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Thyroid Diseases

Goiter Treatment With Iodine Sensitivity

04/25/2006

Question:

How can goiter be treated with a severe allergic reaction to iodine? (anaphylaxsis)

Answer:

If a goiter is secreting too much thyroid hormone, then there are three options for treatment: surgery, pills, and radioactive iodine.  However, if the goiter is not secreting too much thyroid hormone, and if it is large enough to require treatment, then surgery would be the treatment of choice.

However, not all goiters need to be treated. The main indications for operating on a goiter (that was not making too much thyroid hormone) would be:

1) If the goiter were getting progressively larger and larger

2) If the goiter were causing uncomfortable symptoms by pressing on important structures in the neck.  The symptoms of this would be permanent hoarseness, difficulty swallowing, or (rarely) difficulty breathing. Permanent = hoarseness that is there all of the time and not hoarseness that comes and goes.

Even if there are no symptoms, we would usually operate on a goiter that was so large that it compressed the breathing tube or pushed it aside (usually it would take at CT scan to find that).

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Response by:

Thomas A Murphy, MD, FACP, FACE Thomas A Murphy, MD, FACP, FACE
Associate Professor of Medicine
School of Medicine
Case Western Reserve University