Swollen & Enlarged Thyroid: What it Means & What Causes it

Swollen & Enlarged Thyroid: What it Means & What Causes it

Does it feel like you have an enlarged thyroid?

Do you notice a bulge in your neck or does your neck appear thicker?

Have you felt your thyroid and noticed that it is "lumpy" or "inconsistent"?

Are you experiencing symptoms that make you think there is a problem with your thyroid?

If you answered yes to any of these questions then you may have an issue with your thyroid gland. 

This post will teach you all that you need to know about an enlarged/swollen thyroid including what it means, how to diagnose it, your next steps and more


What is an Enlarged/Swollen Thyroid?

Let's start with some thyroid basics:

Your thyroid is an endocrine (hormone) gland that sits at the base of your neck. 

It produces some of the most important hormones known in the human body: T3 and T4 known as thyroid hormones

Disorders, including anatomical changes to the thyroid, can cause serious problems in the body which often present with certain symptoms. 

These symptoms range from minor fatigue to massive weight gain, hair loss, constipation and so on

For such an important little gland in your body, there are a lot of potential problems that can arise with its function. 

One of these problems is an enlargement of the gland. 

This enlargement is often termed a "goiter" or a "swollen thyroid" and it is incredibly common

The problem with an enlarged thyroid is that it is a nonspecific term which is simply used to describe the shape and size of the thyroid gland (1).

Knowing that your thyroid is enlarged or swollen doesn't necessarily say anything about the function of your gland (which is perhaps one of the most important aspects of your thyroid). 

We will talk how to properly assess if your gland is functioning properly in the testing section below, but for now, let's discuss the potential causes of an enlarged thyroid. 

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Causes of an Enlarged Thyroid

Knowing that your thyroid is enlarged is not a diagnosis by itself. 

It's more helpful to think of an enlarged thyroid gland as an observation or as a description of what is happening. 

This is because there are actually many different conditions which result in thyroid gland enlargement. 

These conditions range from infections, inflammation of the gland, nutrient deficiencies, cancer and even autoimmune disease. 

An important part of treating an enlarged thyroid gland is correctly identifying and diagnosing what is happening. 

This important step can be done through blood testing and imaging (discussed below). 

The range of medical conditions which can cause thyroid gland enlargement include: 

These diseases can be differentiated based on how they present (your symptoms), how they affect the size of your thyroid gland (diffuse enlargement or isolated enlargement), how they look on ultrasound imaging and how they affect thyroid hormone production

Enlarged Thyroid vs Painful Thyroid

It's important to differentiate between an enlarged thyroid gland and a painful thyroid gland. 

This one single symptom is unique to very few conditions and can easily help you figure out a diagnosis. 

Your thyroid gland is an organ and is susceptible to inflammation and infection, just like other parts of your body

This condition occurs very rarely, however, because for the most part your thyroid is protected from the rest of your body. 

Infections such as viral and bacterial bugs can result in a condition known as subacute thyroiditis (4).

This is one of the very few conditions which cause pain in the thyroid gland when touching it. 

Subacute thyroiditis can also result in an enlargement of the thyroid gland but it's almost always associated with pain. 

This pain is important because it can easily help differentiate other, more serious, conditions which cause an enlargement of your thyroid gland. 

Does an Enlarged Thyroid Cause Symptoms? 

Anatomical changes to your thyroid, such as changes to the size or shape of your thyroid, are most often found incidentally. 

Patients are often quite surprised that they even have a thyroid issue until they are notified by their physician during a routine exam. 

Problems which cause changes in the shape and size of thyroid usually do NOT cause problems with the production of thyroid hormone. 

This is important because the symptoms associated with dysregulated thyroid hormone production are often profound and easy to identify. 

Instead, disorders to the shape and size usually are asymptomatic. 

What this means is that they do NOT cause any symptoms. 

Now, this isn't true for all disorders because there are always exceptions. 

One such exception is the if the size of your thyroid grows to a size large enough to cause local anatomical issues (5).

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These issues might present as problems swallowing, changes to your vocal cords or a change in your voice, or a bulge that is noticeable in your neck. 

Occasionally, if your enlarged thyroid is due to swelling or inflammation, then you might also experience pain when touching your neck. 

Some conditions which result in an enlargement of your thyroid gland are reversible and may go away on their own (such as some causes of Thyroiditis) while others may persist and cause permanent thyroid damage (such as Hashimoto's thyroiditis). 

Hopefully, you're beginning to understand that in order to really understand what is happening with your thyroid gland you will need further evaluation. 

Imaging and Evaluating your Thyroid

One of the best ways to look at your thyroid gland is by imaging it or looking at it via ultrasound (6).

Ultrasound is a nearly painless procedure which allows radiologists to look at the size, shape, texture and other characteristics of your thyroid gland. 

Because the thyroid gland is near to the surface of your skin it can easily (usually) be assessed with this type of imaging. 

