If you think you have a goitre, see your GP. They can examine your neck to see if there's any thyroid gland swelling. They may request blood tests to check if your thyroid gland is working properly.

Thyroid function test

A thyroid function test is a type of blood test.

A sample of your blood is taken and measured for levels of:

• thyroid-stimulating hormone (TSH)
• thyroxine and triiodothyronine (the thyroid hormones) 

If you have lower- or higher-than-average levels of these hormones, it could mean you have a thyroid disorder or you're at risk of developing one in the future.

Read more detailed information about diagnosing an overactive thyroid and diagnosing an underactive thyroid.

Referral to a hospital specialist

Your GP may refer you to a specialist thyroid clinic or a specialist in hormone-related illnesses (an endocrinologist) if you have a thyroid swelling and:

• it's getting bigger
• you have a family history of thyroid cancer
• you have had radiation treatment to your neck 
• you have swollen lymph nodes in your neck
• you're a child or teenager
• you're 65 or over
• your voice has changed
• you're making a high-pitched noise as you breathe
• you're having difficulty breathing or swallowing

If you're referred to a specialist, you may have further tests on the goitre in hospital.

These include:

• a radioactive iodine scan
• an ultrasound scan
• fine needle aspiration (biopsy)

Radioactive iodine scan

With this scan, a small amount of radioactive iodine is injected into a vein in your arm.

The iodine builds up in your thyroid gland, which can then be studied using a special camera.

The scan can provide useful information about the structure and function of your thyroid gland.

As the amount of radiation used is very small, it's perfectly safe for most people. But it may not be suitable if you're pregnant.

Ultrasound scan

An ultrasound scan uses high-frequency sound waves to create an image of part of the inside of your body.

It can be used to:

• build up a picture of the inside of your thyroid gland
• assess the size of your thyroid gland
• check whether there are any enlarged nodules in your thyroid gland not found during the physical examination

Fine-needle aspiration

Fine-needle aspiration is a procedure where a sample of the goitre is extracted so the cells inside it can be tested.

This procedure is often known as a biopsy. 

During the procedure, a fine needle on the end of a syringe is inserted into the goitre in your throat.

A sample of the fluid or tissue inside the goitre is sucked through the needle into the syringe.

The sample can be examined under a microscope to determine what kind of cells are inside the goitre.

Treatment for a goitre can include medicine, hormone therapy and surgery.

The treatment you receive will depend on:

• the size of the goitre
• the symptoms the goitre is causing
• whether you have any underlying thyroid condition

You may just be monitored if tests reveal your thyroid gland is working normally and the goitre is small. 

If your goitre is interfering with your breathing or swallowing and it has not responded to other forms of treatment, you may need surgery to remove part or all of your thyroid gland.

This procedure is known as a thyroidectomy.

Treating thyroid gland problems

If tests reveal a problem with your thyroid gland, you may receive treatment for:

• an overactive thyroid gland (hyperthyroidism), which may include taking a type of medicine known as thionamides or a type of radiotherapy called radioiodine treatment
• an underactive thyroid gland (hypothyroidism), which usually involves taking a synthetic hormone called levothyroxine to replicate your normal thyroid function

Read more about treating hypothyroidism and treating hyperthyroidism.

Iodine supplements

A well-balanced diet usually provides all the iodine your body needs. Iodine supplements are not usually required in developed countries like the UK.

A GP can give more advice about extra supplements, if needed.

Iodine supplements are available in many health food shops without a prescription.

But always talk to a GP before taking them, as the amount of iodine needed varies from person to person.

Taking too much iodine may cause other health problems, and could also have toxic effects.

Thyroid gland surgery

Before having surgery to remove some or all of your thyroid gland, you'll be given a general anaesthetic so you're unconscious and unable to feel anything.

During surgery, the surgeon makes a cut in the front of your neck so they can see your thyroid gland.

How much of the thyroid gland is removed depends on the underlying condition causing the goitre.

The procedure reduces the size of your goitre and the amount of thyroid hormones being produced.

The surgeon will attempt to remove enough of your thyroid gland to relieve your symptoms, while leaving enough so normal thyroid hormone production can continue.

But you may need hormone therapy after surgery if this is not possible.

Complications of thyroid gland surgery

Surgery to remove some or all of the thyroid gland is usually safe, but as with all operations, there's a risk of complications.

The risk of complications happening after thyroid gland surgery is estimated to be 1 to 2 in 100.

Before having the surgery, discuss the risks with your surgeon.

Infection, nerve damage and parathyroid gland damage are the main complications of thyroid gland surgery.

Infection

As with all surgery, there's a risk of infection after thyroid surgery.

Nerve damage

The thyroid gland is very close to the laryngeal nerves, which control your vocal cords.

If these are accidentally damaged during surgery, your voice and breathing could be affected.

Permanent damage to the laryngeal nerves affects 1 to 2 people in every 100 who have this type of surgery.

Temporary damage may affect up to 5 people in every 100.

Parathyroid gland damage

The parathyroid glands are tiny glands behind the thyroid. They help regulate the amount of calcium in your body.

If the parathyroid glands are damaged during thyroid surgery, you'll probably need to take calcium supplements for the rest of your life.