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Does a goiter always require surgery?

The natural history of a benign goiter is usually slow enlargement or growth of its nodules. Therefore, observation can be safe. A goiter is treated if there is a suspicion of the nodules harboring cancer, if the goiter is growing quickly or hormonally overactive, or if the goiter's large size is causing compressive symptoms, such as hoarseness, difficulty swallowing, or difficulty breathing
For more information go the endocrinediseases.org:
Benign non-toxic multinodular goiter
A goiter is an abnormal growth of the thyroid gland, and the determination for surgery is based upon the cause and whether or not the goiter produces obstructive symptoms. There are several possible reasons goiters develop, including autoimmune disease, inflammation or malignancy. Some causes can be treated with medications that may limit, or even reverse, the thyroid growth, eliminating the need for surgery.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.