The good news about ultrasound testing is that it is NOT associated with radiation exposure and is therefore considered to be very safe (7) (perhaps the safest of all imaging methods). 

Doctors are often taught that the only way to hurt someone with an ultrasound is by throwing the machine at them

Ultrasound is very important if you have an enlarged thyroid because it can further help to diagnose what exactly you are dealing with. 

For instance:

If you have a single large thyroid nodule, ultrasound can pick up that nodule and give information regarding the size, shape, and consistency of the nodule. 

This information can help to determine if the nodule is benign (about 97% of all nodules are benign and harmless (8)) or potentially cancerous (around 3% of nodules may be cancerous) and also help determine if you need a biopsy. 

Other conditions which cause thyroid enlargement may be consistent and make your thyroid look "irregularly inconsistent" throughout the entire gland. 

Conditions which cause this type of pattern tend to result in inflammation of the entire gland or may be caused by nutrient deficiencies such as iodine deficiency. 

In addition to ultrasound testing, there are other ways to check your thyroid gland such as uptake tests or CT scans (Computed Tomography). 

These tests usually come after ultrasound testing and your Doctor can help you determine if you need them. 

Lab testing for your Thyroid

Looking at your thyroid gland via imaging doesn't usually give you any information about the FUNCTION of the thyroid gland. 

The function of your thyroid gland is very important because it relates to how well your thyroid is able to produce thyroid hormone. 

Any change to the ability of your gland to produce thyroid hormone will result in very specific symptoms that are too big to be ignored and these symptoms will often drive people into the Doctors office for evaluation

Fortunately, many conditions that result in thyroid gland enlargement (such as thyroid nodules) usually do not interfere with thyroid hormone production

Some conditions, such as Hashimoto's thyroiditis, cause both thyroid gland enlargement AND thyroid hormone issues. 

Because of this each and every patient with a known or suspected thyroid gland issue should undergo thyroid function testing with blood tests. 

To test your thyroid function you will need the following tests

  • TSH (Thyroid Stimulating Hormone) (9) - This will help you understand if your brain is talking to your thyroid gland. 
  • Free T3 (10) - This is the most important thyroid hormone in your body and is responsible for the majority of thyroid cellular activity/ 
  • Free T4 (11) - This is the most abundant thyroid hormone in your body and is important because it acts as a reservoir for T3 thyroid hormone. 
  • Thyroid Antibodies - The presence or absence of thyroid antibodies can help you understand if you have an autoimmune disease or if your body is attacking your own thyroid gland. 

These lab tests represent the most basic tests necessary to evaluate your thyroid but they are NOT the only lab tests you can use. 

You can find a complete list of lab tests which can be used to assess your thyroid function here

Your Next Steps + Treating your Thyroid

If you suspect (or know) that you have an enlarged or swollen thyroid gland then you may be wondering what are you supposed to do next. 

The world of thyroid management can be difficult to navigate, but I've created a list of steps below that you can check off to ensure that you are on the right track. 

Following this list will help you with proper diagnosis and treatment (if necessary). 

Final Thoughts

Your thyroid gland is a very important hormone secreting organ in your body. 

Because of its importance, you should always evaluate any suspected problems of this gland including enlargement. 

Testing your thyroid can be done easily with blood tests and ultrasound testing. 

These basic tests can give you a solid starting point and help point you in the right direction. 


Many causes of an enlarged thyroid do not necessarily require treatment, but some may cause permanent damage if not identified and treated

Now I want to hear from you:

Are you having issues with your thyroid gland?

Is your thyroid gland enlarged or swollen?

Are you also experiencing symptoms?

Have you been assessed by a Doctor yet? Do you have a diagnosis?

Leave your comments below! 

References (Click to Expand)

swollen thyroid? Here's what causes it

Dr. Westin Childs

About Dr. Westin Childs

Hey! I'm Westin Childs D.O. (former Osteopathic Physician). I don't practice medicine anymore and instead specialize in helping people like YOU who have thyroid problems, hormone imbalances, and weight loss resistance. I love to write and share what I've learned over the years. I also happen to formulate the best supplements on the market (well, at least in my opinion!) and I'm proud to say that over 45,000+ people have used them over the last 4.5 years. You can read more about my own personal health journey and why I am so passionate about what I do here.

14 thoughts on “Swollen & Enlarged Thyroid: What it Means & What Causes it”

  1. Hi, I am a 41 yr caucasian female. I was diagnosed with hypothyroidism in 2008 during 2 back to back pregnancies. I was put on levothyroxine 75mcg. I had a small nodule on ultrasound. Fast forward to 2018. Over the past 10 years increasing fatigue, unexplained joint pain, shoulder (?frozen shoulder),? TMJ, painful finger joints. Recently facial pain with shooting nerve pain, chronic ear and face pain, weight gain at now is 200. Sciatic back pain and extreme fatigue to the point of dr. Suggesting narcolepsy dx and being prescribed Provigil. Labs show Tsh at 4.9, platelet count at 499. Vit d deficiency, thyroid ultrasound shows inflammation of the thyroid, multiple nodules in r lobe. Ultrasound tech comment difficult to scan and heterogeneous appearance. Family dr increased levothyroxine to 88mcg and referral to an endocrinologist. Any advice on how to improve things on my own.?
    I am an RRT, POLYSOMNOGRAPHER AND ULTRASOUND TECH. Desperately seeking help!!

