GOITRE

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Endocrinology , Endocrine Surgery

ABOUT THE DISEASE

Goiter is an enlarged thyroid gland. The thyroid gland is a butterfly shaped gland which sits at the base of the front of the neck below the adam`s apple. The gland produces hormones (thyroxine (also called T4) and a small amount of triiodothyronine (also called T3)), that regulate mood, body temperature, pulse rate, and digestion.

CAUSES

Simple goiters develop when the thyroid gland does not make enough thyroid hormone to meet the body’s needs. The thyroid gland tries to make up for this shortage by enlarging.

Endemic goiters occur in people within certain geographic areas who do not get enough iodine in their diet.

Other causes include:
- Drugs like Lithium, Amino glutethimide, Amiodarone, etc
- Hereditary factors
- Certain foods (soy, peanuts, vegetables in the broccoli family)
- Smoking
- Graves disease
- Thyroid Cancer
- Thyroditis
- Pregnancy
- Exposure to radiation

SYMPTOMS

The symptoms vary depending upon the cause of goiter, the main symptom being an enlarged thyroid gland.

• Swelling in the lower part of the neck.
• A tight feeling in the throat.
• A hoarse voice.

In rare cases, an enlarged thyroid can put pressure on the windpipe (trachea) and food tube (esophagus). This can lead to:

• Coughing.
• Wheezing.
• Difficulty swallowing.
• Difficulty breathing.

When a goiter is the result of hyperthyroidism, symptoms may include:

• Rapid or irregular heart beat.
• Sickness in stomach (nausea).
• Vomiting.
• Diarrhea.
• Shaking.
• Irritable feeling.
• Bulging eyes.
• Weight loss.
• Heat sensitivity.
• Anxiety.

When a goiter is the result of hypothyroidism, symptoms may include:

• Tiredness.
• Dry skin.
• Constipation.
• Weight gain.
• Irregular menstrual cycle.
• Depressed mood.
• Sensitivity.

DIAGNOSIS

- Physical examination
- Blood tests - T4 (Free Thyroxine) & TSH (Thyroid stimulating hormone)
- Ultrasound
- Biopsy
- Thyroid scan and uptake

TREATMENT METHODS

Treatment will depend on the cause of the goiter & may include:

• Monitoring - As in some cases, no treatment is necessary other than regular check ups.
• Medications and iodine supplements
• Radioactive iodine treatment
• Surgery (Thyroidectomy) - to remove all or part of the gland may be recommended.