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I have a goiter that is very visible and have been told by…

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I have a goiter that...
I have a goiter that is very visible and have been told by my Endocrinologist in Florida that it is cosmetic and if I wanted to have it removed I would have to take medication every day for the rest of my life. I have chosen to not have surgery for cosmetic reasons but it does bother me because I have had people mention my neck and ask what is wrong. My thyroid blood tests that I have done every year are normal. I also have had ultra sounds showing a very large mass/goiter causing the swelling in my neck. I am now living in Athens Georgia and there is only one Edocrinologist here and he does not participate with my insurance. I noticed the swelling in my neck when I was about 23 and I am now 58. The size has stayed the same. Any suggestions are appreciated. Thank You.
Submitted: 6 years ago.Category: Endocrinology
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3/7/2012
Endocrinologist: Dr. David, Other replied 6 years ago
Dr. David
Dr. David, Other
Category: Endocrinology
Satisfied Customers: 50,138
Experience: Experienced physician, undergraduate studies at MIT, studied Engineering, qualified to answer your questions.
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This is Dr. David

the medication would be a thyroid hormone pill like synthroid which would be very safe.

synthroid would not shrink the goiter.

I think cosmetically both options are not optimal. if you have surgery, you can have a scar. if you don't have surgery, you have a large goiter.

another option is to use radioactive iodine to ablate the thyroid gland. this may or may not shrink the goiter.

if the goiter is enlarging, you should get an ultrasound and biopsy, bit the size sounds very stable.

I would have the radioactive iodine to see if that would help shrink it. if not, I would have surgery to cut it out since the gland is not really working for you anyway and just go on synthoid like you have been on.
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Customer reply replied 6 years ago

You mention that I try radioactive iodine and you also said to have surgery to cut out the goiter since the gland is not really working anyway. If the thyroid gland is not working then why are all my thyroid tests normal?

Endocrinologist: Dr. David, Other replied 6 years ago
oh, I though you are taking synthoid now.

my mistake.

if you are not taking synthroid and your thyroid function testing is normal, then your thyroid is producing thyroid hormone.

so if your thyroid is working, then your decision would be to remove the thyroid with surgery, or live with the goiter.
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Customer reply replied 6 years ago

Well, I noticed it when I was 23 and I am now 58 so I think I will just deal with the swelling from the goiter and the comments people make when they notice it. I had heard that kelp may help or iodine. Any other suggestions you may have to shrink it would be appreciated.

Endocrinologist: Dr. David, Other replied 6 years ago
kelp has a lot of iodine in it.

everyone's thyroid need iodine to help make thyroid hormone.

the thyroid is really the only organ which takes up iodine.

that is why radioactive iodine is so effective in targetting the thyroid.

sometimes goiter can be due to iodine difficiency, so that is when kelp and iodine salt can help. but I don't think you are suffering from iodine difficiency.

"Radioactive iodine therapy for nontoxic goiters was reintroduced in the 1990s. Careful studies have shown a reduction in thyroid volume in nearly all patients after a single dose of therapy"

http://emedicine.medscape.com/article/120392-treatment

http://www.thyroidmanager.org/2011/06/01/approach-to-the-patient-with-nontoxic-multinodular-goiter/
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Customer reply replied 6 years ago

Can a goiter turn cancerous? I will check out the sites you shared and appreciate any other suggestions you may have on this. Appreciate your support.

Thank You,

Josette Colquitt

Endocrinologist: Dr. David, Other replied 6 years ago
I have seen one goiter turn into a thyroid lymphoma. this is rare, but can happen. and usually manifests as the goiter enlarging more than it usually
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Customer reply replied 6 years ago

How large was the goiter and did it grow quiclkly because I have not seen any change in size in mine in many years. How large/visible was the patients goiter.

Endocrinologist: Dr. David, Other replied 6 years ago
in my patient who had the goiter turn into lymphoma, his thyroid was as large has his fist
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Customer reply replied 6 years ago
I appreciate you taking the time to explain to me issues about my goiter. I already had a biopsy a few years ago and it was benign. Since it has not grown any since I was 23 do you think I should have a biopsy again? Did your patient make out ok that had lymphoma?
Endocrinologist: Dr. David, Other replied 6 years ago
no, I don't think you need a biopsy if it has not grown. if it is stable and your thyroid functions are stable, then you don't need to worry. again, changes in goiters into cancer are super super rare.

I did send you an article about how radioactive iodine can shrink the goiter and stop thyroid function without surgery if you want to go that route.

my patient with the goiter that turned into lymphoma did well, we treated with external beam radiation and shrink the lymphoma and goiter and his goiter disappeared without a surgical scar and he continues to take thyroid hormone.
Dr. David
Dr. David, Other
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Customer reply replied 6 years ago

You have helped me so much. I really appreciate it:)

Thank You,

Josette Colquitt

Endocrinologist: Dr. David, Other replied 6 years ago
thank you so much for the accept and super generous bonus

you can always reach me here at JustAnswers.com

please leave positive feedback

best of luck to you.
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