  2. Hello Dr. Child’s. I did a vitamin d3 on September it was 44 iu, told extremely low and was put at 1000 iu a day, checked it after 8 months went to 55 iu, doctor put me on 2000 iu and want to check my levels after 3 months. He doesn’t know why my body is not absorbing vitamin d3. My thyroid is normal, did ultrasound in Greece, slightly enlarged, was told that I might have Hashimotos thyroiditis. The doctor also want to check iron, magnesium, calcium. He thinks I might have celiac disease, but is not necessary to check it, wants to see me after 3 months. I also have hormone issues, low testosterone and high bioavailable testosterone and my body produces lots of hair.
    Let me know what you think is the cause of my vitamin d3 deficiency and why my body is not absorbing vitamin d3. Thanks. I am otherwise healthy female 34 years old.
    Thanks for your blogs, Voula

  3. 24-year-old athlete- good health- in the last 5 months having symptoms of a swollen neck -burning -chills- fatigue. went to the Doctor- all blood work was normal- Cat scan- normal -ultrasound normal- The final diagnosis- my Thyroid is enlarged but it’s functioning properly. But because I am having symptoms the only solution given to me is to take out my Thyroid.- I say no and want to weigh out my options. I have an appointment with the Endocrinologist and will get more information. Your thoughts.

    • Hi Maria,

      Removing your thyroid should be your last option because it’s possible that you may not be a high-level athlete afterward.

  4. I have been done in some lab test like, Xray, ECG and Ultrasound, and their impression is I have Enlarged Thyroid gland with a nodule on the left…but I have not yet met my doctor for some diagnoses on how I cure my disease…Please give some advice..regarding my illness…Thank you so much…Godbless!

  5. I have been diagnosed with an enlarged thyroid with nodules in an area where I previously had cancer in 1990. My right parotid gland was removed. I started feeling a radiating in the area, like electricity running through it. Currently, I am awaiting a biopsy, scheduled August 21, four months after diagnosis. In the meantime I am experiencing all the symptoms of thyroid problems with intense pain when area is stressed by movement or pressure, resulting in difficulty using my right hand and arm. Trying not to become overanxious and to learn and do what I can to improve my thyroid while waiting on the doctors to make their next move.

  6. Hi, I have been on levo for at least 5 years now. One thing I was wondering, almost every doctor I’ve seen for various things comments on my thyroid looking enlarged and suggests I get an ultrasound. Even friends sometimes comment on my pictures (who also have thyroid issues) and point it out, but every time I get a scan (which I have at least 4 times) they say it’s normal. Why do people keep pointing it out but then the test shows normal? Could it be fluctuating? Thanks!

  7. I have an enlarged thyroid and I am having it out because the doctor says I am past the stage of any medication helping. My question is there a good chance they will find cancer? I do not have pain, but they found mine because the swelling has caused my airway is getting narrow between my windpipe and thyroid and I am wheezing and I am also starting to have problems with taking pills.

  8. I have a enlarged thyroid gland it eight inches at the right side of my neck and four inches on the left side I will be surgery on the right side of my neck but I am afraid because it is near my vocal chords.

  9. I have an enlarged thyroid with a nodule. This right side is 7cm with a 2 cm nodule. This was all found by ultra sound. They did a needle biopsies and found abnormal follicular cells but were unsure of exactly what type they were for sure at our local hospital. They sent the slide to the Mayo Clinic and they could not determine what they were. I then was sent to a surgeon to have one side of my thyroid removed and possibly both sides removed depending on what they find. the surgery is this week. My voice is changing and it is pressing on my throat making it difficult to swallow at times. I have been on levothyroxine for about 20 yrs now. Is there something I could of some to of prevented my current situation?

  10. Hi Dr
    My name is rushel livan
    I live in Guyana and I have an enlarged thyroid on my right side. I already did a by biopsy it not cancer but they say I have low active thyroid. Can u help me with some home remedies cause i am taking levothyroxine one a day 50g

  11. My name is Wayne and I’ve got 2 nodules dx by CT scan. Referral made to see a endocrinologist I’m assuming labs were ok because md said was not concerned. No bx as of yet but always have dry mouth & sore throat. Am 75 and was wondering if by chance could be cancer. I have recently had vascular surgery aortic arch graft placement due to stenosis & aneurysm and have had to set this problem aside for a while as I’m still healing. Wondering what could be done once I can start addressing this problem or could it be something else? Thanks


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