Goitre
The term “goitre” simply refers to the abnormal enlargement of the thyroid gland. The swelling of thyroid gland which further leads to a swelling of the neck or larynx (voice box). It can be associated with a thyroid gland that is functioning properly or not. The thyroid gland is a small butterfly-shaped gland in the neck, just in front of the windpipe (trachea). It produces thyroid hormones, which helps to regulate the body’s metabolism (the process that turns food into energy). A swelling of thyroid gland can further lead to a swelling of the neck or larynx (voice box).
Goitre is also known as Iodine deficiency disorder as Iodine deficiency is the most common cause of prevalence of goitre. It is estimated that more than 1.5 billion people in the world are at risk from iodine deficiency disorders out of which about 200 million people reside in India.
Types of goitre: There are two different types of goitre:
Diffuse small goitre, where your entire thyroid gland swells to a larger size and feels smooth to the touch
Nodular goitre, where certain sections, or “nodules”, of your thyroid gland swell and feel lumpy to the touch
Symptoms
The main symptom of goitre is swelling of the thyroid gland (a gland in the neck that produces hormones), which causes a lump to develop in the throat.
Symptoms are associated with conditions like:
Hyperthyroidism:
Weight loss
Increased appetite
Heat intolerance.
Hypothyroidism:
Weight gain
Constipation
Cold intolerance
Fatigue
Dry and scaly skin
Causes
Iodine deficiency: It is also one of the leading causes of hypothyroidism, known as Hashimoto's disease. As with Graves' disease, Hashimoto's thyroiditis is an autoimmune disease. Rather than over-stimulating the gland, Hashimoto's thyroiditis interferes with the gland's ability to produce hormones. In order to compensate for this, the body causes the gland to swell, resulting in a goitre.
Overactive thyroid gland : Goitre can develop if the thyroid gland becomes overactive (hyperthyroidism), leading to too many thyroid hormones being produced. Increased hormone production will over-stimulates the thyroid gland and causes it to swell. The leading cause of hyperthyroidism is a condition called Graves' disease. Graves' disease causes immune system (the body’s natural defense system) to send antibodies (proteins that fight infections) to the thyroid gland. The antibodies stimulate the thyroid gland, causing an increased amount of thyroid hormones to be released.
Underactive thyroid gland : A goitre can also develop if the thyroid gland becomes underactive (hypothyroidism). Underactive thyroid gland does not produce enough thyroid hormones, the body will stimulate it to produce more. This can cause the thyroid gland to swell.
Diagnosis
Physical examination: Examining the swelling will help the physician diagnose goitre
A diffuse small goitre, where entire thyroid gland swells up
A nodular goitre, where certain sections, or "nodules" of thyroid gland swell up.
Thyroid function tests: Hyperthyroidism and hypothyroidism can be diagnosed by testing the levels of thyroid hormones in blood. Doctor measures hormones Thyroxine and Triiodothryronine secreted by the thyroid gland itself, as well as thyroid-stimulating hormone (TSH), a chemical released by the pituitary gland that triggers hormone production in the thyroid.
The thyroid gland produces two hormones:
• Thyroxine
• Triiodothyronine: An excessive amount of these two hormones would indicate an underlying condition that is making thyroid gland overactive, such as Graves' disease .
Hypothyroidism: Can be diagnosed with low levels of thyroid hormone in bloodstream, higher quantities of TSH circulating in blood as body attempts to increase production of thyroid hormones. The reverse is true with hyperthyroidism, in which TSH levels are below normal and circulating thyroid-hormone levels are high.
To determine the cause of hyperthyroidism, doctors often do other blood tests looking at certain thyroid antibodies. Raised levels of these antibodies can enable the doctor to pinpoint the cause of an overactive thyroid.
Ultrasound: Doctor may also request either a normal ultrasound scan of neck or a radioactive iodide uptake scan. In radioactive iodide test the doctor uses a special film to create a picture showing the exact location of the radioactive iodide in thyroid gland. Nodules that appear suddenly are typically fluid-filled cysts and are often benign. They can be evaluated with a non-invasive ultrasound examination. If blood tests indicate that the nodules are producing excess thyroid hormone and if have other symptoms, doctor will treat for hyperthyroidism.
Information provided here is just for understanding of health. For more queries consult your doctor.
Treatments
The management of Goitre will depend upon whether the patient is suffering from hypothyroidism or hyperthyroidism.
Hypothryroidism: If diagnosis reveals an underactive thyroid gland, treatment involves using a synthetic (man-made) hormone to replicate normal thyroid function. This is called hormone therapy. The synthetic hormone, which is called levothyroxine, it is taken orally (by mouth), usually once a day.
Hyperthyroidism: An overactive thyroid gland can be cured by thinoamides. Thionamides are drugs that help to reduce the amount of thyroid hormones produced by thyroid gland.
Radioactive Iodine: Radioactive iodine is another treatment for an overactive thyroid gland that is taken orally (by mouth). When the iodine reaches thyroid gland, it destroys the thyroid cells and reduces the size of the goitre. However, the treatment may cause thyroid gland to become underactive.
Iodine supplements: Iodine supplements are also available in many health food shops without prescription.
Surgery: If goitre is interferes with breathing, or swallowing, and has not responded to other forms of treatment, surgery may be required to remove part, or all, of your thyroid gland.
Information provided here is just for understanding of health. For more queries consult your doctor.
References:
NHS
U S National Library of Science
