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By Nick Harding
October 27, 2025 — 5.00am
According to new research, a thick neck can be an accurate predictor of cardiovascular risk, as well as indicate type 2 diabetes – even after adjusting for BMI and waist circumference.
This was the conclusion of a 2010 analysis of data from the Framingham Heart Study, a long-running American research project into heart disease that began in 1948.
In 2022, researchers using the same data also established a link between neck circumference and atrial fibrillation (irregular heartbeat), which can increase the risk of stroke and heart failure. In addition to this, large necks are also associated with sleep disorders, particularly sleep apnoea, which itself can lead to heart disease and stroke.
Problems with your neck can be indicators of more significant health issues.Credit: Getty Images
As Dr Mike Dilkes, an ENT consultant at London’s Health Hub, says: “Generally, if a man’s neck is above 17 inches [43cm] in circumference, this could be a warning sign for several conditions.”
For women the threshold is 41cm. Larger necks indicate increased upper body fat and can also be a proxy for visceral fat, which is the harmful fat that sits in the abdominal cavity around the organs.
Muscular athletes such as rugby players, with large necks due to muscle mass, not fat, do not have to worry, however, as athletes generally have better airway health and cardiovascular markers than non-athletes with similar-sized necks.
But what else can our necks tell us about our health? Dr Dilkes highlights the signs to watch out for.
Seven warning signs your neck is trying to tell you
Sagging jowls
A flabby neck can indicate a risk of sleep apnoea. Excess fat deposits around the neck and upper airway can narrow the airway passage. When a person lies down, especially on their back, this extra soft tissue can collapse or press inward, partially blocking airflow.
Dr Wilkes explains: “Muscle tone is lost and the general weight of the fat compresses the airway. 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 could indicate an enlarged thyroid gland, otherwise known as a goitre, which presents as a swelling or fullness in the lower front part of the neck, just below the Adam’s apple or on one side of the neck.
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The thyroid gland produces hormones that regulate metabolism. An enlarged thyroid could be caused by an overactive thyroid, also known as thyrotoxicosis or hyperthyroidism. Symptoms include weight loss, increased appetite, heat intolerance, excessive sweating, palpitations, anxiety, irritability, tremors and fatigue.
The condition can also cause changes in menstrual cycles, diarrhoea, muscle weakness and hair thinning. It is more common in women than men, and underlying causes can be Graves’ disease, nodules on the thyroid, or medicines such as amiodarone, which is used to treat an irregular heartbeat.
One rare complication of hyperthyroidism is thyroid storm, a potentially life-threatening condition.
Dr Dilkes says: “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.”
Neck pain
Neck pain is common and generally results from muscle strain or tension, caused by poor posture, sleeping awkwardly or long hours at a desk looking at a computer. It can also be caused by neck arthritis and is common with age.
More serious persistent pain can indicate disc herniation, compression of the spinal cord, spinal infection, spinal tumours and infections such as meningitis.
Neck pain is common especially among those who spend hours sitting at a desk.Credit: Shutterstock
Swelling in the neck, accompanied by difficulty swallowing
Also linked to the thyroid, this could indicate an iodine deficiency.
While severe deficiency is rare, studies have shown that mild to moderate deficiency is prevalent as a result of changing dietary habits, such as drinking less milk and a rise in plant-based diets.
Nodes or lumps in the side of the neck
Swollen glands in the neck are usually a sign the body is fighting an infection. Swollen glands can be accompanied by flu-like symptoms, a sore throat, a rough rash, scabs and sores, severe muscle aches, nausea and vomiting.
“Swollen glands could suggest sepsis in the mouth or throat, or tonsillitis,” explains Dr Dilkes. “Tongue cancer is also a possibility.”
Bulging vein
A bulging, ropey vein in the neck can be a sign of increased pressure in the venous system and, while sometimes harmless, it can also indicate an underlying heart or circulatory problem, such as kidney or liver disease, right-sided heart failure, or pulmonary hypertension.
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The jugular veins drain blood from the head and neck back to the heart, and a bulging jugular vein can indicate that the right side of the heart isn’t pumping efficiently. If this is the case, blood can back up into these veins, making them appear swollen or pulsating.
Throbbing lump
Often called a pulsatile mass, a new or enlarged throbbing lump in the neck that beats in time with your pulse, or is on one side only, could mean an artery has weakened, ballooned or developed an abnormal growth.
While rare, a weak, ballooned area that expands with each heartbeat could rupture (causing an aneurysm) or form a blood clot that travels to the brain, increasing the risk of stroke.
A lump could also be a carotid body tumour (paraganglioma), which is a benign growth that develops on the small cluster of nerve tissue next to the carotid artery, a major blood vessel located on the side of the neck. Though usually not life-threatening, it often needs surgery or monitoring.
Other causes could be 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.
The Telegraph, London
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