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Originally published on 29th March 2016 Last updated on 2nd September 2019
Have you ever noticed that your neck seems enlarged or been told it ‘sticks out’? Does it feel uncomfortable to swallow? Do you struggle to swallow or feel a lump in your throat? Ever feel hoarse?
You could have an enlarged thyroid gland, also called a goitre. It can be slight or very noticeable. Nodules and cysts are also a possibility and should be taken seriously.
There could be many reasons for goitres or other abnormalities, so I’ve them up below.
If you have Hashimoto’s, like 90% of those with hypothyroidism, it means your thyroid is being attacked by your own immune system, which can cause the thyroid gland to swell from inflammation. 
This autoimmune condition can even cause the destruction of your thyroid gland and function altogether. Treating your Hashimoto’s successfully (by lowering thyroid antibodies) can decrease the inflammation and size of a goitre, as the disease is calmed down and managed more effectively. Going gluten-free may be a specific thing that helps.
Iodine deficiency can also cause a goitre.
Like Hashimoto’s, your thyroid can enlarge due to having Graves’ Disease, another autoimmune disease. With Graves’, your thyroid hormones increase (hyperthyroidism), and your TSH gets progressively lower as you become more hyperthyroid.
Some people can have both hypothyroidism and hyperthyroidism.
Subacute thyroiditis is a rare condition and is thought to be caused by a viral infection, as it often occurs after one, such as the mumps, flu or a cold. The first signs are soreness and tenderness in the area of the thyroid gland, and sometimes pain spreading to other parts of the neck, ears or jaw, with symptoms of hyperthyroidism or, later, hyperthyroidism. It may cause your neck to feel sore.
Nodules and Cysts
A nodule is a swelling or lump, which can be a solid or liquid filled cyst or mass. The cause for these is often unknown, but thyroid patients can see these abnormal growths from being left undiagnosed or from non-optimised thyroid levels.
These causes suggest that inadequate treatment and management of thyroid issues can lead to nodules. More than 90% of all thyroid nodules are usually benign. 
Nodules can also be cysts. Only a very small percentage of these are cancerous, so try not to worry. The best thing is always to get yourself checked out as soon as possible.
Iodine deficiency can also cause nodules, but it’s important to not supplement with iodine unless you know you are deficient. Dr Datis Kharazzian also suggests that it can aggravate Hashimoto’s. You can do an iodine loading test to find out if you need iodine supplements before jumping straight in with supplementing. Eating a lot of goitrogenic foods is sometimes said to negatively affect iodine use by the thyroid, too.
Cancer of the thyroid gland is another, albeit small possibility, and is diagnosed by doing a fine needle biopsy. Thyroid Cancer isn’t very common, but it could, however, also be a reason for a goitre, nodules or other abnormalities.
At the end of the day, if your thyroid/neck looks enlarged, you really ought to explore why, and I strongly suggest having a doctor examine it as soon as you notice.
You can click on the hyperlinks in the above post to learn more and see references to information given.
Do you know how to check your neck for abnormalities?
Rachel Hill is the highly ranked and multi-award winning thyroid patient advocate, writer, speaker and author behind The Invisible Hypothyroidism. Her thyroid advocacy work includes writing articles, authoring books, producing her Thyroid Family email newsletters and speaking on podcasts, as well as being a founding board member for the American College of Thyroidology. She is well-recognised as a crucial contributor to the thyroid community and has a large social media presence. Her books include “Be Your Own Thyroid Advocate” and “You, Me and Hypothyroidism”.