The incidence rates of papillary, follicular, and anaplastic thyroid carcinomas appear to be related to endemic goiter and iodine supplementation, with surgery being required in essentially all of these cases. Abstract The primary role of iodine deficiency in goitrogenesis and the prevention and treatment of endemic goiter by iodine supplementation is firmly established.
Publication types Research Support, Non-U. Gov't Research Support, U. Gov't, Non-P. The most common cause of goiters worldwide is a lack of iodine in the diet. In the United States, where the use of iodized salt is common, goiters are caused by conditions that change thyroid function or factors that affect thyroid growth.
Treatment depends on the cause of the goiter, symptoms, and complications resulting from the goiter. Small goiters that aren't noticeable and don't cause problems usually don't need treatment. Most people with goiters have no signs or symptoms other than a swelling at the base of the neck. In many cases, the goiter is small enough that it's only discovered during a routine medical exam or an imaging test for another condition.
Other signs or symptoms depend on whether thyroid function changes, how quickly the goiter grows and whether it obstructs breathing. The size or position of a goiter may obstruct the airway and voice box. Signs and symptoms may include:. The pituitary gland and the hypothalamus are located within the brain and control hormone production.
Two hormones produced by the thyroid are thyroxine T-4 and triiodothyronine T When the thyroid releases T-4 and T-3 into the bloodstream, they play a role in many functions in the body, including the regulation of:. The thyroid gland also produces calcitonin, a hormone that helps regulate the amount of calcium in the blood. The pituitary gland and hypothalamus control the rate at which T-4 and T-3 are produced and released. The hypothalamus is a specialized region at the base of the brain.
It acts as a thermostat for maintaining balance in multiple body systems. The hypothalamus signals the pituitary gland to make a hormone known as thyroid-stimulating hormone TSH. The pituitary gland — located below the hypothalamus — releases a certain amount of TSH , depending on how much T-4 and T-3 are in the blood.
The thyroid gland, in turn, regulates its production of hormones based on the amount of TSH it receives from the pituitary gland. Enlargement of the thyroid can expand the gland well beyond its typical size and cause a noticeable bulge in the neck. This can be caused by single or multiple nodules lumps in the thyroid or by an autoimmune process.
Anyone can develop a goiter. It may be present at birth or occur at any time throughout life. Some common risk factors for goiters include:.
A goiter itself usually doesn't cause complications. Your doctor will check for neck for swelling. Blood tests can detect changes in hormone levels and an increased production of antibodies, which are produced in response to an infection or injury or overactivity of immune system.
Your doctor may order scans of your thyroid. This is usually done when your thyroid level is elevated. These scans show the size and condition of your goiter, overactivity of some parts or whole thyroid. An ultrasound produces images of your neck, the size of your goiter, and whether there are nodules. Over time, an ultrasound can track changes in those nodules and the goiter.
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. Your doctor will decide on a course of treatment based on the size and condition of your goiter, and symptoms associated with it. Treatment is also based on health problems that contribute to the goiter.
If you have hypothyroidism or hyperthyroidism, medications to treat these conditions may be enough to shrink a goiter. Medications corticosteroids to reduce your inflammation may be used if you have thyroiditis. In people with toxic multinodular goiters, 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. Depending on your type of goiter, you may need to increase or decrease your iodine intake at home. Many goiters disappear with treatment, while others may increase in size. Speak with your doctor if your symptoms increase or become worse. If your thyroid continues to make more hormones than you need, this can lead to hyperthyroidism. Not making enough hormones may lead to hypothyroidism.
It can cause a goiter, or enlarged thyroid, which can make…. There is a long-established connection between conditions of the thyroid and depression.
0コメント