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Thyroid Physiology  

Thyroid Disease

Goiter

• Abraham

• Brix

• Dugrillon, Gartner, Pisarev

• Flechas

• Furlanetto

• Hennemen

• Hintze

• Jooste

• Kahaly

• Koutras, Papanastasiou

• Kreissl

• Lee

• McClendon

• Meng

• Rasmussen

• Shomon

• Stubner

• Studer, Derwahl

• Wolff

IODINE and GOITER

A goiter is an enlarged thyroid gland. The enlargement can be due either to an increased number of cells or to an increase in the size of individual cells.

The enlargement is an adaptive response, as the thyroid attempts to produce more thyroid hormone.  It attempts to produce more thyroid hormone due to Thyroid Stimulating Hormone (TSH) from the pituitary, in response to low levels of thyroid hormones in the blood.

The whole thyroid can be enlarged, which is called "diffuse", or the thyroid can have nodules which are enlarged which is called "nodular" or "multi-nodular" goiter.

A doctor can sometimes detect a goiter by feeling the thyroid area. But, sometimes it can become symptomatic before it gets to that point. Goiter can cause food to get stuck in the upper throat and will sometimes cause one to choke awake at night. It is one cause of sleep apnea.

Symptoms of goiter

The primary symptom of goiter is a swelling of the thyroid, a butterfly gland at the front of the neck just below the Adam's Apple.  Other possible symptoms are the following:

• A tight feeling in your throat

• Coughing

• Hoarseness

• Difficulty swallowing

• Difficulty breathing

• Choking awake at night

• Food getting stuck in the upper throat.

Causes of Goiter

The primary cause of goiter is iodine deficiency.  It can also be caused by goitrogenic substances, including certain foods and drugs. Sometimes, it is said to be caused by the following:

• Hypothyroidism

• Hyperthyroidism.

• Autoimmune thyroid disease

• Graves' disease

• Hashimoto's thyroiditis

• Thyroiditis

• Thyroid cyst

• Puberty - can cause simple goiter

• Pregnancy - can cause simple goiter

How to Treat a Goiter

If the goiter is due to iodine deficiency, increasing the amount of iodine is sometimes all that is necessary.

If the goiter is due to consuming goitrogens in excessive quantities, you should eliminate the goitrogenic substance.

If one has a goiter due to elevated TSH, this can sometimes be reversed with thyroid medication.

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  Copyright: Zoe, 2006.