Goiter diagnosis

If you suspect that you may have a goiter, see your healthcare provider for a physical exam to get the proper diagnosis. Your provider may discover an enlarged thyroid gland by feeling your neck and having you swallow. In some cases, your provider may also be able to feel the presence of nodules. Your provider may also measure the level of certain hormones in your blood to see whether your thyroid is underactive or overactive. Several tests may be used to diagnose^[16] a goiter, including:

• Hormone tests: Blood testing can be used to determine how much hormone your thyroid and pituitary gland produce. If your thyroid is underactive, your thyroid hormone level will be low, while your thyroid-stimulating hormone (TSH) from your pituitary gland will be elevated in an attempt to stimulate your thyroid to produce more thyroid hormone.

Goiters that are caused by overactive thyroid glands are usually associated with high thyroid hormone levels and lower than normal TSH levels.

• Antibody tests: Some goiters are caused by the production of abnormal antibodies. Blood tests can be used to confirm the presence of these antibodies.
• Ultrasonography: Ultrasonography is used to determine the size of your thyroid and detect nodules that may have previously gone undetected. This exam involves using a wand-like device (transducer) to bounce sound waves through the neck and back, which generates images of your thyroid on a computer screen.
• Thyroid scans: Thyroid scans are more invasive and time-consuming than some other testing used to diagnose goiters. They help collect information about the nature and size of the thyroid gland. Thyroid scans require a radioactive isotope to be injected into a vein on the inside of your elbow. You then lie on a table with your head stretched backward while a special camera produces an image of your thyroid on a computer screen.
• Biopsies: Fine-needle aspiration biopsies used ultrasound to guide a needle into your thyroid, allowing tissue or fluid samples to be obtained for testing.