The thyroid gland is located in the front of the neck, on both sides of the trachea. The early symptoms of goiter are not obvious, occasionally you may find the neck is thicker when you look in the mirror, as the disease progresses, the following symptoms may appear after the thyroid gland enlarges to a certain degree: 1. compression of the trachea: this is more common, action shortness of breath may appear, if the swelling is larger, one side of the enlargement compresses the trachea to shift to the healthy side, bilateral enlargement compresses the trachea become flattened, narrowing of the trachea will lead to breathing difficulties, and the enlarged thyroid gland behind the sternum is especially serious. 2. Compression of the recurrent laryngeal nerve: Initial irritation of the recurrent laryngeal nerve, such as hoarseness and spasmodic coughing, and prolonged compression can cause severe hoarseness and loss of voice due to paralysis of the recurrent laryngeal nerve. Compression of the sympathetic ganglion in the neck can cause Horner’s syndrome, with sunken ipsilateral eyes, drooping eyelids and narrow pupils. 3, compression of the esophagus: can cause swallowing difficulties, choking sensation in the esophagus, etc., generally rare, only seen in adenomas extending between the esophagus and trachea, or when there are malignant changes, then there are often symptoms of persistent dysphagia. 4, compression of deep neck veins: adenoma often causes pressure on large blood vessels, and compression of the jugular vein is common, which can cause impaired blood return to the head and neck and cervical and facial bruising; compression of the superior vena cava can cause facial edema, jugular varices, edema and obvious varicose veins in the skin of the chest and upper arm. An enlarged thyroid gland may be caused by diseases such as hyperthyroidism and thyroid cancer. In addition to causing a range of pressure symptoms it can also cause emotional irritability and cardiac arrhythmia. Thyroid cancer usually has no other abnormal symptoms, but metastasis can cause endemic goiter in the early stage with no conscious symptoms except for enlargement of the gland, and as the gland gradually enlarges and compresses the surrounding organs and tissues, it can cause the above local compression symptoms in the later stage.