What should you know about large goitre in neck?

A goitre may develop when the thyroid becomes enlarged overall or forms one or more areas of swelling. Thyroid hormone production can be normal, too high, or too low; the size of the swelling does not by itself show how the gland is functioning. Some people notice a visible fullness at the front of the neck, a tight collar feeling, cough, voice change, or difficulty swallowing. Others have no symptoms beyond the swelling.

A clinician will feel the neck and ask about changes in weight, energy, heartbeat, heat or cold tolerance, bowel habits and family history. A [Thyroid Function Test](/treatments/diagnostics-and-screening/thyroid-function-test/) helps check hormone activity. The cause may include thyroid inflammation, autoimmune thyroid disease or nodular change, so examination is useful even when the swelling is painless.

Arrange a [GP Consultation](/treatments/consultations-and-assessment/gp-consultation/) for a new, growing or persistent neck swelling. Keep a note of when it appeared, whether it changes with swallowing, and any breathing, swallowing or voice symptoms. Do not squeeze the swelling or start thyroid supplements without medical advice.

Your clinician may arrange further thyroid assessment based on the examination and blood results. Symptoms of an overactive thyroid can include tremor, sweating and a racing heartbeat; an underactive thyroid can cause tiredness, dry skin and feeling cold. More information is available about [Hyperthyroidism](/conditions/hyperthyroidism/) and [Hypothyroidism](/conditions/hypothyroidism/).

Seek urgent medical help if the swelling causes trouble breathing, noisy breathing, inability to swallow fluids, or rapidly worsens. Arrange prompt assessment for a new voice change, choking episodes, or a firm swelling that continues to enlarge. Severe palpitations, fainting or chest pain also need urgent attention, whether or not the goitre is the cause.

Ask what may be causing the enlargement, whether your thyroid hormone levels are normal, and whether the swelling is pressing on your windpipe or food pipe. You can also ask which symptoms should prompt urgent review and when the neck should be checked again.