I Developed a Goitre: A Case Study

Alan recalls that when he celebrated his fiftieth birthday he was feeling pleased with his efforts at getting fit for the big event. “Turning 50 is quite a milestone, and I wanted to make sure I faced the next ten years feeling healthy and ready for anything,” he says. For the previous few months, he had changed his diet, eating much more healthily and taking regular exercise. “I was swimming three times a week, eating a low fat and low sugar diet, avoiding dairy foods and generally looking after myself - or so I though,” he adds.

A Throat Swelling Causes Anxiety

Alan and his wife Juliet celebrated in style with a large family party followed by a Mediterranean cruise that lasted for 2 weeks. They had only been back for about three weeks when Alan noticed that his Adam’s apple seemed to have grown. “I even joked one morning that my new fitness regime was turning me into more of a rugged figure but it started to niggle at me and I began to search around the internet to find out what might cause a lump in the throat. I was also conscious that my throat felt a bit strange, a sort of tight feeling that could be a bit uncomfortable,” he remembers.

The internet searching did not allay Alan’s niggles, in fact they turned them into severe anxiety. “All I seemed to read pointed to the possibility that a lump in the throat meant throat cancer. I dared not admit to Juliet what I had been looking up and I sort of sank into a black depression.” Juliet did not know what Alan was worried about - she had barely registered his comments about his Adam’s apple and was puzzled and concerned. Instead of getting up early and going swimming, and being full of life and wanting to socialise at the weekends, Alan became withdrawn, bad tempered and only wanted to stay in bed til late - spending hours at other times searching on the internet.

Row about a Possible Affair

Juliet started to add up what was happening and the night before she and Alan were due to go out to dinner to celebrate their 24th wedding anniversary, she finally confronted him with her worst fears. “With all the moping and searching the internet, she had come to the conclusion that I was having an affair. That’s when I realised that I couldn’t keep my worries to myself any longer and I admitted that I had been searching for information about throat cancer because I thought I was dying.” Juliet, who was originally a nurse but then retrained as a life coach once her children were in secondary school, thought this was rather melodramatic and insisted that Alan go to see their GP to find out what the problem really was.

“She pointed out that there are all sorts of reasons why lumps and swellings occur in the throat - they rarely mean that it's throat cancer. I had imagined all sorts of horrors but on the morning I went to see the GP, I just wanted to know the truth, once and for all,” says Alan.

An Enlarged Thyroid Gland

After being examined and having some blood tests, Alan’s mind was put at rest. He did not have throat cancer, or thyroid cancer. Instead, he had a goitre. “I thought that was what people had years ago but I had no idea what caused it. The goitres I have seen have been huge but my swelling was relatively small,” says Alan.

The GP explained that about 7% of people over 45 can experience swelling of their thyroid gland and there are several underlying reasons. One is an overactive thyroid, but another is an underactive thyroid - both can cause the thyroid to enlarge and swell. In Alan’s case, however, he had neither - he was deficient in iodine.

Iodine Deficiency and Goitre

Iodine deficiency used to be one of the most common causes of goitre until the 1990s when iodine was added in small amounts to table salt. Because of his low-salt diet, Alan had been avoiding getting table salt, and his iodine levels had become depleted. “Iodine is a major component of the thyroid hormones and when the body runs low, the thyroid gland compensates by getting bigger - hence the goitre,” he explains.

After supplements to address the problem, Alan’s thyroid returned to normal over the next few months, and he is back to his old routine of swimming and socialising and has even more of a spring in his step these days. “The whole experience made me realise how precious every day is - so I don’t waste any time looking up medical conditions on the internet now,” he laughs.