Published September 3 2013
Although most of the people I work with who have hyperthyroid conditions have Graves’ Disease, I have also worked with patients with the condition known as multinodular goiter. This is a condition characterized by a goiter (enlargement of the thyroid gland), along with multiple thyroid nodules. Unlike Graves’ Disease, most people who have a multinodular goiter don’t have an autoimmune component. While I’ve had success in helping people with this condition, it does seem to be a greater challenge helping some of these people restore their health back to normal.
There are two types of multinodular goiters. There is a multinodular toxic goiter, which involves an excess production of thyroid hormone. There is also a non-toxic multinodular goiter, which involves an enlargement of the thyroid gland, along with thyroid nodules, but the person doesn’t experience hyperthyroidism. To no surprise, toxic multinodular goiter is more challenging to treat naturally when compared to non-toxic multinodular goiter.
What Causes The Development of a Multinodular Goiter?
As for what causes a multinodular goiter, the exact cause is unknown. There is evidence that in some cases an iodine deficiency relates to this condition, and one study I came across stated that the prevalence of nodular goiter is directly related to the degree of iodine deficiency (1). The article goes on to state that “in iodine deficient areas such as some Italian regions, nodular goiter is present in 25-33% of the population, whereas in iodine sufficient areas the prevalence of nodular goiter is comprised between 0.4 and 7.2%, with the frequency increasing with age”.
So does this mean that I recommend for everyone with multinodular goiter to take iodine? Not necessarily, as just like everyone else, I will test for an iodine deficiency. And if the person is deficient in iodine then there is a high probability that I will recommend for them to supplement with iodine. On the other hand, if the person doesn’t have an iodine deficiency then I won’t tell them supplement with iodine. Just like everyone else I consult with, I will evaluate their adrenals, gut, minerals, heavy metals, etc. And I will of course look to address any compromised areas.
When an iodine deficiency isn’t the culprit in multinodular goiter, toxins could very well be a big issue. And while many of my patients go through a 21-detoxification program, doing this alone might not be sufficient. Part of the challenge is that it’s impossible to determine how toxic each person is. Although I evaluate the heavy metals through a hair mineral analysis, there are many other toxins which can be causing problems. The company Metametrix has testing for numerous toxins, as you can test for BPA, VOCs, PCBs, organophosphates, chlorinated pesticides, phthalates, and parabens.
However, I have two problems with such testing. The first problem is that testing for all of these toxins is expensive, and many people are unable to afford such testing. The second problem I have is that there are many other toxins which can’t be tested. In other words, while the toxins tested through Metametrix can provide some valuable information, this type of testing won’t reveal all of the toxins in one’s body. And so I just assume that everyone is toxic.
What Is The Conventional Treatment Method For Multinodular Goiter?
Numerous studies show that a total thyroidectomy should be considered the procedure of choice for multinodular goiter (2) (3). This is true even when the someone has benign multinodular goiter (4). Some medical doctors might not recommend surgery if someone has non-toxic multinodular goiter. However, a total thyroidectomy is used frequently for toxic multinodular goiter (5).
One big concern with having a multinodular goiter is the risk of thyroid cancer. While the risk of thyroid cancer in people with this condition is relatively low, a malignancy is still possible. One study looked to compare the thyroid cancer incidence in people with toxic and non-toxic multinodular goiter, and concluded that the incidence of malignancy in toxic multinodular goiter is not very low as thought earlier, and is nearly the same in non-toxic multinodular goiter (6). However, a more recent study looked at whether the prevalence of thyroid cancer is different in thyroid glands with a single nodule versus multinodular goiter (7). It actually involved fourteen studies which included 23,565 patients with multinodular goiter, and 20,723 patients with a single nodule. The conclusion was that thyroid cancer might actually be less frequent in multinodular goiter, and this is especially true outside of the United States and possibly in iodine-deficient areas.
So does this mean that you shouldn’t be concerned about thyroid cancer? There is always a concern, but just as is the case with everything else, one needs to look at both the risks and benefits. And while the risk of having thyroid cancer in people with a multinodular goiter is low, it still is possible. However, there are risks with thyroid surgery itself, such as damage to the parathyroid glands and/or laryngeal nerve. The risk of these procedures is somewhat low, but it is still a risk. And even if the surgery is successful, a total thyroidectomy will mean taking thyroid hormone on a permanent basis. Once again, this might be necessary for some people, but is it really the only option for every single person with a multinodular goiter?
Can Natural Treatment Methods Help With Multinodular Goiter?
Natural treatment methods can help many people with multinodular goiter. If an iodine deficiency is the cause of the condition then this usually is relatively easy to correct. But when there is another cause it can be more challenging. But as is the case with primary hyperthyroidism and Graves’ Disease, there is a cause behind multinodular goiter. And while at times it can be a challenge to restore someone’s health back to normal, if one can avoid a total thyroidectomy then in my opinion it is worth looking into a natural treatment protocol.
In summary, multinodular goiter can be helped naturally, although at times it can be a challenge. Sometimes it can be caused by an iodine deficiency, although there can be other factors which can cause this condition, such as toxic overload. Either way, since the medical approach usually involves a complete thyroidectomy, in many cases it is at least worth looking into natural treatment methods.