The Basics of Goiter

Thyroid is an endocrine gland that sits right in front of the larynx, at the base of the neck. It is responsible for producing certain hormones in the body such as Triiodothyronine (T3) as well as Thyroxine (T4). It works hand in hand with the hypothalamus and the pituitary gland to make sure these hormones are maintained at the right balance to be released into the bloodstream and reach every cell in our body.

Dr. Bridget Brady, Director of Education Experience in the University of Texas Dell Medical School, explains that T3 and T4 hormone levels must be neither too high nor too low because it can cause an array of symptoms that may lead to severe illnesses. Of the many diseases caused by an imbalance in thyroid hormones, goiters are probably the most common. Goiters are usually painless; requiring no further medical intervention, but very large goiters can pose a massive threat on a person’s health.

What is a Goiter?

A goiter is an abnormal enlargement of the thyroid gland, in part on in its entirety. Researches such as that from the Mayo Clinic and BioMed Central Ltd. has shared that the most common reason for developing a goiter is the lack of iodine in a person’s diet. Of 800 million people with iodine deficiency, 200 million are afflicted with goiters, according to an article by Dr. James R. Mulinda in Medscape. The World Health Organization even considers this disease as a “determinant of the prevalence and severity of iodine deficiency disorders in populations”.

Causes of Goiter

The causes of goiters differ based on their type. According to the Cleveland Clinic, goiters may be classified as simple, endemic, and sporadic.

Simple goiters are caused by the underproduction of hormones by the thyroid gland. It tries to make up for the deficiency by growing in size.

Endemic goiters depend on the location wherein the environment itself is iodine deficient. Areas such as Northwest Ethiopia were found to have 37.6% endemic goiter prevalence in children due to low iodine in their diets.

Sporadic goiters, on the other hand, may have no known cause, but attributions are directed at certain drugs used for treatments of other illnesses.

Goiters are also found to be hereditary and are more prevalent in women over age 40. Other diseases such as Thyroiditis, Hashimoto’s, or Grave’s Diseases can also lead to the development of goiter/s.

Symptoms of Goiter

The most obvious symptom of a goiter is the visible swelling on the neck area. The enlarged thyroid puts pressure on the trachea and esophagus, making it difficult for a person affected to breathe or swallow food. Cough, hoarseness of voice and excessive pain at the base of the neck are also symptoms of goiter.

Possible Treatments of Goiter

Since most goiters are painless, these do not require any treatment at all. However, once goiters exhibit symptoms, especially excessive pain and enlargement of the thyroid area, then treatment is advisable.

Treatments include iodine supplementation leading to reduction in size of the goiter. Thyroid hormone therapy is also advised for patients with Hashimoto’s disease as therapy can restore hormone levels to normal and may prevent the goiter from getting larger. Nevertheless, for severe cases of goiter such as from Thyroiditis, The American Thyroid Association still thinks it is best to undergo surgery. They also advise patients to have regular monitoring to check the stage of the goiter to prevent the aggravation of the disease.

 

Citations and references:

  1. Brady, B. (Updated 2018 July). Thyroid Gland: Overview - How this endocrine-related thyroid gland functions, and what symptoms might be a clue for hyperthyroidism and hypothyroidism. EndocrineWeb. Retrieved from https://www.endocrineweb.com/conditions/thyroid-nodules/thyroid-gland-controls-bodys-metabolism-how-it-works-symptoms-hyperthyroi
  2. The Mayo Clinic. Goiter. Retrieved from https://www.mayoclinic.org/diseases-conditions/goiter/symptoms-causes/syc-20351829
  3. Mesele, M., Degu G., Gebrehiwot H., (2014 February 7). Prevalence and associated factors of goiter among rural children aged 6-12 years old in Northwest Ethiopia, cross -sectional study. BioMed Central Ltd. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3996147/ and https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-14-130
  4. Mulinda, J. R. (Updated 2018 March 13). What is the global prevalence of goiter? Medscape. Retrieved from https://www.medscape.com/answers/120034-102149/what-is-the-global-prevalence-of-goiter
  5. The World Health Organization. (2014). Goitre as a determinant of the prevalence and severity of iodine deficiency disorders in populations. Retrieved from http://apps.who.int/iris/bitstream/handle/10665/133706/WHO_NMH_NHD_EPG_14.5_eng.pdf?ua=1
  6. Cleveland Clinic. (Reviewed 2015 August 28). Goiter. Retrieved from https://my.clevelandclinic.org/health/diseases/12625-goiter
  7. American Thyroid Association. Goiter. Retrieved from https://www.thyroid.org/goiter/
  8. MedlinePlus. (Reviewed 2018 February 22). Simple Goiter. Retrieved from https://medlineplus.gov/ency/article/001178.htm
  9. UCLA Endocrine Center. Thyroid Goiter. Retrieved from https://www.uclahealth.org/endocrine-center/thyroid-goiter

 

 

 

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