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Goitre

Anyone can develop a goitre, but the chances increase with age. Women are also more likely to develop a goitre [1]. A goitre is a swelling of the thyroid gland that causes a swelling on the neck [1].


The thyroid gland is a butterfly-shaped gland situated in front of the windpipe [2]. This gland is responsible for producing and secreting hormones that regulate growth and metabolism [2].


Most cases of goitre are “simple” goitre which does not involve inflammation or any detriment to thyroid function, produces no symptoms, or obvious cause [2]. Some people experience a small amount of swelling, while others can have considerable swelling that constricts the trachea, thus causes breathing problems [2].


However, an enlarged thyroid does not necessarily mean that the thyroid gland is not functioning. A person with goitre may have a thyroid gland that is [2]:

  • Creating too much hormone- hyperthyroidism

  • Creating too little hormone- hypothyroidism

  • Creating the typical amount of hormone- euthyroidism

Goitres are more common in females than males, especially after menopause and are generally more common after the age of 40 [2]. In addition, the degree of swelling and the severity of symptoms produced by the goitre depends on the individual [2].


When symptoms occur, the following are most common [2]:

  1. Throat tightness, cough, and hoarseness

  2. Trouble swallowing

  3. In severe cases, difficulty breathing


Other symptoms may be present because of the underlying cause of the goitre [2].

Hyperthyroidism, or an overactive thyroid, can cause symptoms such as [2]:

  • Nervousness

  • Palpitations

  • Hyperactivity

  • Heat hypersensitivity

  • Fatigue

  • Increased appetite

  • Hair loss

  • Weight loss

Hypothyroidism, or an underactive thyroid, can cause symptoms such as [2]:

  • An intolerance to the cold

  • Constipation

  • Personality changes

  • Hair loss

  • Weight gain

The following are some of the known causes of goitre [2]:

  • Iodine deficiency- the most common cause of goitres is a lack of iodine in the diet. The thyroid needs iodine to create thyroid hormones, which regulate metabolism [2]. Iodine is essential to helping your thyroid produce thyroid hormones. When you don’t have enough iodine, the thyroid works extra hard to make thyroid hormone, causing the gland to grow larger [3].

  • Smoking: thiocyanate in tobacco smoke interferes with iodine absorption and can cause enlargement of the thyroid gland [2]

  • Hormonal changes: pregnancy, puberty, and menopause can affect thyroid function.

  • Thyroiditis: an inflammation caused by infection, for example, can lead to gaiter.

  • Lithium: this psychiatric drug can interfere with thyroid function [2]

  • Too much iodine: can trigger thyroid inflammation

  • Radiation therapy: can trigger a swollen thyroid, particularly when administered to the neck.

  • Thyroid cancer: more common in females [2]

Goitre is diagnosed after clinical examination of the neck area and running diagnostic tests that include these below [3]:

  1. Blood tests- Blood tests can detect changes in hormone levels and increased production of antibodies, which are produced in response to an infection or injury or overactivity of the immune system.

  2. Thyroid scan- This is usually done when your thyroid level is elevated. These scans show the size and condition of your goitre, overactivity of some parts or whole thyroid.

  3. Ultrasound- An ultrasound produces images of your neck, the size of your goitre, and whether there are nodules. Over time, an ultrasound can track changes in those nodules and the goitre.

  4. Biopsy- A biopsy is a procedure that involves taking small samples of your thyroid nodules if present. The samples are sent to a laboratory for examination.

Goitre has various courses of treatment based on the size and condition of the swelling, as well as the symptoms and health problems associated with it. The follow include some methods in which goitre can be treated [3]:

  1. Medications- medications to treat these conditions may be enough to shrink a goitre. Medications (corticosteroids) to reduce your inflammation may be used if you have thyroiditis [3].

  2. Surgeries- Surgical removal of your thyroid, known as thyroidectomy, is an option if it does not respond to medication therapy.

  3. Radioactive iodine- “in people with toxic multinodular goitres, radioactive iodine (RAI) may be necessary. The RAI is ingested orally and then travels to your thyroid through your blood, where it destroys the overactive thyroid tissue”.

  4. Home care- depending on your type of goitre, you may need to adjust your iodine intake at home.

Furthermore, if the goitre is small and does not cause any problems, you may not require any treatment at all [3]


Reference

1. Medical News Today. Everything you need to know about goiter. 2020. Available at: https://www.medicalnewstoday.com/articles/167559

2. NHS. Goiter. Last reviewed, 2019. Available at: https://www.nhs.uk/cons/goitre/.Healthline. What You Need to Know About Goiter. 2019. Available at: https://www.healthline.com/health/goiter-simple#symptoms


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