Podcast - What You Need To Know About Shrinking a Goiter


EPISODE 27

A goiter is an enlargement of the thyroid gland, and both people with hyperthyroidism/Graves’ disease and hypothyroidism/Hashimoto’s can experience this. In this episode Dr. Eric will discuss some of the common causes of a goiter, and what you can do to shrink it.

During this episode you’ll learn:

  • Common causes of a goiter
  • Whether taking iodine can help shrink a goiter
  • If you should avoid goitrogenic foods such as broccoli
  • When surgery is necessary for a goiter
  • How to shrink a goiter
  • Whether using essential oils can shrink a goiter

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Here is the transcript for this episode:

Welcome back to the Save My Thyroid podcast. This is Dr. Eric Osansky. In this episode, I am going to discuss whether or not you can shrink a goiter.

I want to start off by sharing that when I was dealing with Graves’ Disease, I had a mild goiter. It definitely wasn’t a large one. When I swallowed certain things, specifically fish oil capsules, they would get lodged in my throat sometimes. It wasn’t noticeably big, but it did cause some problems. Fortunately, that did resolve once my hyperthyroidism resolved. So it is definitely possible to shrink a goiter, but it depends on the cause and severity of it.

Let’s go ahead and discuss some of the common causes of a goiter. Thyroid hormone imbalance is one. People with hyperthyroidism or hypothyroidism can get one. Of course, insulin resistance. Problems with estrogen metabolism. These are also potential causes of thyroid nodules, which I will discuss in a different episode. There is also a physiological goiter, which you can develop during puberty or pregnancy. Also, an iodine deficiency. A lot of controversy with iodine.

There is some controversy with goitrogens. Goitrogens are agents or foods that can inhibit thyroid activity and production. When it comes to goitrogenic foods—including cruciferous vegetables like broccoli, cabbage, kale, Brussels sprouts, and cauliflower—in my experience, these very rarely inhibit thyroid activity. In fact, a number of years ago, when dealing with pregnant women, one dilemma is they are looking to naturally manage their hyperthyroid symptoms. This becomes challenging because you are not supposed to take agents such as bugleweed during pregnancy. L-carnitine in higher doses has antithyroid properties, but there is no research showing that taking 2,000-4,000mg of L-carnitine is safe during pregnancy.

What I did with some of my hyperthyroid patients is encouraged them to eat larger amounts of cruciferous vegetables to see if that could help lower thyroid hormone levels, and it didn’t really help. The vegetables were raw. When you cook them that can decrease the goitrogenic properties. I encouraged them to have larger amounts of so-called goitrogenic vegetables. I don’t see any problem with eating cruciferous vegetables. But for those with hyperthyroidism, I don’t see eating cruciferous vegetables as a way to manage hyperthyroidism.

Soy is a goitrogen as well. There are also certain medications that can be goitrogenic.

Radiation exposure is another cause of a goiter. TSH release from pituitary glands. High TSH, regardless of the cause, could be hypothyroidism. That is a common cause for people with Hashimoto’s. That doesn’t always lead to a goiter, but it can. If someone has a pituitary problem that is causing a TSH release, that can also cause a goiter. Autoimmunity in general, but definitely more common with thyroid autoimmunity. According to the research, certain infections can also lead to a goiter.

Obviously, the goal is to try to avoid surgery whenever possible. I still want to discuss when it’s necessary though. If someone has a real large goiter, surgery might be the best option. I am not saying everyone with a large goiter should get surgery, but it is worth mentioning that very large goiters are unlikely to decrease from their original size. They might decrease, but if it is that large, it won’t get normal 100%. Some people might be fine with that. For some people, it might not be fine, and they might decide to get surgery. If the goiter is large and causing obstruction, then surgery might be necessary.

Another situation where surgery should probably be considered is if there is a malignancy, if someone has thyroid cancer. Of course, many people with thyroid cancer end up getting thyroid surgery. If someone has a large goiter with no obstruction, and cancer is suspected, then in my opinion, they might as well try to address the cause of the goiter.

With that being said, let’s go ahead and discuss how to shrink a goiter. Of course, you want to address the cause of the problem. If the cause of the problem is high or low thyroid hormones, you’ll want to do everything you can to balance thyroid hormone levels. This might involve taking antithyroid medication if you have hyperthyroidism. If you have hypothyroidism, you might take thyroid hormone replacement. But while doing this, you also want to address the cause of the problem, and not just rely on the medication or hormone replacement on a long-term basis.

Inflammation can be a factor. You want to do things to reduce inflammation. You want to determine if insulin resistance, estrogen metabolism, or both are the potential cause of the problem.

Consider an iodine deficiency. This is very controversial, as I mentioned. I had a good experience with iodine a few years ago, but not everybody does, so I don’t encourage everybody to take iodine. Even if they have a deficiency, some people might not do well with iodine. I’m saying consider an iodine deficiency. But you also want to be cautious and work with a practitioner.

A lot of people over the years have asked whether essential oils can help with thyroid health, but more specifically with how to shrink a goiter. It really does depend on the person. There are some people who have received great benefits from rubbing essential oils such as myrrh and frankincense specifically, as well as others. They don’t necessarily directly affect the thyroid gland, but they play a role in reducing inflammation. But some people also didn’t receive benefits when using these.

I also need to mention that essential oils are very concentrated. You would only need to use one or two drops of each essential oil. If you’re using myrrh or frankincense, you would use one or two drops of each. Then you would want to dilute them with a carrier oil such as fractionated coconut oil. You would not want to directly put any essential oil on your thyroid gland or any area of your body. Essential oils may be something to consider, especially to reduce inflammation. Ultimately, you want to address the cause of the inflammation. When someone has a thyroid hormone imbalance, especially Graves’ or Hashimoto’s, these are immune conditions, so using essential oils probably won’t address the autoimmune components.

You probably will need to do other things to shrink the goiter. If someone has a non-autoimmune component, like toxic multinodular goiter, two common causes are problems with estrogen metabolism and insulin resistance, so these will need to be addressed.

It will take time. Itdefinitely isn’t something where in a few days, and most of the time not even a few weeks, you will see significant changes. You do need to give it time. It probably is a good idea to work with a practitioner to help with the shrinking.

That’s all I wanted to discuss. Hope you found it valuable. I look forward to seeing you in the next episode.