Published October 26 2015
A goiter is an enlargement of the thyroid gland, and is commonly seen when someone has an imbalance of thyroid hormone. A goiter can be present in both hyperthyroid and hypothyroid conditions. I had a small goiter when I was dealing with Graves’ Disease, and even though it was small I had some difficulty swallowing certain supplements, especially fish oils. In some people the goiter can become severe enough where it can cause extreme difficulty in swallowing, as well as breathing.
I commonly receive emails from people who have a goiter and want to know if natural treatment methods can help. They want to know which foods they should avoid, and what supplements and herbs they can take to shrink their goiter. Unfortunately not all goiters can be decreased. And of course if someone has a large goiter that is causing an obstruction then a natural treatment approach might not be the best option. When this isn’t the case, then in order to effectively shrink a goiter, the goal should be to address the underlying cause. And so let’s go ahead and look at some of the common causes of goiters.
Iodine Deficiency. An iodine deficiency is a common cause of a goiter. If someone is consuming a good amount of iodized salt then this might not be an issue, although besides the fact that a lot of people use natural sea salt instead of iodized salt, another problem is that certain goitrogens can inhibit iodine metabolism. In other words, even if you get plenty of iodine in your diet, exposure to goitrogens can interfere with its metabolism. Although there is some concern over raw foods such as broccoli, kale, and cabbage having a goitrogenic effect, eating these foods usually won’t cause an iodine deficiency, and so in most cases I encourage my patients to continue eating these healthy foods.
Certain environmental toxins can have a goitrogenic effect, and exposure to these toxins can lead to an iodine deficiency, even in someone who consumes iodized salt on a daily basis. Bromine can be a big factor in iodine deficiency (1), as it competes for the same receptors as iodine. And bromine exposure is common, as it’s found in flour and dough conditioners in the form of potassium bromate. Potassium bromate can induce oxidative stress and may contribute to neoplasia in endocrine glands (2). It also has been shown to be nephrotoxic in both human and animal studies (3). Plus, in addition to chlorine, bromine is commonly used in swimming pools as a disinfectant (4). Thiocyanates and perchlorate also have a goitrogenic effect. Studies show that consumption of naturally occurring goitrogens, certain environmental toxins, and cigarette smoke can significantly increase thiocyanate concentrations to levels potentially capable of affecting the thyroid gland (5).
Hyperthyroidism. An excess of thyroid hormone can also cause a goiter. In this case the obvious solution is to decrease the thyroid hormone levels. The conventional method usually involves giving the person antithyroid medication, although radioactive iodine treatment is commonly recommended to obliterate the cells of the thyroid gland. There are natural herbs and supplements which have antithyroid activity such as bugleweed, lemon balm, and higher doses of L-carnitine, and so all of these can help as well. Of course the primary goal should be to address the cause of the hyperthyroid condition. Most cases of hyperthyroidism are due to Graves’ Disease, which is an autoimmune condition which involves the immune system attacking the TSH receptors, which in turn leads to the excess production of thyroid hormone. While taking antithyroid drugs or herbs can help lower the thyroid hormone levels and thus shrink one’s goiter, one also should try to find out what’s triggering the autoimmune response so they can remove this trigger and restore the health of the person.
Hypothyroidism. Although an iodine deficiency can cause hypothyroidism, in most cases, hypothyroidism is caused by the immune system attacking the thyroid gland. This of course describes Hashimoto’s Thyroiditis, which is an autoimmune condition that results in damage to the thyroid gland, and thus the thyroid hormone levels will usually decrease. When the thyroid hormone levels get low the pituitary gland produces more TSH, which signals the thyroid gland to produce thyroid hormone, and this in turn can cause the gland to enlarge. While taking thyroid hormone medication might be necessary at times and can help to shrink the goiter, just as is the case with Graves’ Disease, the goal should be to address the autoimmune component of the condition.
