What Is Goiter?
Goiter is characterized by enlargement of the thyroid gland. It is not a common disease nowadays because of use of iodized salt. The causes of goiter include iodine deficiency, Grave’s disease, and Hashimoto’s disease. In this condition, the thyroid gland becomes large from its actual size. The thyroid gland is a butterfly-shaped gland present below Adam’s apple. Usually, goiter does not cause any signs and symptoms, sometimes causes difficulty in breathing and swallowing. When the number of nodules gets increased, there is an increased secretion of thyroid hormone. Increased secretion of thyroid hormone affects digestion, development of the brain, and heart and muscle function. There are different types of goiter which are classified on the basis of causes and symptoms.
Different Types Of Goiter
There are mainly three types of goiter.
1. Colloid Goiter
Colloid goiter is also known as adenomatous goiter. This type of goiter is developed due to the deficiency of iodine. Iodine is a mineral which is important for the production of thyroid hormones. This type of goiter is usually caused by those people who live in an area where iodine is scarce. This type of goiter does not spread to other parts of the body and is non-cancerous.
Iodine deficiency: Thyroid gland requires iodine for the manufacture of thyroid hormones.
Smoking: In tobacco, thiocyanate is present which affects the functioning of the thyroid gland.
Usually, goiter does not cause any type of symptom however increased size of the thyroid gland may result in the following symptoms
- A visible inflammation on neck
- Difficulty in breathing
- Difficulty in swallowing
- Neck vein distension especially when the patient raises the arm above his head
Thyroid Hormone Replacement Therapy
This therapy is used in the case of iodine deficiency. Hormone replacement inhibits the secretion of thyroid-stimulating hormone.
It is a surgical procedure. This procedure is performed when the patient feels either breathing or swallowing difficulties, or both because of the large size of nodules. In this procedure, the doctor will remove some part or all of the thyroid gland.
Radioactive iodine reaches on thyroid gland through the bloodstream and causes a reduction in the size of nodules.
If the condition is complemented with increased secretion of thyroid hormone, treatment strategy involves anti-thyroid medications and radioactive iodine.
2. Toxic Nodular or Multinodular Goiter
Toxic or Multinodular goiter is an active goiter which is associated from hypothyroidism. In this condition, one or more nodule develops in the thyroid gland which increases secretion of thyroid hormones. A simple goiter can convert into a toxic goiter.
Grave’s Disease: In this disease antibodies which are produced by the immune system affects the thyroid gland and increases the production of thyroid hormone.
Autoimmune Disease: Autoimmune disease such as Hashimoto’s thyroiditis increases the secretion of the hormone.
Simple Goiter: Usually a simple goiter may be converted to a toxic goiter.
Patient with toxic goiter experiences various symptoms such as
- Difficulties in breathing and swallowing
- Visible inflammation in the neck
In a surgical process, your doctor will remove all or part of the thyroid gland. The process for removal of the thyroid gland is known as a thyroidectomy.
Radioactive iodine destroys the thyroid cells and reduces the size of nodules.
Antithyroid medications such as methimazole or propylthiouracil can be administered to treat toxic or multinodular goiter.
3. Nontoxic or Sporadic Goiter
Causes of nontoxic or sporadic goiter are unknown. This type of goiter may be caused as a side effect of some drugs. Lithium, which is used to treat disorders related to mood such as bipolar disorder, may cause sporadic goiter. This type of goiter does not cause any effect on the functioning of the thyroid gland.
Causes of nontoxic goiter are still unknown. Some possible causes of nontoxic goiter are as follows
- Family history
- Use of medications such as lithium
- Consumption of substance which is responsible for inhibiting of thyroid hormone production
- Too little consumption of iodine
Nontoxic goiter does not cause any type of symptoms but when the size of nontoxic goiter is increased then they can cause some common and visible symptoms such as;
- Swelling in neck
- Difficulties in breathing and swallowing
Hormone Suppression Therapy
For reducing the size of the thyroid gland, thyroid hormone can be used.
When the size of the thyroid gland is increased to a level that it starts affecting the normal routine functions, the doctor may recommend thyroidectomy.
Radioactive iodine is also used in the management of sporadic goiter.
There are various types of goiter. Classification is done based on causes, symptoms and treatment options. Generally, goiter is divided into toxic, non-toxic and colloid.
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