Multinodular Goiter Surgery and Medication

What to Expect from our Endocrinologists

Providence Saint John’s Health Center provides comprehensive and compassionate medical services in the field of endocrinology. If you have been diagnosed with multinodular goiter or if you are observing symptoms related to the condition, schedule an appointment with us right away. From diagnosis to treatment and recovery, our expert staff at the Endocrine Tumor and Bone Disease Program, led by physician-scientists Dr. Melanie Goldfarb and Dr. Frederick Singer, will have the answers for all of your needs.

Diagnosing Multinodular Goiter

When you consult an endocrinologist, the first thing you can expect is a set of questions about your family’s medical history. In this portion, you may be asked whether anyone else among your close relatives have had goiter or other growths in the chest and neck area. This is usually followed by a thorough physical examination that will help your doctor assess the situation closely.

The next step is to have a thyroid ultrasound. This is a painless and non-intrusive procedure where sound waves are projected through a person’s neck. The ultrasound device converts sound patterns into images and provides useful information such as the size of the goiter, how many nodules it has, whether it’s solid or cystic, how light or dark it appears and what its general features are.

Depending on thyroid cancer risk factors such as nodule sizes, family history, and ultrasound findings, your doctor may request a fine needle aspiration biopsy. This procedure extracts cells from a nodule using a small needle similar to those used to draw blood. A cytologist then performs a microscope examination in a laboratory for proper evaluation.

Treatment, Recovery, and After-Effects

Surgery where part or all of the thyroid is removed (thyroidectomy) is the most effective option for treating multinodular goiter. Medication has been given as an option in the past, but research has shown that this approach is usually ineffective.

Thyroidectomy is done under general anesthesia, so you will not be conscious during the procedure. After sedation, the patient is taken to an operating room and is hooked up to vital sign monitors. When pre-operation preparations are complete, the operating team starts with a small incision at the middle of the neck. All or part of the thyroid is removed and depending on the patient’s condition, and surrounding lymph nodes may also be removed. Thyroidectomy usually takes several hours and the patient will be taken to a recovery room afterwards.

Normally, patients can leave the hospital a full day after surgery. They may experience hoarseness or weakness of the voice, but breathing and swallowing should be normal. The effects on the voice are usually temporary and will usually go away within several days. After 10 days or so, patients typically are able to perform most, if not all of their regular activities.

About Multinodular Goiter and Its Symptoms

Goiter is the general term used to describe a state of abnormal enlargement in the thyroid gland. The thyroid is a ductless gland located in the neck. It secretes hormones that regulate growth and development in the human body. When goiter is caused by the growth of multiple nodules, it’s referred to as multinodular goiter.

At this point, it is unclear what causes the growth of thyroid nodules, though medical researchers suspect genetic factors, exposure to radiation and nutritional deficiencies as the likely risk factors. The appearance of thyroid nodules becomes more likely as people age and is more common in women than in men.

Most cases of multinodular goiter do not produce symptoms that warrant treatment. However, there are cases when the thyroid grows large enough to an extent where it becomes unsightly and obstructive to normal breathing and swallowing. Under these conditions, endocrinologists usually propose a surgical solution to address the problem.

If the multinodular goiter causes the thyroid to produce excessive amounts of hormones, it’s referred to as toxic multinodular goiter. In this condition, the afflicted individual may experience one or more of the following symptoms:

  • Increased heart rate
  • Unexplained weight loss
  • Tremors
  • Irritability
  • General weakness and fatigue
  • Oversensitivity to heat

The growth of nodules in the thyroid may also be a cause for cancer concerns. While 90% of multinodular goiter cases have benign growths, endocrinologists and other medical specialists might suggest a fine needle aspiration biopsy to rule out the disease. 

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