SantiagoHEMA
Specialized Hospital for Advanced Medicine: labs, cardiology and the procedure in the same building, fifteen minutes from the airport. The most practical choice if you fly in.
Goiter
Goiter is the enlarged thyroid. Often it causes no symptoms and is only monitored; in other cases it compresses, becomes visible or alters hormone function, and then a treatment has to be decided.
What it is
What goiter is, and which type it can be.
- DiffuseThe gland enlarges uniformly.It usually comes with altered hormone, too much or too little, and is managed with the endocrinologist.
- NodularOne or several nodules form.The most common after forty, and almost always benign.
- ToxicOne or more nodules produce hormone autonomously.It is detected in the labs before it shows in the neck.
When it is treated
It is treated only if it causes discomfort, becomes visible or alters the hormone.
European guidelines are explicit: a benign goiter that causes no symptoms and no cosmetic problem is not treated, it is monitored with ultrasound. It is treated when there is pressure when swallowing or lying down, a change of voice, a sensation of fullness in the neck or choking, when it is visible, or when it produces too much hormone.
European Thyroid Association, guideline on minimally invasive treatments of benign thyroid nodules, 2020.
The options
The options change with the case.
- WatchIt is monitored with ultrasound every six to twelve months, together with labs.The right option for most small goiters without symptoms.
- Radiofrequency ablationIt is indicated for benign nodular goiter that causes compression or is visible.It shrinks the nodule without removing the gland, under local anesthesia, as an outpatient. Requires two prior benign biopsies.
- RadioiodineIt is the first option when the goiter produces hormone autonomously.That is what the guidelines recommend. Ablation is considered when the patient prefers another route or when radioiodine does not suit them.
- SurgeryIt is indicated when the goiter is very large or extends into the chest.Also when malignancy is suspected or the nodules are too numerous to treat with ablation.
Thyroid ablation
This treatment suits some nodules, not every one.
There are established criteria, and they are what we will assess with you at your first consultation.
Probably yes, if
a biopsy confirmed the nodule is benign and, in addition,
- it measures more than two centimeters
- it causes discomfort when swallowing or speaking
- it is visible on your neck, and that affects you
- it has grown on follow-up scans
Probably not, if
- the ultrasound shows high-risk features
- the nodule is mostly fluid, because then the first option is a different, simpler technique
If you have a cancer diagnosis
In a very small papillary carcinoma with no nodes, the guidelines contemplate ablation in selected patients. If the cancer is larger than one centimeter or has spread, surgery is what is indicated, and Dr. Jacobo performs it himself.
Google reviews
5.046 reviewsSee on GooglePatient reviews.
Thyroid and cancer surgery patients, and patients from abroad, tell how their experience with the doctor was.
I want to express my deepest gratitude to the doctor for being my guide and support during one of the most difficult times of my life: my thyroid cancer treatment. From…
Yaskira PerezMay 2026Dr. Jacobo is highly professional, skilled, and incredibly kind. He takes the time to explain every step and every procedure, ensuring his patients have no unanswered…
Rosemil OvalleFebruary 2025Dr. Jacobo is an excellent professional with world-class attention to detail. When treating a close relative with thyroid surgery, at a leading center in the field, he…
Anthony TejadaJanuary 2025Wonderful doctor. I had no idea I'd been suffering from thyroid problems for some time, and you gave me an accurate diagnosis that changed my life. Thank you so much…
Ana AguileraJanuary 2025I had a total thyroidectomy performed by Dr. Jacobo. It was a difficult surgery, but I came out of the operating room feeling excellent. Dr. Jacobo loves what he does…
Sheila Sabrina Calderon cuelloJune 2025I am incredibly grateful for the care I received from Dr. Jacobo. I initially found him through a Google search while looking for alternative treatment options for my…
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About goiter
What people ask about goiter.
Almost never. Goiter is the size of the gland, not its nature. When there are nodules, they are studied with ultrasound and, if needed, biopsy, and the great majority turn out benign.
If it is nodular, benign and causes discomfort, yes: radiofrequency ablation shrinks the nodule and keeps the thyroid. If it is diffuse or very large, the answer is usually different. It is decided at the consultation, with your ultrasound.
If the gland is kept, usually not. If it is all removed, yes. It is one of the factors considered when deciding between operating and treating it another way.
Iodine deficiency can cause goiter, but in the Dominican Republic salt is iodized and that is no longer the usual cause. No natural treatment shrinks a nodular goiter.
Locations
Choose the center closest to you.
Santo DomingoClínica Abreu
In Gazcue, in the center of the capital, about 35 minutes from the airport. The clinic's first radiofrequency ablation session took place here.
San Francisco de MacorísCentro Médico Siglo 21
Office in suite 106, for patients in the northeast who prefer not to travel to Santiago.
With your ultrasound, at the consultation we determine which of the two cases is yours.
In person in Santiago, Santo Domingo or San Francisco de Macorís, or virtual from wherever you are. If you have no studies yet, the evaluation begins precisely with them.