Thyroid patients can become normal

Thyroid enlargement

Causes & Symptoms

What is Thyroid Enlargement?

The thyroid is located on the front of the neck, under the larynx and next to the trachea and esophagus. A normal-sized thyroid is butterfly-shaped and consists of two lobes that are joined together. At the back are the parathyroid glands.
The thyroid produces certain hormones, the main component of which is iodine. They are partly responsible for a normal metabolism. If the thyroid does not get enough iodine, it cannot produce enough hormones. To compensate for the hormone deficiency, the thyroid gland is stimulated in its growth, forms new gland cells and enlarges.
On average, the thyroid gland has a normal volume of up to 18 ml. One speaks of an enlarged thyroid gland if its total volume exceeds 25 ml in men or 18 ml in women. The enlargement can affect the entire tissue or come from single or multiple nodes in the thyroid gland. In addition to the sheer increase in size or nodular changes, accompanying functional disorders often occur.
"Warm" or "cold" knots
In the individual nodes of the thyroid gland, the absorbed iodine is processed into hormones to varying degrees. With the help of so-called scintigraphy - an examination in which low-level radioactive iodine is administered into the veins - the ability to produce hormones is made visible.
Metabolically active areas in which a particularly large amount of iodine is processed and thus far too many hormones are produced are called “hot nodes”. Usually these are benign changes. However, when they produce too much thyroid hormone, they need to be removed to avoid hyperthyroidism.
About the same amount of hormones are produced in "warm nodes" as in the rest of the thyroid tissue. Warm knots are always benign.
Areas in the thyroid, on the other hand, where no iodine is absorbed and almost no thyroid hormone is produced, are called "cold nodules". The suspicion here is that the cells are malignant.

Thyroid enlargement: causes

The most common cause of thyroid enlargement is a nutritional deficiency in iodine, which is required for the production of thyroid hormones. If there is not enough iodine available, the thyroid reacts with an enlargement.

But another thyroid disease, such as thyroiditis, thyroid nodules or even cancer, can lead to an enlarged thyroid.

Other causes of thyroid enlargement:
  • Graves disease
  • Certain medications such as anti-thyroid drugs (for hyperthyroidism) or lithium (for manic-depressive illness)
  • Cysts in the thyroid gland

Symptoms: signs of an enlarged thyroid

A slight to moderate enlargement of the thyroid gland does not cause any symptoms at first. However, as the size increases, it usually becomes visible. Symptoms of hyperthyroidism or hypothyroidism are usually not present. Alarm signs are a foreign body sensation in the throat, swallowing disorders and new, permanent hoarseness. In these cases you should consult a doctor immediately.


Diagnostics: This is how we determine an enlargement of the thyroid gland

First, we determine the volume of your thyroid through an ultrasound scan. Nodes, enlargements, structures that are suspected of being cancerous, calcifications and cysts can also be easily identified. With the help of the aforementioned scintigraphy, we can then further differentiate existing nodes.
Cold lumps can be suspected of being cancerous. For a precise overall assessment, laboratory tests are carried out in this case to determine the thyroid hormone levels in the blood.