A thick neck could be a precursor to serious health complications such as cardiovascular risk, diabetes or worse, according to long-running research.
Data from a 2010 analysis, the Framingham Heart Study, a U.S. research project into heart disease that began in 1948, was revisited by researchers in 2022, to establish a link between neck circumference and atrial fibrillation, an irregular heartbeat condition which can increase the risk of stroke and heart failure.
Sleep apnea, a disorder where breathing repeatedly stops and starts due to throat muscles relaxing and blocking the airway, is also linked to having a large neck as well as other sleep disorders, which can lead to heart disease and stroke.
“Generally, if a man’s neck is above 17 inches in circumference, this could be a warning sign for several conditions,” explains Dr Mike Dilkes, an ENT surgeon at London’s HealthHub.
Dr Dilkes adds that, for women, the circumference threshold is 16 inches, with a larger neck indicating more upper body fat as well as being a proxy for visceral fat.
The latter is a type of body fat hidden deep inside the abdomen around vital organs such as the liver, pancreas, and intestines, but it can lead to serious health problems such as type 2 diabetes, heart disease, and certain cancers.
Larger necks do not solely indicate health issues, as seen in many athletes, such as rugby players, who have larger circumferences due to muscle mass, instead of fat.
They often also have better airway health and cardiovascular markers than those who are less active than they are with similar-sized necks.
Dr Dilkes has highlighted seven signs related to your neck which could be a subtle clue to something deeper going on:
Sagging jowls or a flabby neck
A sagging jowl or flabby neck may indicate risk of sleep apnoea as fat deposits around the neck can compress the airway, especially when lying down.
“Muscle tone is lost and the general weight of the fat compresses the airway,” Dr Dilkes explains, adding “even if the tissue is not very heavy, if there’s enough of it, it will obstruct the airway sufficiently to stop breathing.”
Lump at the front or side of the neck
This sign could be an enlarged thyroid gland (goitre). Often linked to hyperthyroidism, which affects metabolism and can cause symptoms like weight loss, anxiety, and fatigue.
“If you notice a swelling in the front or side of your neck, you should definitely have it looked at and have a blood test for thyroid function,” the ENT surgeon suggests.
Neck pain
Commonly due to muscle strain or arthritis, persistent neck pain might signal spinal issues, infections, or even tumours.
Swelling with difficulty swallowing
This may be due to iodine deficiency, historically known as “Derbyshire neck”. Though rarer, these symptoms are still a concern today due to changing diets, especially among women and girls.
Lumps or swollen glands on the side
Usually a sign of infection, lumps or swollen glands could also suggest tonsillitis, sepsis, or even tongue cancer.
“Swollen glands could suggest sepsis in the mouth or throat, or tonsillitis. Tongue cancer is also a possibility.”
Bulging neck vein
This sign might indicate heart or circulatory problems, such as right-sided heart failure or pulmonary hypertension. The jugular vein is often used as a visible gauge of central venous pressure.
“In medical exams, clinicians use the height of the jugular vein as a visible gauge of central venous pressure,” Dr Dilkes explains.
Throbbing lump (pulsatile mass)
This could be a carotid artery aneurysm or a carotid body tumour. These are rare but serious and may require surgery or monitoring.
Other potential causes include trauma-related swelling, an enlarged thyroid artery or arteriovenous malformation (AVM), an abnormal connection between arteries and veins that can result in death if left untreated.
