GOITER – A DISEASE OF THYROID GLAND

WHAT IS GOITER?

Goiter is a disease of thyroid gland and is a condition where in simpler terms, the enlargement of the thyroid gland takes place. The thyroid gland is one of the endocrine glands which is butterfly shaped and is bilobed, it is located at the base of the neck.

The thyroid gland being an endocrine gland secretes thyroid hormones T3 and T4 which perform several functions in the body.

Goiters are usually painless. Some types can cause cough and make it a bit difficult for the person to swallow and breathe.

The treatment  usually depends on the size, their symptoms and causes. Some types that are small in size do not require any specific treatment as they are unnoticeable and do not cause any specific problems.

TYPES 

The type of goiter entirely depends on the cause of it. There are basically three main types of goiter :

Endemic or colloid goiter

• This type of goiter is a result of iodine deficiency
• Iodine is a mineral that is necessary in our body for the production of thyroid hormones.
• People that reside in areas having lack of iodine content in the soil usually are the ones that are most prone to this type of goiter.

Toxic nodular or multi – nodular goiter

• In this type of goiter, the thyroid gland of the patient consists of autonomously functioning one or more small nodules.
• These small nodules enlarges over a period of time
• The nodules that are formed, produce their own thyroid hormone and this results in a condition called hyperthyroidism

Sporadic or non – toxic goiter

• Sporadic or non – toxic goiter is basically a diffuse or enlargement of thyroid gland that usually do not result from an inflammation
• The exact cause of this type is still unknown yet
• This is a benign type of goiter
• This type do not usually affect the production of thyroid hormones from the thyroid gland

SYMPTOMS 

It is not necessary for goiters to cause signs and symptoms and not all types cause it. Some of the signs and symptoms that occur due to goiter are listed below :

• Coughing
• Hoarseness, that is the voice becomes scratchy
• Difficulty in swallowing food ( this is due to the squeezing of food pipe)
• Difficulty in breathing
• A tight feeling in throat
• A swelling at the base of the neck, usually below the Adam’s apple (this is the primary symptom)
• Dizziness while raising the arm above the head
• Wheezing ( this is due the squeezing of wind pipe)

CAUSES 

The thyroid gland basically produces two thyroid hormones – T3 and T4. Along with these thyroid hormones it also produces a hormone named calcitonin that regulates the amount of calcium in our body.

The secretion of these hormones from the thyroid gland depends on the pituitary gland and hypothalamus. These produce tropic hormone – TSH (thyroid stimulating hormone).

The TSH regulates the secretions of hormones from the thyroid glands.

At times when the TSH stimulates the thyroid gland to produce more hormones, hyperthyroidism is caused which might be one of the reasons of goiter.

Some of the other reasons that might lead to goiter directly or indirectly are listed below :

Iodine deficiency

• This is the primary reason for the cause of goiter.
• Iodine is the mineral which is essential for the production of thyroid hormone.
• In people who lack iodine or have iodine deficiency, goiter is bound to occur in them

Grave’s disease

• Grave’s disease in simpler terms means hyperthyroidism
• Hyperthyroidism is basically when the thyroid gland secretes thyroid hormones in excess.
• In people who have Grave’s disease, the antibodies produced in them by the immune system by mistake attack their own thyroid gland
• This stimulates the thyroid gland to produce more thyroxine, as a result the thyroid gland swells up hence causing goiter.

Hashimoto’s disease

• Hashimoto’s disease in simpler terms is hypothyroidism.
• Hypothyroidism is a condition in which the thyroid gland produces thyroid hormone in less amount
• This is also an autoimmune disorder like Grave’s disease
• As Hashimoto’s disorder stimulates the thyroid gland to produce less thyroxine, the pituitary gland as a result produces more TSH which as a result causes the thyroid gland to swell up hence causing goiter.

Thyroid cancer

• Thyroid cancer is way too less common than thyroid benign nodules.
• To classify whether is nodule is malignant (cancerous) or not, a biopsy of the thyroid gland can be done

Multinodular goiter

• At times, several small, solid fluid – filled lumps that are called nodules developon each side f the thyroid gland.
• This causes the thyroid gland to swell up hence causing goiter

Solitary thyroid nodules

• In solitary thyroid nodule, a single nodule that is a benign ( non – cancerous ) one develops on a part of the thyroid gland.
• This causes the thyroid gland to swell up hence causing goiter
• These benign nodules do not usually convert themselves into a malignant.

Pregnancy

• During pregnancy, a hormone named human gonadotropic hormone (HCG) is produced.
• This hormone might cause the enlargement of the thyroid gland slightly which might lead to goiter.

Inflammation

• Inflammation of the thyroid gland is known as thyroiditis.
• This may lead to pain and swelling in the thyroid gland.
• During this condition the thyroid gland may produce too much (hyperthyroidism) or too little ( hypothyroidism) thyroid hormones.
• This may eventually lead to goiter

Exposure to radiation 

• People who undergo radiation treatments regularly or frequently develop a chance of thyroid gland being swelled up.
• These radiations do not include CT scan or MRI radiations. It includes radiations coming from other sources.

 

DIAGNOSIS 

If the doctor suspects goiter in a patient, the patient may be advised to undergo the following diagnostic tests for the diagnosis of goiter.

• Physical examination
• Hormonal tests
• Antibodies test
• Ultrasound of the thyroid gland
• Thyroid scan
• CT scan of thyroid gland
• Magnetic resonance imaging (MRI) of the thyroid gland
• Certain blood tests
• Biopsy of thyroid gland

TREATMENT 

The treatment that a person receives if he or she is diagnosed with goiter entirely depends on the type of goiter he or she is having and the symptoms. Sometimes the treatment is also based on the health problems that contribute to goiter.

Below listed are some treatments that can help in curing goiter :

• Medications (cortisteroids)
• Surgeries
• Radioactive iodine
• Care at home
• Biopsy