Goiters can have many causes. In many parts of the world, people do not ingest enough iodine, which the thyroid needs to function. To compensate for this, the thyroid swells and develops goiter. Autoimmune disorders can cause an overactive or underactive thyroid and can also lead to goiter. Sometimes hormones present during pregnancy can cause goiters. Illnesses such as thyroiditis can cause goiters to grow as well.
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Honor Society of Nursing (STTI) answered
The exact causes of thyroid nodules or multinodular goiters are unknown. In general, the development of goiter is due to a complex mix of genetic and environmental factors. Iodine deficiency as a cause of goiter is rare in North America and most of Europe. However, even in areas of iodine deficiency most patients do not develop goiters.