Goiter is the enlargement and enlargement of the thyroid gland in the neck. A goiter can be caused by a variety of factors and conditions, and in some cases, no treatment is needed. However, sometimes the treatment may extend to surgical operation. You can find more information below.

What is goiter?

The condition called goiter is a benign enlargement of the thyroid gland , a tiny organ located under the larynx in the neck. The thyroid hormones thyroxine and triiodothyronine are produced by the thyroid gland. For this, the thyroid needs iodine. Iodine deficiency is the most common cause of goiter.

A healthy thyroid gland consists of two lobes nestled together like butterflies. Its texture is very soft and weighs approximately 12 to 20 grams on average. With more than 90 percent of all thyroid disorders, goiter is the most common disorder.

For example, in Germany, one in three adults has an iodine deficiency, one in three adults has iodine deficiency and they require treatment. Although changes in the thyroid gland are rare in those under 35 years of age, they are slightly more common in older people.

With a slight enlargement of the thyroid gland, there are usually no symptoms, and the enlargement is discovered only by chance. However, it is a disease that can continue to progress. The thyroid rarely gets so large that the pressure and tightness in the neck causes complaints such as difficulty swallowing, discomfort when wearing high-necked clothing, and shortness of breath in certain positions of the head.

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Islets of tissue that do not produce hormones can cause an enlarged thyroid gland, and in rare cases, cancer may develop. When hormone production decreases, it can lead to symptoms such as rapid heartbeat, weight loss, irritability and insomnia in some cases.

Types of goiter and their causes

A goiter is usually caused by an iodine deficiency. The thyroid needs iodine to produce the thyroid hormones T3 (triiodothyronine) and T4 (tetraiodothyronine, also thyroxine).

If the thyroid gland has too little iodine to produce hormones, the body tries to compensate by producing more thyroid cells. These are designed to preserve thyroid function for as long as possible. Thus, the thyroid tissue slowly proliferates and a goiter is formed.

Risk factors such as hereditary predispositions and smoking are also known. In addition, malignant changes such as thyroid cancer, autoimmune disease , or thyroid inflammation can cause the thyroid to enlarge. Inflammation of the thyroid gland may be accompanied by an overactive thyroid ( toxic goiter ).

Causes of the endemic species

Endemic goiter, also called colloidal goiter, occurs due to iodine deficiency. Iodine is used in the production of thyroid hormones. When there is not enough iodine to make these hormones, the thyroid gland becomes enlarged.

Causes of the sporadic type

Sporadic goiter or non-toxic goiter can also occur because the thyroid does not produce enough hormones to meet the body’s needs. In some cases of sporadic goiter, the exact cause is unknown but can be attributed to:

  • Genetic
  • Side effects of drugs (such as the side effects of lithium)
  • Other diseases or disorders of the thyroid
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What are the symptoms of goiter?

The symptoms of a goiter depend on the size of the thyroid gland. As the thyroid grows , the feeling of pressure and tightness in the throat becomes more and more uncomfortable . Some patients always feel a lump in the throat , others only notice the enlargement of the thyroid gland by the size of the collar, which changes when buying clothes .

The thyroid gland is located just below the Adam’s apple. If the thyroid gland enlarges, it puts pressure on the windpipe and gets stuck. This is noticeable by a loud breathing noise . The patient experiences shortness of breath during exercise or certain movements of the head . A large goiter can also put pressure on the vocal cords, esophagus, or blood vessels, causing hoarseness, difficulty swallowing, or a blockage of blood in the brain .

How is goiter diagnosed?

Various tests can be used to diagnose and evaluate goiter, including:

  • Physical examination: Your doctor may tell you that the thyroid gland is enlarged by feeling the neck area for signs of nodules and tenderness.
  • Hormone test: This blood test measures the level of thyroid hormone, which shows whether the thyroid is working properly.
  • Antibody test: This blood test looks for antibodies produced in some forms of goiter.
  • Thyroid ultrasound: Ultrasound is a procedure that sends high-frequency sound waves through body tissues. These are saved and converted to video or photos. These images show the size of the thyroid gland.
  • Thyroid scan: This imaging test provides information about the size and function of the gland. In this test, a small amount of radioactive material is injected into a vein to produce an image of the thyroid on a computer screen. This test is not preferred very often because it is useful only in certain situations.
  • CT scan or MRI: If the goiter is very large or has spread to the chest, these can be used to measure the size and spread of the goiter.
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How is goiter treated?

Potential treatment is aimed at relieving symptoms caused by a goiter that puts pressure on other tissue structures (for example, the trachea) and correcting an overactive or underactive thyroid. If goiter is perceived as an aesthetic disorder, surgery may be required. Surgery is usually necessary if there is difficulty breathing or swallowing.

In some cases, the thyroid gland changes minimally or grows slowly. Rarely, especially in the elderly, controls are usually completely sufficient, unless there are any complications, suspected cancer, or significant aesthetic defects. A medical examination should be performed , especially if symptoms change or enlargement of the thyroid gland is rapidly progressing . In some patients, the goiter regresses on its own.

Radioiodine therapy is a good alternative to surgery for elderly patients. Radioactive iodine is administered to the patient, which accumulates in the thyroid gland and destroys the cells there, thereby reducing the volume of the goiter. This treatment is only possible in specially equipped clinics.

Administration of iodine, possibly in combination with thyroid hormones, may also have a beneficial effect on thyroid enlargement in some patients. An attempt at drug therapy (iodized thyroid hormone) should not take longer than one to two years. Taking medications permanently carries more risks than benefits.

In the case of overt hyperthyroidism, treatment with drugs that inhibit the production of hormones in the thyroid (called thyroid drugs) and in the case of hypothyroidism with thyroid hormones.

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