The top indicator that your thyroid is off isn’t very subtle at all. In fact, it’s likely staring at you in the mirror every day. “The most common sign of a thyroid problem is a swollen neck caused by an enlarged goiter,” Jaydeep Tripathy, MD, a primary care doctor at Doctor Spring, told Best Life.ae0fcc31ae342fd3a1346ebb1f342fcb Rajeev Sharma, MD, an endocrinologist at Roswell Park Comprehensive Cancer Center (RPCCC), explains on the center’s website that “any enlargement or abnormal growth of the thyroid gland is considered a goiter.” You’ll notice this enlargement low on the front of your neck, where your butterfly-shaped thyroid gland is located. Goiters crop up in approximately five percent of people in the U.S., according to John Hopkins Medicine, and are usually not threatening, unless the cause is due to thyroid cancer. So it’s always worth getting any lump in your neck checked out. And for more symptoms to pay attention to, If This Happens When You Eat or Drink, You Need Your Thyroid Checked. In addition to swelling near your Adam’s apple, the main symptoms of a goiter are “feeling of tightness in the throat area, hoarseness (scratchy voice), neck vein swelling, dizziness when the arms are raised above the head,” the Cleveland Clinic explains. Less common signs of a goiter could be coughing, wheezing, difficulty swallowing, and difficulty breathing. But sometimes goiters don’t cause any signs or symptoms, experts at the Mayo Clinic note. Again, if you think something’s up, talk to your doctor. According to Cleveland Clinic, goiters can be diagnosed through a physical exam, hormone test, antibody test, ultrasound of the thyroid, a thyroid scan, a CT scan, or an MRI scan. And for more useful information delivered straight to your inbox, sign up for our daily newsletter. The two main forms of thyroid disease are hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid), and goiters can be found in people with both. “A goiter indicates there is a condition present which is causing the thyroid to grow abnormally,” the ATA explains. In addition to goiters though, people who have hyperthyroidism can have a variety of symptoms, including an increased resting pulse rate, diarrhea, nausea, vomiting, rapid heartbeat, sweating without exercise or increased room temperature, agitation, and restlessness. Patients with hypothyroidism may experience symptoms like fatigue, dry skin, constipation, weight gain, and menstrual irregularities on top of goiters. And for another common occurrence that should lead you to a doctor, If You Notice This on Your Nails, Get Your Thyroid Checked, Doctors Say. According to the ATA, the existence of a goiter “doesn’t necessarily mean that the thyroid gland is malfunctioning”; it could also mean that you’re pregnant or have an iodine deficiency. While it’s not a problem in the U.S. very often, people who lack iodine in their diet often notice the presence of goiters, Medical News Today reports. Iodine, which is found in iodized salt and other U.S.-manufactured foods, is used by the thyroid to create metabolism-regulating hormones. The National Institutes of Health (NIH) recommends people consume iodine naturally by eating fish and dairy products, both rich sources of iodine. Pregnant women’s bodies produce a hormone known as human chorionic gonadotropin, which can cause the thyroid to enlarge, the Cleveland Clinic explains. “Pregnancy-associated goiters occur much more frequently in iodine-deficient areas of the world,” the AMA says, adding that it’s also relatively uncommon in the U.S. And for more thyroid concerns, If You Notice This With Your Eyes, Get Your Thyroid Checked, Doctors Say.