Goiter, or “bosyo” in Filipino, is defined as an enlargement of the thyroid gland that presents as a painless, midline neck mass. The basic laboratory work-up for a patient with goiter usually includes a blood test for thyroid hormone levels (TSH, FT4 and/or FT3), an imaging study (ultrasound or CT scan), and in some cases, a fine needle aspiration biopsy (ultrasound-guided for nodules 1 cm or smaller).
Goiters treated with medication
A patient with goiter may be hyperthyroid (elevated level of thyroid hormones), or hypothyroid (low level of thyroid hormones). A hyperthyroid patient usually presents with the following symptoms: hyperactivity, palpitations, nervousness, anxiety, weight loss, and heat intolerance. A hypothyroid patient, on the other hand, usually presents with lethargy, fatigue, weight gain, and cold intolerance.
It is best to consult an endocrinologist to get the appropriate medication and avoid the life-threatening complications of uncontrolled thyroid hormone levels – thyrotoxicosis for hyperthyroidism, and myxedema coma for hypothyroidism.
Goiters treated with surgery
A patient with goiter may be euthyroid (normal level of thyroid hormones). These patients usually undergo a fine needle aspiration biopsy to determine if the thyroid nodule is benign or malignant. The recommended type of surgery depends on the results of the biopsy, supplemented by an imaging study (ultrasound or CT scan). Hyperthyroid patients who are not adequately managed with oral medication alone may also be recommended to undergo surgery.
For patients who have been recommePatients without an obvious neck mass nor symptoms can still be diagnosed with goiter, usually through an incidental finding of thyroid nodules from an imaging study (ultrasound, CT or MRI) intended for a different medical condition. The basic work-up for goiter is still done for these patients. Medication may be recommended depending on thyroid hormone levels. A biopsy may also be recommended, depending on the size of the nodule. However, if the nodule is deemed too small for a needle biopsy, it may instead be monitored closely through regular thyroid ultrasound.nded to undergo surgery, it is ideal to consult an otolaryngologist-head and neck surgeon (ENT).
Incidental finding of thyroid nodules
Patients without an obvious neck mass nor symptoms can still be diagnosed with goiter, usually through an incidental finding of thyroid nodules from an imaging study (ultrasound, CT or MRI) intended for a different medical condition. The basic work-up for goiter is still done for these patients. Medication may be recommended depending on thyroid hormone levels. A biopsy may also be recommended, depending on the size of the nodule. However, if the nodule is deemed too small for a needle biopsy, it may instead be monitored closely through regular thyroid ultrasound.