A multinodular goitre, or nodular goitre, is a thyroid condition marked by multiple benign nodules forming within the thyroid gland. This often results in the gland enlarging, leading to a visible or palpable swelling in the neck. Multinodular goitres are fairly common and can range in size, causing varying symptoms or potential complications. The exact cause of multinodular goitre isn’t always clear, but several factors may contribute to its development. Iodine deficiency, genetic predisposition, and exposure to goitrogenic substances (compounds that disrupt thyroid function, found in some foods, medications, and environmental chemicals) can all play a role.

Symptoms of multinodular goitre depend on the size and location of the nodules. Common symptoms include:

• Visible Neck Swelling: The most noticeable sign is a lump or bulge at the front of the throat.
• Difficulty Swallowing: Large nodules may compress the oesophagus, making swallowing uncomfortable or difficult.
• Hoarseness: Nodules pressing against the vocal cords can cause changes in voice quality.
• Pressure and Discomfort: A sensation of fullness or pressure in the neck may be experienced.
• Breathing Difficulties: In rare cases, very large nodules can obstruct the airway, leading to breathing issues.

Diagnosis involves a physical exam, ultrasound imaging, and blood tests to assess thyroid hormone levels. A fine-needle aspiration biopsy may be performed to rule out thyroid cancer if nodules appear suspicious.

Treatment for multinodular goitre varies based on nodule size, symptoms, and underlying causes. Options include:

• Thyroid Hormone Replacement: Levothyroxine may be prescribed to suppress nodule growth and manage symptoms, particularly in cases linked to iodine deficiency.
• Radioactive Iodine Ablation: This treatment can help shrink the goitre and relieve compression symptoms.
• Thyroid Surgery (Thyroidectomy): Removing part or all of the thyroid gland may be necessary if nodules are large, cause severe symptoms, or have cancerous potential.
• Ethanol Ablation: For cystic nodules, this minimally invasive procedure can reduce nodule size and alleviate symptoms.

Regular follow-up is essential to monitor the goitre’s size and detect any changes. While multinodular goitres are generally benign, it’s important to rule out cancer and manage any symptoms or complications effectively.