What is a Goiter?
The thyroid gland is an organ that is butterfly-shaped found at the base of the neck right below the Adam’s apple. Often this thyroid gland will grow larger than is normal – and this condition is referred to as goiter or in the United Kingdom goitre. While goiters are normally painless, a goiter that is very large can trigger a cough as well as making it hard for the individual to breathe or swallow.
The more common reason for a goiter globally is an absence of dietary iodine. In the United States, most individual use salt that is iodized, so goiter is most often caused by the underproduction or overproduction of hormones from the thyroid gland or due to nodes that grow in the gland itself.
Treatment for a goiter is determined by the goiter size, the symptoms as well as the underlying reason for the problem. Small goiters which are not noticeable and do not cause any problem normally do not need treatment.
Goiter Symptoms
Symptoms and signs are not cause by all goiters. When they do develop, they can include:
- A swelling that is visible at the base of the neck which can be especially obvious when the individual shaves or applies makeup
- Feeling of tightness in the throat
- Hoarseness
- Coughing
- Difficulty in breathing
- Difficulty in swallowing
Goiter Causes
The thyroid gland manages 2 hormones –triiodothyronine or T-3 and thyroxine. These hormones flow in the blood system and help to regulate the body metabolism. They do the following:
- Manage the rate which the body uses carbohydrates as well as fats
- Helps manage the control of the temperature of the body
- Effect the heart rate
- Helps control the manufacture of proteins
- Produces calcitonin – hormone that manages the calcium amount in the blood
The pituitary gland as well as hypothalamus manages the degree at which these hormones are released and produced. This process starts when the hypothalamus –a tiny organ at the base of the brain that performs as a thermostat for the entire system – motions to the pituitary gland to create a hormone referred to as “thyroid-stimulating hormone” or TSH. The pituitary gland – also situated at the base of the brain – discharges a definite amount of TSH, contingent on how much T-3 and thyroxine are in the blood. The thyroid gland then in turn controls the creation of hormones built on the quantity of TSH received from the pituitary gland.
A goiter does not automatically mean the thyroid gland is not working routinely. Even if it is enlarged, the thyroid may create amounts that are normal of hormones. It can similarly, still, produce too little or too much T-3 and thyroxine.
There are numerous factors that may cause the thyroid gland to expand. Amid the more common are:
Deficiency of Iodine
Iodine is vital for the creation of hormones of the thyroid and occurs generally in seawater as well as in the soil on the coast. In the unindustrialized areas of the world, individuals living at higher elevations or live inland are very frequently iodine-poor and may develop goiters when the thyroid grows as the result of a struggle to acquire further iodine. The iodine deficiency initially can be made worse by diets which are high in hormone hindering foods, for instance broccoli, cabbage as well as cauliflower. While a deficiency of iodine in the diet is the major cause for a goiter in numerous areas of the globe, this is not the situation in those countries anywhere iodine is routinely added to regular table salt as well as added foods.
Graves’ disease
Goiter may often occur when the thyroid gland creates too much hormones (hyperthyroidism). With Graves’ disease, antibodies created by the immune system incorrectly attack the thyroid gland, causing an excess production of thyroxine. This causes the thyroid to swell.
Hashimoto’s disease
A goiter can result also from a thyroid that is underactive (hypothyroidism). Like Graves’ disease, Hashimoto’s disease is a disorder of the autoimmune type. But rather than causing the thyroid to create too much hormone, Hashimoto’s damage the thyroid so that it creates too little. Detecting a lower level of hormone, the pituitary gland creates more TSH to motivate the thyroid. Detecting a lower level of hormone the pituitary gland creates more TSH to encourage the thyroid that then causes the gland to become enlarged.
Solitary thyroid nodules
With this condition, a single nodule grows in one side of thyroid. Most nodules are non-cancerous (benign) and does not develop into cancer.
Multinodular goiter
With this disorder, some fluid-filled or solid lumps referred to as nodules grow in both sides of the thyroid, causing whole growth of the gland.
Thyroid cancer
Thyroid cancer is much less common than benign thyroid nodules. Thyroid cancer typically seems as an expansion on one side of the thyroid.
Pregnancy
A hormone created during pregnancy, human chorionic gonadotropin (HCG), can trigger the thyroid gland to increase to some degree.
Inflammation
Thyroiditis is an inflammatory problem that may cause swelling as well as pain in the thyroid.
Goiters may affect everyone. They can exist at birth and arise at any time thru out life, although, they are most common after the age of 50. Certain common issues that are risks for developing a goiter include:
Lack of dietary iodine
Individuals living in those areas where iodine is a small resource and do not have access to iodine supplementation have a high risk of developing goiters.
