Hi! Doctor, Please I’ve being battling with goiter for the past three years now and I am scared of surgery. Please, is there any suggested treatment for it? Thanks

A: Swelling of the thyroid gland which is seen as a neck swelling is called goiter. But how does this develop? I’ll start from the beginning.

Hyperthyroidism is a condition that occurs when your body produces too much thyroid hormones. These hormones are usually produced by a butterfly shaped organ located at the front of your neck, called the thyroid gland. These thyroid hormones produced typically control the rate at which the body converts food t energy (metabolic rate) and also controls a whole lot of other cells and tissues like your bones (the hormones determine how your body incorporates calcium into your bones), the rate of your heart beats, your muscle contraction, cholesterol levels etc

Most cases of hyperthyroidism is caused by Graves’ Disease in which the body no longer recognizes the thyroid gland as part of it and produces antibodies to fight it. In response, the thyroid gland produces excessive amounts of thyroid hormones.

As in the case above, there may not be any family history though it is known to run in families.

Thus in hyperthyroidism, you may have no symptoms (leading to a chance discovery) or you may have symptoms including fast heart beats/palpitations, swelling of the thyroid gland which is seen as a neck swelling (goiter).The higher than normal metabolic rate would lead to symptoms like increased appetite, weight loss, sweating and increased sensitivity to heat, restlessness, tremors, tiredness, difficulty sleeping etc. In Graves’ Disease, there are also eye symptoms which include protrusion of the eyeballs, red and swollen eyelids, watering of the eyes and double vision.

The doctor will examine the person with symptoms and run blood tests to check for the level of thyroid hormones. Treatment could be with surgery, medications or a combination of both. The drug Carbimazole is an example of a medication used for hyperthyroidism, which stops the thyroid gland from making new thyroid hormones but does not affect the hormones already produced. As a result, it may take a while to notice an improvement in symptoms. The use of this drug may be for about 12-18 months in the first instance. This may be sufficient to deal with the situation. In some instances though, this may recur needing more treatment, probably with a different drug.

You will need blood tests regularly though to monitor the level of your thyroid hormones.

Depending on your degree of weight loss, you may need to have a dietician walk you through your diet paces and ensure that you are getting enough calcium and vitamin D. Wearing sunglasses, using eye drops that moisten the eye (artificial tears) and ensuring that the head is elevated when sleeping or lying down will help reduce the symptoms of Graves’ Disease. If you smoke, stop…this may help prevent developing Graves’ Disease or prevent the eye problems associated with it, if you already have the disease.

Treatment for hyperthyroidism is usually effective and so you should be able to live a normal life. You’ve got to focus on the positives and take on each day as it comes. You may not have to take drugs all your life but then again, depending on the outcome of your initial therapy, you may have to. This may sound daunting but really shouldn’t be. Many people take ‘self-imposed’ vitamin supplements every day

Just have a positive attitude about it and learn to look at this cup as half full rather than half empty. Keep your chin up and keep me posted.