Patient's Complete Guide to Goiter

Overview of Goiter

The thyroid is a gland located in your neck region. It releases hormones that maintain bodily functions such as metabolism, heart rate, respiration, and digestion. Goiter ( گِلہَڑ )is a problem in which your thyroid is enlarged. It can be either a temporary issue or a serious problem that requires medical attention.

Occurrence of Goiter

Globally, the main cause of goiter is iodine deficiency. As per Wickham's study in the United Kingdom, 16% of the population had a goiter. In Pakistan, approximately 25% of studies reported a 70% prevalence of goiter. It mostly affects females as compared to males.

Signs and Symptoms of Goiter

Along with a lump in your neck, here are some common signs and symptoms of goiter:

  • Hoarseness
  • Dizziness when you raise your arms
  • Swollen neck veins
  • Coughing
  • Trouble breathing or swallowing
  • Sweating
  • Diarrhoea
  • Irregular period
  • Nausea
  • Fast heartbeat
  • Shakiness
  • Tiredness
  • Weight gain

Types of Goiter

Goiter can be of various types depending upon various factors such as:

  • Simple Goiter: This condition occurs when your thyroid gland does not secrete enough hormones. 
  • Endemic Goiters: Endemic goiters or colloid goiters are caused by a deficiency of iodine in your diet. Your thyroid requires iodine to produce its hormones. 
  • Sporadic or Non Toxic Goiters: These types of goiters can occur without any known reason. Sometimes, certain drugs and medications can trigger them.
  • Multinodular Goiters: You may develop a multinodular goiter if a lump called a nodule grows in your thyroid.

Causes of Goiter

Here are some common reasons that increase the size of your thyroid gland: 

  • Iodine Deficiency: Iodine is mainly required for the production of thyroid hormones. It is mostly present in seawater and coastal areas. People living in developing countries are mostly iodine deficient and are more prone to goiters. Certain foods such as cabbage, broccoli, and cauliflower are rich in hormone-inhibiting agents. If you use these foods more often your iodine deficiency may be made worse.
  • Graves' Disease: Graves’ disease can develop if your thyroid gland produces thyroid hormone in excess (hyperthyroidism). In this disease, the antibodies produced by the immune system mistakenly attack the thyroid gland. It causes the overproduction of thyroxine which results in swelling of the thyroid.
  • Hashimoto's Disease: You can also develop goiter due to under activation of the thyroid (hypothyroidism). Hashimoto's disease is also an autoimmune disorder. But it damages your thyroid in a way that it produces too little hormone.
  • Pregnancy: A hormone human chorionic gonadotropin (HCG) which is released during pregnancy, may cause your thyroid gland to increase in size.
  • Inflammation: Inflammation of the thyroid called Thyroiditis may cause pain and swelling in your thyroid. It also triggers the body to produce abundant or too little thyroxine.

Risk Factors of Goiter

Some common risk factors associated with goiters are:

  • Lack of Dietary Iodine: If your diet is iodine deficient your chances of developing goiter are increased. 
  • Age: After 40 years of age you become more likely to be affected by goiter. 
  • Pregnancy and Menopause: In women, mostly pregnant and those suffering from menopause face thyroid problems. 
  • Female: Women are more prone to develop thyroid disorders as compared to men. 
  • Medical History: A family history of any autoimmune disease increases your risk.
  • Certain Medications: Certain medicines, such as heart drug amiodarone and the psychiatric drug lithium increase your risk.
  • Radiation Exposure: Your risk increases if you've undergone radiation or been exposed to radiation in a nuclear facility.

Prevention

Goiter can be prevented by making sure that the level of iodine in the body is normal. By eating a balanced diet and yoghurt the level of iodine in the body can be maintained. Nowadays manufacturer’s produce iodine-rich salt and its intake is the best preventive measure to tackle the issue of goiter.

Diagnosis

On your first visit, your doctor will check the swelling on your neck. Your medical officer may suggest the following diagnostic tests:

  • Blood Test: Through blood tests levels of hormones and antibodies can be estimated. These hormones and antibodies are produced after an infection or damage to the immune system.
  • Thyroid Scan: If your thyroid level is elevated your doctor may recommend a CT scan or MRI scan of your thyroid. These scans provide information about the size and condition of your goiter. Through this overactivity of some parts or whole thyroid can be estimated.
  • Ultrasound: An ultrasound provides images of your neck area, size of the goiter, and location of nodules. Over time, alteration in these nodules and the goiter can be noticed through ultrasound imaging.
  • Biopsy: To perform a biopsy, a small sample of your goiter tissues will be taken. Further, the samples will be sent to a laboratory for examination.

Treatment of Goiter | When to Consult a Doctor

Your doctor will opt for a treatment method based on the size, symptoms, and condition of your goiter. Treatment is also associated with health issues that contribute to the goiter.

  • Home Care: Depending on the type of goiter, you can adjust the level of iodine in your diet at home. If your goiter is not causing any serious health issues then you might don’t have to seek medical treatment.
  • Medications: If you are suffering from hypothyroidism or hyperthyroidism, your goiter can be shrunk by medications. Medications such as corticosteroids may be used to reduce inflammation.
  • Radioactive Iodine: Radioactive iodine (RAI) may be a basic requirement in people with toxic multinodular goiters. It is ingested orally, which then moves to your thyroid through the blood. In the thyroid, it destroys the overactive thyroid tissues.
  • Surgeries: Removal of the thyroid through surgery also known as thyroidectomy will be done if your goiter is excessively large. This method will be used only if your goiter cannot be treated with medicines.

Speciality for Goiter

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