At what point does Goiter require extra treatment?
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Goiter is not less common again these days, we see it very often, so it is easy for people to even describe it when asked, but for the sake of formality and proper introduction, I would still describe it, A goiter is an enlarged thyroid gland that causes swelling to happen around the neck, there are several reasons why it could happen, but it could significantly be an indication that the thyroid gland is producing excessive or limited thyroid hormone, the affected person may feel tightness in the throat and inability to swallow appropriately.
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What does the thyroid hormone stand for? Thyroid hormones travel from the thyroid gland through the blood to every part of the body. Thyroid hormones are responsible for how the body uses the food consumed for energy, and help your organs function appropriately. They affect the rate of metabolism, which means how fast or how slow the brain, liver, muscles, heart, and other parts of the body function. In a case when your metabolism is too slow or too fast, you may begin to feel tired or cold, in a case of excessive thyroid hormone, you feel warm or nervous.
Goiter happens to be one of the most common disorders of thyroid diseases, but when it happens, it doesn't necessarily indicate that the thyroid is functioning abnormally, instead, it could be a signal that there is an underlying thyroid disease that requires urgent treatment and attention. Normally, these goiters are harnessed, and after some time they go away on their own even without treatment, but when the goiter becomes large and creates bothersome symptoms, that is when it begins to create bothersome symptoms.
The normal human thyroid should weigh 10-20 grams which is around 0.3-0.6 ounces, some of the goitrous thyroid glands would weigh as much as 1,000 grams which is over 2 pounds. We could either have the entire thyroid gland enlarged or have a more large thyroid nodule. The function of the thyroid gland could either be normal, decreased, or increased. When a goiter is large, it could create choking sensations that could create serious difficulty while breathing and swallowing.
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Endemic goiter is the most common type of goiter, caused by the deficiency of iodine. Iodine is a very essential nutrient required for the production of thyroid hormone. At the point when the intake of iodine is low, then the production of thyroid hormone is low, and in response, the pituitary gland secretes a higher quantity of hormone thyrotropin, (which is a thyroid-stimulating hormone) intending to restore thyroid hormone production to normal.
Excessive thyrotropin stimulates not just the production of thyroid hormone back to normal, but also the thyroid growth. Endemic goiter is more common amongst the female gender than the male. There are several other causes and types of goiter, and one of them is caused by a defect in one of the syntheses of thyroid hormone. Like the case of iodine deficiency as well, these defect leads to an increased thyrotropin secretion. Other causes are cases of multiple nodules in the thyroid by lymphocytes or other inflammatory cells, or the stimulation of thyroid growth by antibodies that activate the thyroid in the same manner as it does with thyrotropin, as it occurs in the disorder called Graves Disease.
We have Nontoxic goiter (sporadic type), the cause is often unknown, although it may be caused by medications like lithium. Lithium is used for the treatment of mood disorders like bipolar disorder.
Toxic nodular or multinodular goiter, is formed with the enlargement of one or more small nodules. The nodules produce their thyroid hormone known as hyperthyroidism, it often forms generally by an extension of simple goiter.
There is a risk of a goiter if;
- You do not get sufficient iodine in your diet.
- If you are a female.
- If you are over 40 years of age.
- If you are pregnant or you are experiencing menopause.
- If you have had radiation therapy around the neck or the chest area, radiation can change the way the thyroid functions.
The major symptom of goiter is a noticeable swelling around the neck, the presence of nodules on your thyroid would range in size, from very small to very large. The presence of nodules could increase the appearance of swelling, other symptoms include; coughing, difficulty breathing or swallowing, hoarseness in the voice, and dizziness when the arm is raised above the head.
If the goiter is not obvious yet, it could be found during a physical examination around the neck when the doctor feels swelling around the neck, the doctor could also use other tests to figure out the cause of the goiter and to show the extent of its advancement, some of the instrument of tests are;
Antibody tests for Hashimoto's disease and Grave's disease.
Hormone tests to help show if your thyroid gland is underactive or overactive.
A thyroid scan to look at the thyroid, especially when your thyroid is overactive.
A biopsy, with the use of a needle to get the sample of the patient's thyroid for testing.
The treatment for goiter depends on its size and its symptoms, if the goiter size is small and the thyroid is making little amounts of thyroid hormone, then your doctor may observe the goiter over time rather than starting treatment instantly. The possible treatment are;
Medicines for overactive or underactive thyroid.
Radioactive iodine is used for overactive thyroid.
Surgery is rare, but the removal of the thyroid gland may be recommended for the taking out of large goiter, this case is used when there is a breathing or swallowing issue for nodules or thyroid cancer.
Summary.
A goiter is a swelling that happens with the thyroid gland, it is often harmless, although it can be a signal for an underlying thyroid condition. Depending on the cause of the goiter, it may just disappear on its own without any need for treatments, and doctors could recommend treatments for the case of an underlying thyroid disease or if the thyroid appears to disrupt normal life activities.
References.
https://www.medicalnewstoday.com/articles/167559#summary
https://www.ncbi.nlm.nih.gov/books/NBK562161/
https://academic.oup.com/jcem/article/98/1/27A/2823239?login=false
https://medlineplus.gov/ency/article/001178.htm
https://www.healthline.com/health/goiter-simple#diagnosis
https://www.britannica.com/science/Zellweger-syndrome
https://www.intechopen.com/chapters/69905
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