Thyroid inflammation. Inflammation of the thyroid gland is also known as thyroiditis. I briefly mentioned Hashimoto’s Thyroiditis, which is the most common cause of thyroid inflammation. This once again is caused by the immune system attacking the thyroid gland. However, other conditions can also cause thyroid inflammation. Subacute thyroiditis involves thyroid inflammation which in turn damages thyroid follicles. This leads to large amounts of thyroid hormones being released into the circulation. This condition is usually caused by a virus and is temporary. Direct trauma to the thyroid gland of course can result in thyroid inflammation. There are a few case studies which showed that trauma to the thyroid gland can lead to thyroid storm (6) (7).
Multinodular goiter. This condition involves enlargement of the thyroid gland, along with multiple goiters. Iodine deficiency is a common cause of multinodular goiter (8) (9). Radioactive iodine is commonly recommended for multinodular goiter, although some people respond to a natural treatment approach. I’ve written a separate article on this entitled “Multinodular Goiter and Natural Treatment Methods“.
Pregnancy. During pregnancy there are metabolic changes which require an increased output of thyroid hormone. While having an iodine deficiency or Hashimoto’s Thyroiditis alone can lead to a goiter, due to the increased requirements of thyroid hormone during pregnancy, the risk of developing a goiter is even greater for a pregnant woman who has an iodine deficiency and/or Hashimoto’s Thyroiditis (10). With regards to iodine, the World Health Organization recommends 200 mcg of iodine per day for pregnant women (11). Some pregnant women with Hashimoto’s Thyroiditis might be cautious about taking iodine during pregnancy, and I discussed this in detail in a post I wrote entitled “Should Pregnant Women With Hashimoto’s Thyroiditis Take Iodine?“.
Are There Any Supplements You Can Take That Can Shrink Your Goiter?
Although I realize that many people are looking for a quick fix or a “magic” supplement to improve their health, regardless of what condition you’re dealing with, the goal should be to address the underlying cause of the problem. And it’s no exception when someone has a goiter. While there are supplements and herbs which can help to shrink a goiter, you first need to try to find the underlying cause. For example, if someone has hyperthyroidism then they can take antithyroid medication or an herb such as bugleweed to lower the thyroid hormone levels, which in turn can help with the goiter. However, doing this alone won’t do anything for the underlying cause of the condition. The same concept applies with taking thyroid hormone medication for a condition such as Hashimoto’s Thyroiditis, as this might help to shrink a goiter, but it won’t do anything to address the autoimmune response.
On the other hand, if someone has an iodine deficiency that is causing a goiter, then increasing their iodine intake should help to shrink the goiter. Keep in mind that I’m not suggesting that people with a multinodular goiter should take large amounts of iodine. Although iodine can be beneficial in many cases, there are also risks with taking iodine, especially in very high doses. Plus, if you are being exposed to certain goitrogens such as bromine that is causing the iodine deficiency then this also needs to be addressed.
If someone has thyroid inflammation then once again, addressing the cause of the problem is important. However, in the meantime taking things for inflammation such as turmeric might be helpful. In fact, one study involving 2,335 people showed that turmeric use was associated with reduced goitrogenesis (12). Turmeric has numerous other benefits, and so if someone has a goiter then it might be worth taking a turmeric supplement. It’s important to understand that turmeric is poorly absorbed, and so you want to make sure to take a formulation that greatly increases its bioavailability (13) (14).
So hopefully you have a better understanding of some of the more common causes of a goiter, and what you can do to shrink it. Although many people who have a goiter look to take supplements or herbs to shrink it, the primary goal should be to determine the cause of the goiter. Once you determine the cause of the goiter you can then use the information presented in this article to determine which supplements and herbs might be the most beneficial to help shrink it. If you have a condition such as Graves’ Disease or Hashimoto’s Thyroiditis, just keep in mind that while taking supplements might help to shrink the goiter, these usually won’t do anything to restore the health of the immune system.