Those who suffer from an iodine deficiency are most at risk of developing a goiter or nodule. Smoking can also cause a higher risk of both disorders.12,13,14 In addition, exposure to high levels of nitrate15 (for instance, via drinking water) can also promote the formation of a goiter.

Further risk factors include the following:

  • Hormonal changes during pregnancy, puberty or menopause16
  • Thyroid inflammation17 (thyroiditis)
  • Hyperthyroidism (overactive thyroid)18
  • Hypothyroidism(underactive thyroid)19
  • Basedow’s disease, Hashimoto’s thyroiditis (auto-immune disorders affecting the thyroid)20,12
  • Certain medications (e.g. thyreostatics, lithium)22



  • 12McNeill A. Tobacco use and effects on health. In: European Commission (Eds.): Tobacco or health in the European Union – Past, present and future. Office for Official Publications of the European Communities, p 25-68. Luxembourg, 2004
  • 13Derwahl K. M., Duntas L.H., Butz S.: The Thyroid and Cardiovascular Risk: Merck European Thyroid Symposium, Berlin, 10-13 June, 2004. Thieme; 1 edition (2005)
  • 14Galanti M.R., Granath F., Cnattingius S., Ekbom-Schnell A., Ekbom A., Department of Medicine, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden: Cigarette smoking and the risk of goitre and thyroid nodules amongst parous women. J Intern Med. 2005 Sep;258(3):257-64.
  • 15van Maanen J.M.S. et al.: Consumption of drinking water with high nitrate levels causes hypertrophy of the thyroid. Toxicology Letters, Volume 27, Issues 1-3, June 1994,Pages 365-374. URL doi:10.1016/0378-4274(94)90050-7 (Accessed October 2010)
  • 16Shils M. E. et al.: Modern nutrition in health and diseases. Lippincott Williams & Wilkins; Tenth edition (2005)
  • 17Greenspan, F.S., Gardener, D.G.: Basic and Clinical Endocrinology. McGraw-Hill Medical, 7. edition (2003)
  • 18Terris D.J., Gourin C.G.: Thyroid and Parathyroid Diseases: Medical and Surgical Treatment. Thieme; 1 edition (2008)
  • 19ibid.
  • 20Aufderheide A.C., Rodriguez-Martin C.: The Cambridge encyclopedia of human paleopathology. Cambridge University Press; 1 edition (1998)
  • 21American Association of Clinical Endocrinologists (AACE). Hashimoto’s Thyroiditis: Information for Patients. 2005. (Accessed October 2010)
  • 22cf. Source6