A goitre is an enlarged thyroid gland. It is not a disease in itself but a finding that can have several underlying causes. It is common in Turkey, which lies in a region where iodine deficiency occurs. Most goitres do not need surgery. An operation is considered where there is pressure on the windpipe or oesophagus, a suspicious biopsy result, hyperthyroidism that cannot be controlled with medication, or a goitre extending into the chest.
Although goitre is spoken of as though it were a single disease, it is in fact a finding: an enlarged thyroid gland. The underlying cause varies from person to person, and treatment follows that cause. Turkey lies in a region where iodine deficiency has historically occurred, so goitre is more common here than the global average.
What Does the Thyroid Do?
This butterfly-shaped gland at the front of the neck, just below the Adam's apple, produces the hormones that regulate metabolism. It directly affects body temperature, heart rate, weight balance, digestive speed and mood. It needs iodine to make those hormones; where iodine is short, the gland is driven to work harder and enlarges over time. That is the classic cause of goitre.
Types of Goitre
Simple (diffuse) goitre. The gland is enlarged as a whole, with no nodules. It is usually due to iodine deficiency and hormone levels may be normal.
Nodular goitre. One or more nodules are present within the gland. It is divided into single-nodule and multinodular forms, and is the commonest type.
Toxic goitre. The gland produces excess hormone, that is, hyperthyroidism. It shows as palpitations, weight loss, sweating, tremor and irritability.
Retrosternal goitre. The enlarged gland extends into the chest. Because it can cause breathlessness and difficulty swallowing, the decision to operate comes more readily in this type.
What Are the Symptoms?
Small goitres usually cause no symptoms at all and are found incidentally on examination or ultrasound done for another reason. As the gland enlarges, the following can appear:
- Visible swelling or fullness in the neck
- A sensation of something catching in the throat
- Difficulty swallowing, particularly with solid food
- Breathlessness that worsens lying flat
- Hoarseness or a change in the voice
- Where hormone balance is disturbed: palpitations, fatigue, weight change, feeling cold or excessive sweating
Note. A rapidly growing goitre, a nodule that becomes hard, persistent hoarseness and a palpable lymph node in the neck call for further assessment.
How Is It Assessed?
- Examination. The size and consistency of the gland and the presence of nodules are assessed by hand.
- Blood tests. TSH, free T3 and T4 establish whether the gland is overactive, underactive or normal. Thyroid antibodies are added where needed.
- Ultrasound. The most decisive investigation. Gland volume, the number, size, structure, calcifications and blood flow of nodules are assessed.
- Scintigraphy. Where there is hyperthyroidism, it shows whether a nodule is "hot" or "cold".
- Fine-needle biopsy. Performed on nodules with suspicious features on ultrasound. The result is reported using the Bethesda classification and determines the treatment decision.
Treatment: Not Every Goitre Needs Surgery
This is the most important point. Most goitres are followed at intervals rather than operated on.
Observation. Used for small goitres without symptoms and with a benign biopsy; an annual ultrasound and blood test are generally enough.
Medication. Hormone replacement where the gland is underactive, antithyroid drugs where it is overactive.
Radioactive iodine. Considered as an alternative to surgery in some cases of hyperthyroidism.
Surgery. Comes into consideration where there is:
- A suspicious or malignant biopsy result
- A large goitre pressing on the windpipe or oesophagus
- A retrosternal goitre extending into the chest
- Hyperthyroidism not controlled by medication or radioactive iodine
- A rapidly growing nodule
- Cosmetic concerns arising from marked size
Surgery and Protecting the Voice
The recurrent laryngeal nerve, which moves the vocal cords, runs immediately alongside the thyroid. Nerve monitoring allows it to be tracked continuously during the operation and warns the surgeon on approach.
The incision is placed in a natural crease of the neck, so the scar becomes indistinct over time. Hospital stay is usually 1 to 2 days. Where the whole gland is removed, lifelong hormone replacement is needed; where a single lobe is removed, the remaining part often carries the function on its own.
Because the parathyroid glands that regulate calcium sit immediately behind the thyroid, calcium levels are monitored in the first days. A temporary fall in calcium can occur and usually settles.
Minimally Invasive Thyroid Surgery Training in Rome
In 2009 Op. Dr. Ersan Semerci completed training in minimally invasive thyroid surgery at the Department of Endocrine Surgery, Catholic University of Rome. Thyroid and parathyroid surgery is among the official specialty areas listed on his hospital profile.
He also completed the Thyroid School training programme in 2017. His publications include a study on the prevalence of autoimmune thyroiditis in thyroidectomy cases and research on the comparison of nodule diameter measured by ultrasonography and by macroscopic pathological examination in patients with multinodular goitre. The second bears directly on the subject of this article: it asks how accurately ultrasound reflects nodule size in goitre.
Op. Dr. Ersan Semerci has practised in Mersin since 2010 and currently works at VM Medicalpark Mersin Hospital. Thyroid consultations and operations are carried out at this hospital.
Op. Dr. Ersan Semerci has practised in Mersin since 2010 and currently works at VM Medicalpark Mersin Hospital. Consultations and operations in Goitre are carried out at this hospital. Patients travelling from Mersin and neighbouring provinces can book via WhatsApp.
Book on WhatsAppIs a goitre cancer?
No. A goitre is an enlargement of the thyroid gland and the great majority are benign. The possibility of cancer is assessed through suspicious features on ultrasound and fine-needle biopsy.
Is iodised salt enough for goitre?
Iodised salt is effective in preventing iodine-deficiency goitre at population level. It cannot be expected to reverse an established goitre on its own; treatment follows the cause.
What happens if I do not have surgery?
Where observation has been decided on for a small goitre without symptoms, there is usually no problem. But with a goitre that presses on structures, grows rapidly or has a suspicious biopsy, waiting increases the risks.
Will my voice change after surgery?
Temporary hoarseness can occur and usually settles. Using nerve monitoring during the operation markedly reduces the risk of a permanent voice problem.
Can a goitre come back?
If a single lobe was removed, new nodules can develop in the remaining tissue over time. Follow-up at intervals therefore continues after surgery.
The move from the first days back to normal eating, the foods to limit, why diarrhoea occurs afterwards, and the symptoms that need a doctor.
Answers to the most common questions about appointments, the hospital, treatment scope and surgical experience are in the FAQ section on the home page.
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For Goitre and related symptoms you can book an appointment at VM Medicalpark Mersin Hospital. Mezitli / Mersin, Turkey, weekdays 09:00-17:00.
WhatsApp: +90 542 236 05 33Disclaimer. This article is provided for general information only. It does not constitute medical advice, diagnosis or a treatment recommendation, and it is not a substitute for examination, diagnosis and treatment by a physician. The content is not tailored to any individual and is not intended as advertising. Do not start, change or stop any treatment on the basis of the information here. Consult your own doctor about any decision concerning your health and see a healthcare provider about your symptoms. The site owner accepts no liability for any consequences arising from use of this content. Last updated: 2026-08-11.