Goiter
Basics
Description
- Any enlargement of the thyroid gland
- Classification on the basis of
- Location (cervical vs. substernal)
- Morphology (diffuse vs. nodular)
- Functional status (hypothyroid, euthyroid, or hyperthyroid)
- Etiology (autoimmune, neoplastic, etc.)
Epidemiology
Prevalence
Varies according to dietary iodine
- 5–7% in areas with iodine-replete diet
- >20% in iodine-deficient areas
Etiology and Pathophysiology
- Iodine deficiency is major cause worldwide.
- Iodine excess
- Japanese diets high in seaweed and fish
- Certain drugs and foodstuffs
- Lithium
- Vegetables with thiocyanate metabolite
- Heavy smoking (multinodular goiter)
- Infiltration of gland
- Inflammatory cells (thyroiditis)
- Tumor cells (lymphoma, thyroid cancer)
- TSH receptor activation
- Autoimmune thyroiditis
- Drugs
- Pituitary adenoma
- Thyroid hormone resistance
- Genetics
- Idiopathic
Genetics
- Uncertain but suspected role in some cases
- Familial predisposition
- Occasional gene mutations affecting hormone synthesis
Risk Factors
- Dietary iodine (deficient or excessive)
- Heavy smoking
- Family history
- Female:male = 4:1
General Prevention
Adequate iodine intake
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Citation
Domino, Frank J., et al., editors. "Goiter." 5-Minute Clinical Consult, 33rd ed., Wolters Kluwer, 2025. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816440/all/Goiter.
Goiter. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2025. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816440/all/Goiter. Accessed December 3, 2024.
Goiter. (2025). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (33rd ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816440/all/Goiter
Goiter [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2025. [cited 2024 December 03]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816440/all/Goiter.
* Article titles in AMA citation format should be in sentence-case
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T1 - Goiter
ID - 816440
ED - Domino,Frank J,
ED - Baldor,Robert A,
ED - Golding,Jeremy,
ED - Stephens,Mark B,
BT - 5-Minute Clinical Consult, Updating
UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816440/all/Goiter
PB - Wolters Kluwer
ET - 33
DB - Medicine Central
DP - Unbound Medicine
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