Is My Enlarged Thyroid Cause for Concern?

Monday, 19 May 2014 04:15 PM

By Peter Hibberd, M.D.

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Question: I have been to a couple of primary care doctors in the last few years and my thyroid numbers are generally closer to the lower limits. My thyroid is also enlarged, but because my hormone levels were within the limits, it was OK. Should I be concerned? Or should I take iodine supplements? 

Dr. Hibberd’s answer:
 
I would normally not be overly concerned with low-normal thyroid hormone levels. But an enlarged thyroid with low-normal values is worth assessing to establish whether you have a problem or not. I certainly would not take iodine supplements before further evaluation. But if you happen to be iodine deficient, this could be one of several reasons why your gland is enlarged.
 
You did not mention how you are feeling, so I cannot factor your symptoms into this answer for you.  Usually borderline values have to be evaluated in conjunction with your symptoms and your general medical condition, including any co-existing conditions.
 
An enlarged thyroid gland requires closer attention. If your thyroid hormone levels are lower than your usual baseline, your gland may be enlarging to compensate for the downward trend. It is also possible that you have an autoimmune disorder that is affecting your thyroid. Often an ultra-sensitive TSH (thyroid stimulating hormone) test will help determining what is happening. TSH is a pituitary hormone that elevates to stimulate the production of more thyroid hormone when the brain perceives a deficiency.
 
Since your gland is enlarged, it would be wise for you to see an endocrinologist to decide whether a small supplemental thyroid dose will help reduce it and prevent further enlargement, whether you are iodine deficient, or have early autoimmune problem that should be treated now, in early stages. It is much wiser to prevent an enlarged thyroid than to try to treat an enlarged gland that may not reduce in size despite adequate treatment.

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