Goitre and iodine deficiency
A goitre is a swelling of the thyroid gland at the front of the neck. In Afghanistan the most common cause is too little iodine in food, which can also cause tiredness and, in pregnancy, can harm the development of the baby's brain. Using iodised salt prevents most cases. Most goitres are not cancer, but every new neck lump should be checked.
Symptoms
- Swelling at the front of the neck that moves up when you swallow
- A feeling of tightness in the throat
- Difficulty swallowing or breathing if the goitre is large
- Hoarse voice
- Signs of an underactive or overactive thyroid in some people
Causes
- Too little iodine in food and water (common in mountain areas)
- Not using iodised salt
- Autoimmune thyroid disease (Hashimoto or Graves disease)
- Thyroid nodules
- More common in women and during pregnancy
Prevention
- Use only iodised salt for cooking and at the table
- Keep salt in a closed container away from sunlight and damp, and add it near the end of cooking
- Pregnant and breastfeeding women especially need enough iodine
- Eat a varied diet including eggs, milk and yoghurt
Treatment
- Blood tests (TSH) and often a neck ultrasound to find the cause
- Small goitres with normal hormone levels often only need watching
- Treatment of an underactive or overactive thyroid if present
- Surgery for very large goitres, breathing or swallowing problems, or suspicious lumps
- Do not take iodine tablets or thyroid medicines without a doctor
Common questions
Is a goitre cancer?
Most goitres are not cancer. But a hard, fast-growing or single lump should be checked by a doctor, usually with an ultrasound and sometimes a needle test.
Why is iodised salt important in pregnancy?
The baby needs iodine for brain development. Too little iodine in pregnancy can cause miscarriage and lower the child's ability to learn, so pregnant women should always use iodised salt.