Last updated: June 1, 2021

Summarytoggle arrow icon

Goiter is any abnormal enlargement of the thyroid gland. The condition has various causes, with the most common worldwide being iodine deficiency. In the US, however, Hashimoto's and Graves' disease are more common etiologies. Goiters can be classified based on their morphology, function, or dignity (benign or malignant). Symptoms depend on etiology and are often absent. However, patients may present with hyperthyroidism or hypothyroidism. Large goiters may also cause obstructive symptoms due to compression of the trachea and/or the esophagus. Diagnosis is established based on clinical examination, laboratory tests, and imaging techniques. Management depends on the underlying condition and may include administering iodine (for treating nontoxic euthyroid goiter) or performing surgery (e.g., for treating local compression or thyroid cancers).

Epidemiologytoggle arrow icon

  • Sex: > (4:1)
  • Frequency: decreases with age

Epidemiological data refers to the US, unless otherwise specified.

Etiologytoggle arrow icon

Classificationtoggle arrow icon

Thyroid gland versus goiter


Thyroid function of goiter

Dignity of goiter


Clinical featurestoggle arrow icon

Diagnosticstoggle arrow icon

Classification of goiter by palpation

According to the World Health Organization (WHO) classification:

  • Grade 0: no goiter is palpable or visible.
  • Grade 1: palpable goiter, not visible when neck is held in normal position
  • Grade 2: a clearly swollen neck (also visible in normal position of the neck) that is consistent with a goiter on palpation


Treatmenttoggle arrow icon

  • Nontoxic goiter
    • Treatment is not needed if the patient is asymptomatic.
    • Schedule follow-ups for possible dysfunctional thyroid and/or obstructive symptoms.
  • Large goiter (> 80 mL)
  • Iodine deficiency: iodine supplementation
  • In other cases, goiter treatment varies depending on the exact etiology (see “Etiology” above).

Referencestoggle arrow icon

  1. Lewinski A. The problem of goitre with particular consideration of goitre resulting from iodine deficiency (I): classification, diagnostics and treatment. Neuro Endocrinol Lett. 2002; 23 (4): p.351-355.
  2. Pankow BG, Michalak J, McGee MK. Adult human thyroid weight.. Health Phys. 1985; 49 (6): p.1097-103.
  3. Gómez JM, Maravall FJ, Gómez N, Gumà A, Soler J. Determinants of thyroid volume as measured by ultrasonography in healthy adults randomly selected.. Clin Endocrinol (Oxf). 2000; 53 (5): p.629-34.

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 Evidence-based content, created and peer-reviewed by physicians. Read the disclaimer