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Goitre

 

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Goitre is the swelling of the thyroid gland, which is common in areas where there is a lack of iodine in the diet, although other causes too are present. However goitre can be caused by a range of factors that may need medical attention. A goitre can cause pressure on the gullet (difficulty in swallowing) and on the windpipe (difficulty in breathing). hypothyroidism is usually given with the aim of normalising the level of thyroid stimulating hormone (TSH). Very rarely it affects the voice, causing hoarseness. When it produces these symptoms, the thyroid swelling is sometimes larger and lower in the neck, compressing the gullet and windpipe between the spine and the breastbone. Thyroxine and help to keep the body's functions (the metabolism) working at the correct pace. Many cells and tissues in the body need thyroxine and T3 to keep them working correctly.

A goitre is an enlargement of the thyroid gland. This gland is situated at the front of the throat, below the Adam's apple (larynx). The thyroid gland is in the lower part of the front of the neck. It lies just in front of the trachea (windpipe). Goitre is commoner in women than in men.  Sometimes, however, more thyroid hormone (hyperthyroidism) or less thyroid hormone (hypothyroidism) is produced, thereby causing the symptoms associated with these disorders. A dietary deficiency of iodine, which is a key ingredient in the manufacture of thyroid hormone, can cause goitre in certain populations. Such a goitre is termed endemic, meaning a high incidence of goitre (in more than 10 percent of the population) occurs in a specific community or geographic area. Inadequate dietary intake of iodine, and thus endemic goitre, typically occurs more commonly in fresh water and lake areas than on the sea coast, because of the lack of iodine in fresh water. In contrast, suppressive therapy to minimise the chance of thyroid cancer recurrence or, in some circumstances, to reduce goitre size aims to reduce TSH to levels well below the normal range. The thyroid gland makes thyroid hormones - called thyroxine (T4) and triiodothyronine (T3). These are carried round the body in the bloodstream. The thyroid gland enlarges as it attempts to comply with the pituitary's demands. Apart from iodine deficiency, other causes of goitre involve conditions of the thyroid - such as nodules, cancer, hyperthyroidism and hypothyroidism

A goitre is an enlargement of the thyroid gland that is NOT associated with inflammation or cancer. The swelling of the thyroid gland at the back of the neck is referred to as Goiter A "diffuse goitre" is a goitre that has spread through all of the thyroid (and is contrasted with a "simple goitre", "single thyroid nodule" and "multinodular goitre"). You cannot usually see or feel a normal thyroid gland. If the thyroid enlarges it causes a swelling in the neck which you can see - a goitre. If a person's diet is low in iodine, the pituitary keeps sending chemical messages to the thyroid, but in vain. Goitre can occur as a normal feature of puberty and pregnancy and is not caused by disease.

Causes of Goitre

The common Causes of Goitre :

  • High consumption of certain foods that neutralise iodine, such as cabbage, broccoli and cauliflower. Other foods, like soy, may also induce goitres.
  • Certain drugs, such as lithium and phenylbutazone
  • Physiological - puberty, pregnancy
  • Juvenile goitre due to congenital hypothyroidism
  • Dyshormonogenesis, a genetic enzyme deficiency that interferes with normal thyroid hormone synthesis.
  • Benign or malignant tumours of the thyroid gland .

Symotoms of Goitre

Some common Symotoms of Goitre :

  • Enlargement of the throat, ranging from a small lump to a huge mass.
  • Emotional upsets
  • Depression
  • Irritability
  • Swallowing problems, if the goitre is large enough to press on the oesophagus.
  • Diminished power of concentration.
  • Breathing problems, if the goitre is large enough to press on the windpipe (trachea).

Treatment of Goitre

  • Goitres are often removed because of cosmetic reasons or, more commonly, because they compress other vital structures of the neck including the trachea and the oesophagus making breathing and swallowing difficult
  • Cancer of the thyroid - is treated by surgical removal of the gland, followed by radioactive iodine treatment.
  • If you have a small goitre that is not due to a cancerous nodule, and your thyroid is making the correct amount of thyroxine and T3, then you may not need any treatment.
  • If you have cancer of the thyroid, you will probably need surgery.
  • If these fail to work, part or all of the thyroid gland is surgically removed alternatively, some or all of the thyroid's hormone-producing cells can be destroyed with radioactive iodine treatment.
  • Benign thyroid nodules - are shrunk with medications, destroyed with radioactive iodine treatment or surgically removed, depending on the type.