Goiter is a disease that develops due to the enlargement of the thyroid gland in the front of the neck. In medicine, it is also known as simple or diffuse goiter.
What is Goiter?
Goiter is a disorder that develops due to the enlargement of the thyroid gland. When the expression goiter is used alone, it means "simple diffuse goiter disease". Simple goiter means homogeneous enlargement of the thyroid gland without nodules or thyrotoxicosis. But sometimes, cases accompanied by asymmetric growth or the presence of nodules can also be called goiter alone.
In goiter disease, the secretion of hormones called T3 (Triiodothyronine) and T4 (Thyroxine) secreted by thyroid gasoline is normal. There are no nodules in the thyroid gland. The only physiological difference in which diffuse goiter disease, which is mostly caused by iodine deficiency, occurs in the first years is the enlargement of the thyroid gland. In cases of goiter that occurs during childhood and adolescence, there is widespread enlargement of the thyroid gland. However, when goiter is not treated, the thyroid gland continues to grow and nodules begin to form.
What are the causes of goiter?
Thyroid The main cause of goiter, which is characterized by abnormal growth of the gland, is iodine deficiency in the body. The thyroid gland uses iodine to produce thyroid hormones. The amount of iodine taken can directly affect the levels of T3 and T4 hormones secreted by the thyroid gland. In iodine deficiency, the thyroid gland needs to work harder. This causes the thyroid gland to enlarge. This is the reason why goiter is more common in people who are fed poorly in iodine or live in areas far from sea water.
The second most common cause of goiter is Hashimoto's disease. In the presence of this disease, also known as Hashimoto's thyroiditis, the person's immune system destroys the thyroid gland. As a result, the thyroid gland cannot produce the required amount of hormone for the body. Therefore, the pituitary gland in the brain stimulates the thyroid gland by producing more TSH hormone. As a result, enlargement of the thyroid gland and goiter occur.
Another disease that causes goiter is Graves' disease, popularly known as toxic goiter. Thyroid stimulating immunoglobulin of the immune system In this disease, which causes the secretion of blood, the thyroid hormone produces more hormones than the body needs. As a result, goiter and hyperthyroidism diseases occur.
Cystic structures formed in the thyroid gland are defined as nodules. Thyroid nodules can lead to nodular goiter. In addition to all these, thyroid cancer can also cause swelling of the thyroid gland by affecting thyroid hormone production. However, this is a rare condition.
What are the Symptoms of Goiter Diseases?
Goiter may not cause any symptoms in some cases. However, in some of the patients,
- Swelling in the neck,
- Cough,
- Difficulty swallowing,
- Respiratory distress,
- Symptoms such as a feeling of a lump in the throat,
- Hoarseness may be seen.
What are the Risk Factors for Goiter? Who Gets Goiter?
Goiter; It is more common in people over the age of 50, in women, in those with immune system problems, during pregnancy and menopause, and in people living in some geographies. The main risk factors for goiter can be listed as follows:
- Iodine deficiency: Living in areas far from the sea and not consuming enough iodine through food can lead to iodine deficiency. The lack of iodine used in the production of thyroid hormone causes the thyroid gland to work harder.
- Age: Although goiter can be seen in all age groups, the disease is more common in people over 40. Goiter is seen 4-5 times more frequently in women than in men.
- Pregnancy and menopause: Pregnancy and menopause are the periods when goiter is more common.
- Medicine use: Cardiac drugs and psychiatric disorders Although it is thought that drugs accelerate the development of goiter, such drugs should definitely not be discontinued without the advice of a doctor.
- Genetic Predisposition: Goiter is more common in people with a family history of goiter.
Why Goiter Occurs During Pregnancy?
As the frequency of goiter formation increases during pregnancy, it is observed that goiter enlarges in women who had goiter before pregnancy. Iodine deficient This is more common in women with pre-existing pregnancy. The need for iodine increases due to the increase in iodine loss during pregnancy and the use of iodine by the baby. For this reason, iodine intake should be increased during pregnancy and appropriate treatment should be applied if there is goiter.
How to Diagnose Goiter?
- In case of enlargement of the thyroid gland in the anterior region of the neck due to different reasons, The goiter that occurs is noticed during routine health screenings or when the disease shows symptoms.
- After the person's application to the physician, the physician first listens to the patient's history and performs a physical examination.
- Laboratory tests are performed to measure thyroid hormone levels.
- In addition, the thyroid gland is examined in detail by ultrasonography.
- The physician may request additional scintigraphy and biopsy if necessary.
- The person is diagnosed with goiter in the light of the data obtained.
What are the Goiter Treatment Methods?
Goiter treatment is based on the current state of the disease, It is applied in different ways depending on its size and symptoms.
- If the goiter is small and the symptoms do not bother the patient, the physician may only want the disease to be observed. In this case, it is recommended to go for control at intervals determined by the physician.
- If goiter causes the thyroid gland to work overtime, in other words, if the person has hyperthyroidism, drug treatment is applied.
- If there is a different condition such as inflammation accompanying the disease, these diseases are also treated with medication.
- In cases where the symptoms are severe, some or all of the thyroid gland may need to be surgically removed. After goiter surgery, treatment is supported by medication.
Who and When Is Goiter Surgery Performed?
In some cases, thyroid surgery for the treatment of goiter The gland should be removed. If the diameter of the nodules formed in the thyroid exceeds 2 cm,
- Careful ligation of the thyroid vessels (due to the risk of bleeding after surgery),
- Not removing the parathyroid glands adjacent to the thyroid gland (they regulate calcium metabolism),
- The patient recovers quickly after goiter surgery and can perform his daily functions in a short time. Since the thyroid gland is removed, it is necessary to use the thyroid hormones necessary for the body's metabolism for life.
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