A goitre is an abnormal enlargement of the thyroid gland. Goitres can involve either one or both lobes of the thyroid gland. The gland can be generally enlarged secondary to a disease process such as Grave’s diseases or it can have multiple enlarged thyroid nodules and is termed a multinodular goitre (MNG). The World health organisation (WHO) defines a grade1 goitre as a palpable thyroid mass that is not visualised with the neck in neutral position and a grade 2 as a visually apparent mass with the neck in neutral position.

There are 2 main forms of MNG, depending on the functional state of your goitre. A toxic MNG is a thyroid gland that is not only abnormally enlarged but also produces excess thyroid hormone. A non toxic goitre is enlarged, but is not overproducing thyroid hormone. As goitres increase in size, they may cause compressive symptoms by placing pressure on either the windpipe (trachea) or the oesophagus resulting in difficulty breathing, particularly when lying flat or elevating your arms above your head, or difficulty swallowing. Some goitres continue to grow downwards into the chest and are termed retrosternal goitre.