Sex
Since women are most prone to illnesses of the thyroid, they are also most probable to develop goiters.
Age
The chances of developing a goiter will increase with age.
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Medical history
A family or personal history of diseases that are autoimmune increases the risk of developing goiters
Menopause and Pregnancy
For causes that are not quite clear, problems with thyroids are most likely to happen during menopause or pregnancy.
Certain medications
Certain medical therapies, including antiretrovirals, immunosuppressants, the heart medication amiodarone (known as Pacerone, Cordarone, others) as well as the psychiatric medication lithium (known as Lithobid, Eskalith, others), rises the risk.
Exposure to radiation
The risk rises if there has been radiation therapy to the chest or neck area or exposure to radiation in a nuclear test, facility or accident.
Goiters which are small that do not cause cosmetic or physical problems are not of any concern. But those goiters which are larger can often make it harder to swallow or breathe and in some cases cause hoarseness or a cough.
Goiters resulting from other problems such as hyperthyroidism or hypothyroidism can be linked to numerous symptoms which range from weight gain to fatigue, weight loss, problems sleeping as well as irritability.
Goiter Treatment
A primary care physician can ascertain a thyroid gland that is enlarged merely by examining the neck as well as examining the neck as the individual swallows in the course of routine physical exam. In several cases, the physician can also be capable of feeling the occurrence of any nodules.
Making the diagnosis of goiter can also involve:
Hormone test
Tests of the blood can define the hormone amounts being produced by an individual’s pituitary and thyroid glands. If the thyroid is underactive, the thyroid hormone level will have dropped. At this identical time, the hormone that stimulates the thyroid known as TSH will be higher due to the fact that the pituitary gland is trying to stimulate the thyroid gland to create additional thyroid hormone. Goiters which are connected with a thyroid that is overactive normally consist of an elevation of thyroid hormone in the blood system and a lesser than usual level of TSH.
Antibody test
Several reasons for goiter involve the production of antibodies that are abnormal. A blood test can endorse the occurrence of such antibodies.
Ultrasonography
A wand-like device called a transducer is positioned over the neck. Waves of sound are then bounced thru the back and neck, forming images on a screen of a computer. These images can disclose the size of the thyroid gland as well as whether the gland has any nodules that the doctor cannot have felt.
Thyroid scan
With this exam, an isotope that is radioactive is injected into the vein located on the inside of the elbow. The individual is then laid on a table with the head stretched backwards while a different camera will produce images of the thyroid on the screen of the computer. The time that is needed for this procedure can vary, dependent on how long it can take for the isotope to reach the thyroid gland. These scans will deliver data about the size and nature of the thyroid, but they are more intrusive, time-consuming as well as costing more than ultrasound tests.
Biopsy
Using a biopsy with a fine-needle aspiration, the ultrasound is used to situate the needle into the thyroid in order to obtain a fluid or tissue sample for testing.
Treatment for goiter is dependent on the goiter size, the symptoms and signs, and the causal reason. The physician can advise:
Observation
If the goiter is slight and does not cause any problems and the thyroid is working normally, the physician can advise a wait and see period.
Medications
When and individual has hypothyroidism, thyroid replacement therapy with levothyroxine (known as Synthroid, Levothroid) will usually resolve any symptoms occurring with hypothyroidism and slow the release of TSH from the pituitary gland. This often will decrease the goiter size. For a thyroid gland that is inflamed, the physician may advise aspirin or corticosteroid drug to manage the inflammation. For goiter linked with hyperthyroidism, the physician will advise drugs to normalize the levels of hormone.
Goiter Surgery
Taking out all of a part of the thyroid gland (partial or total thyroidectomy) is one option if the goiter is so large that it is causing difficulty with swallowing or breathing or is uncomfortable or other cases if the goiter nodular causes hyperthyroidism. This surgery is as well the therapy for cancer of the thyroid. The individual will need to take levothyroxine following surgery, dependent on the size of the portion of the gland that is detached.
Radioactive Iodine
In other cases, iodine that is radioactive is utilized to treat a thyroid gland that is overactive. The iodine is taken by mouth and extends to the thyroid gland thru the blood system, eliminating thyroid cells. This therapy results in a reduced size of the goiter, but ultimately can also create a thyroid gland that is underactive. Hormone replacement therapy will the synthetic hormone levothyroxine becomes necessary, normally for life.
Goiter Cure
An underactive or overactive thyroid gland will need medication for the remainder of the individual’s life, but a goiter that is causing any problems can be removed or medication can be given in order to alleviate any increase in size of the gland.
Goiter Pictures
