Goiter and Iodine Disorders

A goiter is an enlarged thyroid gland. It describes anatomy, not hormone function. A patient with a goiter may be euthyroid, hypothyroid, or hyperthyroid, so the visible or palpable enlargement cannot tell the nurse whether thyroid hormone is high, low, or normal. The thyroid enlarges when it is persistently stimulated or structurally altered. Diffuse enlargement may occur with iodine deficiency, Graves disease, or autoimmune thyroiditis. An irregular or nodular gland suggests multinodular goiter or one or more thyroid nodules. Enlargement can also reflect inflammation or, less commonly, malignancy. The clinical question is not simply, “Is the thyroid enlarged?” It is, “Is this gland affecting the airway, producing abnormal hormone levels, or showing features that raise concern for cancer?”