The causes of goiter include iodine deficiency, benign or malignant tumors, and inflammation of the thyroid gland. The use of iodine food additives has greatly reduced the incidence of endemic goiter. Difficulty in determining the incidence of endemic goiter is complicated because many individuals with the condition experience no symptoms and are not diagnosed. Sporadic goiter, or goiter caused by interference with iodine metabolism, is affected by either hereditary factors or ingestion of foods or pharmacologic agents that inhibit T4 production.

Goiter caused by thyroid nodules, a common condition, may also cause no symptoms. Although thyroid nodules or tumors may be either benign or malignant, more than 75% of thyroid nodules are benign.

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