What causes a multinodular goitre?

The thyroid sits at the front of the neck and makes hormones that influence body processes. A multinodular goitre can occur while hormone production remains normal, or when the gland produces too much or too little hormone. Hyperthyroidism may cause palpitations, tremor, heat intolerance and weight loss; hypothyroidism may cause tiredness, feeling cold, dry skin and constipation. The appearance of several nodules does not by itself determine whether treatment is needed.

Arrange a GP consultation for a new or enlarging neck swelling. The clinician may examine the thyroid, ask about swallowing, breathing and voice changes, and request a thyroid function test. Depending on the findings, further imaging or a sample from a particular nodule may be considered. Do not press or massage the swelling, and keep a record of changes in size or symptoms.

Seek prompt assessment if the swelling grows quickly, becomes painful, causes difficulty swallowing or breathing, or is associated with a new persistent hoarse voice. Urgent help is needed for severe breathing difficulty, fainting, marked palpitations or confusion. These symptoms can reflect pressure or significant hormone disturbance and should not wait for routine monitoring.

Ask which tests are appropriate, whether your thyroid hormone levels are normal, and how the nodules will be monitored. Discuss symptoms that should prompt an earlier review and whether any medicines, supplements or previous thyroid problems affect interpretation.