism, medications that increase thyroid hormone production are indicated. Thyroid medications slow or completely block the increased production of thyroid hormones.

In the inflammatory process of the thyroid gland, mainly corticosteroids (anti-inflammatory effect) are indicated.

Treatment with radioactive iodine

In the rare case of a recurrent goiter with the impossibility of surgery, radioiodine treatment is chosen. Radioactive iodine is absorbed into the blood, which then transports it to the thyroid gland.

The radioactive iodine gradually destroys the gland and the thyroid gland shrinks and stops producing excessive amounts of thyroid hormones. The treatment brings with it complications such as complete destruction of the function of the gland and its hypofunction.

Surgical treatment

Surgical intervention is chosen especially for excessive goiter that presses on the surrounding structures and causes associated health complications.

Surgical treatment is also chosen in the case of ineffective pharmacological treatment, the presence of nodules altering the function of the gland, and also in the case of a presumption of gland cancer.

This may involve removal of the entire thyroid gland (strumectomy) or removal of one lobe or part of the gland tissue.