When I dealt with Graves’ disease in 2008/2009 I had a mild goiter, which is a swelling of the thyroid gland. In my case it was caused by the hyperthyroidism associated with my condition. But there can be other causes of goiter, and while I’ve written a few different articles on this topic, since I get a lot of questions related to thyroid swelling I figured I’d put together an updated post which includes five things you should know.
1. Any thyroid hormone imbalance can cause a goiter. In the opening paragraph I mentioned how I had a mild goiter when I dealt with Graves’ disease, and both hyperthyroidism and hypothyroidism can lead to an enlarged thyroid gland. When this is the case the obvious goal should be to correct the thyroid hormone imbalance. While you always want to address the underlying cause, while doing this it might be necessary to take something to increase or decrease the thyroid hormone levels. For example, if someone has hyperthyroidism then they might need to take antithyroid medication (i.e. methimazole) or herbs (i.e. bugleweed), whereas if someone has hypothyroidism they might need to take thyroid hormone replacement.
2. There can be other causes of thyroid swelling. Here are some of the causes of nontoxic goiter according to a research article (1) [1]:
- Physiological goiter (puberty, pregnancy)
- Iodine deficiency
- Goitrogens (broccoli, cabbage, goitrogenic drugs)
- Radiation exposure
- TSH release from the pituitary glands
- Autoimmunity
- Infections
- Granulomatous disease
I’m not going to discuss all of these, but I will talk about a few of them. Let’s start with cruciferous vegetables, which are considered to be goitrogens, which in turn can potentially inhibit thyroid function, thus leading to a goiter. While exposure to goitrogens can be a potential cause of a goiter, most people do fine eating cruciferous vegetables. This includes those with hypothyroidism and hyperthyroidism. In fact, in the past I’ve intentionally tried using raw cruciferous vegetables to lower thyroid hormone levels in some of my hyperthyroid patients with no success. Therefore, I encourage most of my patients to eat plenty of cruciferous vegetables.
Next I’d like to talk about iodine [2], as an iodine deficiency can potentially cause a goiter. In fact, this is how goitrogens can cause a goiter, as they can inhibit iodine metabolism. However, most people with Graves’ disease and Hashimoto’s who have a goiter don’t have one as a result of an iodine deficiency. On the other hand, some cases of toxic multinodular goiter [3] can be caused by an iodine deficiency.
Two other potential causes of a goiter not mentioned above include insulin resistance [4] and problems with estrogen metabolism [5]. These two conditions not only can cause a goiter, but can also lead to the development of thyroid nodules [6] as well. As a result, it’s important to address these problems.
3. Essential oils such as myrrh and frankincense might help if the cause of the goiter is inflammatory in nature. The truth is that other natural anti-inflammatory agents can help to reduce a goiter if it’s inflammatory in nature. But I’m focusing on essential oils [7] here because a lot of people ask whether rubbing essential oils on their thyroid gland can help. Once again, it depends on the cause of the problem, as there are people who have received great benefits from rubbing essential oils such as myrrh and frankincense on their thyroid gland, but there also have been people who didn’t see any benefits when using these. I need to remind you that essential oils are very concentrated, and so you only would need to use one or two drops of each essential oil, and you would want to dilute them with a carrier oil (i.e. fractionated coconut oil). Then you can put the diluted oils in a roller ball and rub it on the thyroid gland.
4. Surgery may be the best option for some people with larger goiters. I’m not suggesting that everyone with a large goiter should get thyroid surgery, but it’s important to mention that very large goiters are unlikely to decrease to their original size. This doesn’t mean that they can’t shrink at all, but if the goiter is very large and is causing any type of obstruction then surgery might be necessary. And I probably don’t have to mention that another situation when surgery probably is necessary is when there is a malignancy. That being said, if someone has a very large goiter with no obstruction, and cancer isn’t suspected, then they might as well try to address the cause of the goiter.
5. In order to shrink a goiter you need to address the cause of the thyroid swelling. It’s not always easy to determine the underlying cause. If someone developed a goiter shortly after being diagnosed with hyperthyroidism or hypothyroidism then it makes sense to first address the cause of the thyroid hormone imbalance and see if the thyroid swelling decreases. If this doesn’t happen then other causes are likely, and I listed some of the more common ones earlier.
So when someone asks if there is anything they can do to shrink their goiter, in most cases the answer is “yes”, although how much depends on the size of the goiter. And you need to find and address the cause of the problem. Below I’ll list what I would focus on in the order of priority for those who have a goiter:
1. Balance your thyroid hormone levels. Once again, this includes taking antithyroid medication or herbs for those with hyperthyroidism/Graves’ disease, and thyroid hormone replacement for those with hypothyroidism/Hashimoto’s. Obviously these aren’t permanent fixes, but they might be necessary to take while addressing the underlying cause.
2. Do things to reduce inflammation. Just as is the case with balancing the thyroid hormone levels, you want to address the cause of the inflammation. For example, if someone has inflammation due to a gut infection or eating gluten, then taking a turmeric supplement isn’t the solution. That being said, sometimes supplementation can help, and I’ll add that having healthy vitamin D levels are essential.
3. Determine if insulin resistance and/or estrogen metabolism are problems, and if so, address them. I won’t get into detail with these here, as I’ve written separate articles on insulin resistance [4] and estrogen metabolism [5], and you also might want to check out this video on estrogen metabolism [8].
4. Consider an iodine deficiency. This is especially true if someone has non-autoimmune hypothyroidism or multinodular goiter. If testing for iodine I would recommend urinary iodine testing.
What’s Your Experience With Thyroid Swelling?
Have you dealt with a goiter, or do you currently have one? And if so, what have you done to try to address the cause of it? Please feel free to share your experience with everyone in the comments below. Thank you for sharing!