The term “goitre” simply refers to the abnormal enlargement of the thyroid gland. The thyroid gland is a small butterfly-shaped gland in the neck, just in front of the windpipe (trachea). It produces thyroid hormones, which helps to regulate the body’s metabolism (the process that turns food into energy). A swelling of thyroid gland can further lead to a swelling of the neck or larynx (voice box).
Goitre is also known as Iodine deficiency disorder as Iodine deficiency is the most common cause of prevalence of goitre. It is estimated that more than 1.5 billion people in the world are at risk from iodine deficiency disorders out of which about 200 million people reside in India.
Types of goitre:There are two different types of goitre:
- Diffuse small goitre, where entire thyroid gland enlarges to a larger size and feels smooth to the touch
- Nodular goitre, where certain sections, or “nodules”, of thyroid gland enlarge and feel lumpy to the touch
The main symptom of goitre is swelling of the thyroid gland which causes a lump to develop in the throat. An enlarged thyroid gland can put pressure on trachea (wind pipe) and oesophagus (food tube), this can lead to breathing difficulties, cough, hoarseness of voice, difficulty in swallowing specially with solid foods.
Symptoms associated with conditions like hyperthyroidism and hypothyroidism:
- Weight loss
- Increased appetite
- Heat intolerance.
- Weight gain
- Cold intolerance
- Dry and scaly skin
The most common cause of goitre is Iodine deficiency. It is one of the leading causes of hypothyroidism.
Hyperthyroidism (Overactive thyroid gland): Goitre can develop if the thyroid gland becomes overactive (hyperthyroidism), leading to too much thyroid hormones being produced. Increased hormone production will over-stimulate the thyroid gland and causes it to enlarge.The leading cause of hyperthyroidism is Graves’ disease. Graves’ disease causes immune system (the body’s natural defense system) to send antibodies (proteins that fight infections) to the thyroid gland. The antibodies stimulate the thyroid gland, causing an increased amount of thyroid hormones to be released.
Hyporthyroidism (Underactive thyroid gland): Goitre can also develop if the thyroid gland becomes underactive (hypothyroidism). Underactive thyroid gland does not produce enough thyroid hormones, the body will stimulate it to produce more. This can cause the thyroid gland to enlarge. Hashimoto’s thyroiditis is an autoimmune disease causing hypothyroidism.
Physical examination: Examination of the swelling will help the physician to diagnose goitre.
A diffuse small goitre, where entire thyroid gland swells up
A nodular goitre, where certain sections, or “nodules” of thyroid gland swell up.
Thyroid function tests: Hyperthyroidism and hypothyroidism can be diagnosed by testing the levels of thyroid hormones in blood. Doctor measures hormones Thyroxine and Triidothyronine secreted by the thyroid gland and thyroid-stimulating hormone (TSH), a chemical released by the pituitary gland that triggers hormone production in the thyroid.
Hypothyroidism: Can be diagnosed with low levels of thyroid hormone and higher quantities of TSH circulating in blood, as body attempts to increase production of thyroid hormones.
Hyperthyroidism: The reverse is true with hyperthyroidism, in which TSH levels are below normal and circulating thyroid-hormone levels are high such as Graves’ disease.
To determine the cause of hyperthyroidism, doctors often do other blood tests looking at certain thyroid antibodies. Raised levels of these antibodies can enable the doctor to pinpoint the cause of an overactive thyroid.
Ultrasound: Doctor may advice either a normal ultrasound scan of neck or a radioactive iodide uptake scan. In radioactive iodide test the doctor uses a special film to create a picture showing the exact location of the radioactive iodide in thyroid gland. Nodules that appear suddenly are typically fluid-filled cysts and are often benign. They can be evaluated with a non-invasive ultrasound examination.
Information provided here is just for understanding of health. For more queries consult the physician .
The management of Goitre will depend upon whether the patient is suffering from hypothyroidism or hyperthyroidism.
Hypothryroidism: If diagnosis reveals an underactive thyroid gland, treatment involves using a synthetic (man-made) hormone to replicate normal thyroid function. This is called hormone therapy. The synthetic hormone, which is called levothyroxine, it is taken orally (by mouth), usually once a day.
Hyperthyroidism: An overactive thyroid gland can be cured by thinoamides. Thionamides are drugs that help to reduce the amount of thyroid hormones produced by thyroid gland.
Radioactive Iodine: Radioactive iodine is another treatment for an overactive thyroid gland that is taken orally (by mouth). When the iodine reaches thyroid gland, it destroys the thyroid cells and reduces the size of the goitre. However, the treatment may cause thyroid gland to become underactive.
Iodine supplements: The regular consumption of iodated salt provides protection from goitre due to hypothytyroidism.
Surgery: If goitre is interferes with breathing, or swallowing, and has not responded to other forms of treatment, surgery may be required to remove part, or all, of your thyroid gland.
Information provided here is just for understanding of health. For more queries consult your doctor.