Goiter

21:53 - 4 May , 2021

Disease

What is Goiter?

It is a condition in which the thyroid gland grows excessively due to iodine deficiency in the body, hyperthyroidism, hypothyroidism, the presence of nodules, or thyroid cancer.  When the enlargement is not serious it is practically unnoticeable and does not cause symptoms, so it does not require treatment. However, in a large goiter there are complications that cause coughing fits, problems swallowing or breathing properly.  Having a goiter does not necessarily imply that the thyroid gland is dysfunctional, but it does point to an underlying cause for this condition.  Based on its morphological characteristics, goiter is classified into:
  • Diffuse: the enlargement is general and no nodules are present. 
  • Uninodular: enlargement accompanied by a nodule.
  • Multinodular: when several nodules appear.
Regarding thyroid functioning, goiter can be:
  • Normal: the gland works correctly.
  • Hypofunctioning:  low hormone production. 
  • Hyperfunctioning: high hormonal production.

Symptoms

Some small goiters may not show symptoms, but the most frequent are:
  • Bulge in the front of the neck.
  • Difficulty swallowing and breathing.
  • Tightness in neck and throat.
  • Cough.
Also, not having enough thyroid hormones can make you feel tired and cold. But if you have an excess of thyroid hormones, you will feel nervous and hot. Generally, in cases of hyperthyroidism there is the presence of goiter since the excess of thyroid hormones causes the gland to grow and have a greater production capacity.  On the contrary, when there is hypothyroidism, goiter only appears in some cases. Potential risks: Goiter can affect anyone, it can be present at birth or arise at any time throughout life. However, there are some risk factors that can contribute to the appearance of this condition, such as:
  • Being a woman and over 40 years old.
  • Family history with autoimmune diseases or goiter.
  • Being pregnant or in the menopausal stage.
  • Having received radiotherapy treatments.
  • Intake of some drugs.
  • Eating a low-iodine diet.
  • Having Hashimoto's disease.

Diagnosis and treatment

Goiter is usually detected on a physical examination by looking at and feeling the lump in the neck. Your doctor will request diagnostic studies that allow him to know the reasons for your condition and what stage it is in, including: 
  • Blood tests to find out if your thyroid gland is overactive or underactive.
  • Thyroid scan.
  • Antibody tests to check for Hashimoto's disease or other abnormalities.
  • Ultrasound to observe the size of the thyroid and verify the presence of nodules.
  • CT scan or MRI of the neck to examine the trachea.
If considered necessary, he or she will also request a thyroid gland biopsy. The treatment to follow will depend on the goiter’s cause, its size, and the symptoms. You may require medication for an overactive or underactive thyroid, as well as radioactive iodine to shrink it.  Smaller goiters or goiters with reduced nodules require only periodic monitoring. Sometimes when large nodules, cancer, or goiter that cause breathing or swallowing problems are detected, surgery is required to remove the thyroid gland, In ABC Medical Center’s Internal Medicine Department, we offer health care services with the highest quality and safety, from the prevention, diagnosis, timely treatment, and monitoring of infectious, respiratory, endocrinological, dermatological, rheumatic, nephrological, gastrointestinal, and hematological pathologies of both chronic-degenerative diseases and acute conditions, through a comprehensive and multidisciplinary model.

Fuentes: 

  • thyroid.org
  • hormone.org
  • medlineplus.gov
  • mayoclinic.org
  • topdoctors.es
  • cun.es
  • medigraphic.com
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  • Mendoza Romo-Ramírez MA, Mendoza Romo MA, Ramírez-Arriola MC. Cáncer papilar en bocio multinodular gigante. Med Int Mex. 2017;33(5):705-707.
  • Mesa IO, Valdés SLM, Barrios CD, et al. Comportamiento quirúrgico de las patologías del tiroides. Revista Cubana de Cirugía. 2020;59(1):1-16.
  • Puerto LJA, Torres AL, Cabanes RE. Bocio nodular quístico recidivante. A propósito de un caso. Finlay. 2019;9(2):152-157.
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