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Medical Article

Treatment of Goitre

The abnormal enlargement of the thyroid gland is called goitre.  The presence of a goiter doesn’t necessarily mean that the thyroid gland is malfunctioning. A goitre can occur in a gland that produce too much hormone (hyperthyroidism) too little hormone (hypothyroidism), or the correct amount of hormone (euthyroidism). Excessive stimulation of the thyroid gland by TSH can result in goitre.

Types of Goitre

Goiter is classified as diffuse or nodular. In diffuse goiter thyroid gland swells and is smooth to touch. In the case of nodular goiter,  fluid-filled lumps called thyroid nodules develop in the thyroid gland. It is further classified into two types, only one nodule as uninodular and more than one nodule as multinodular. These nodules can be inactive or toxic. 

Goiter is also classified as endemic and sporadic. Due to insufficient iodine intake endemic goiter can occur. 10% of the community is usually affected. Sporadic goitre affects lesser number of individual. Dietary iodine deficiency, family history, age and female gender are the factors involved. 

Causes of Goitre

There are many causes involved with goitre. Insufficient iodine intake or high consumption of foods that neutralize iodine, namely cabbage, broccoli and cauliflower. Soy also induces goitre. 

Drugs such as lithium and phenylbutazone also cause thyroid cancer such as infiltrating papillary thyroid cancer, lymphoma and anaplastic thyroid cancer, thyroid nodules, hyperthyroidism, thyroiditis etc., causes goitre. 

Symptoms and signs of Goitre

Enlargement of the thyroid gland in the throat is due to goitre. It appears like smooth swelling due to the presence of nodules. During swallowing it moves vertically.  A large goitre that presses the esophagus or food pipe creates difficulty in swallowing. A large goitre that presses the windpipe causes difficulty in breathing. Voice hoarseness is also one of the symptoms and signs of goitre. 

Diagnosis of Goitre

A doctor can examine signs related to thyroid enlargement, such as the size of the gland or nodule, its firmness, mobility and tenderness. 

Blood check helps to identify thyroid hormone levels and specific antibodies.  If TSH is elevated the patient is identified to have an underactive thyroid. Some patients with goitre may have normal thyroid hormone levels. 

If the thyroid nodule is larger than 1.0-1.5 cm in diameter and with TSH level normal or high, then patient is advised fine needle aspiration biopsy. It will reveal a benign nodule, thyroid cancer, or an uncertain diagnosis. 

Ultrasound scan or a radioactive iodine scan also is used to diagnose. A radioactive scan helps to determine if the nodule is a hot nodule or a cold nodule. Cancerous nodules appear to be cold nodule on a radioactive scan, though benign nodules may also appear cold. 

Treatment for Goitre

Goitre due to hyperthyroidism is treated with drugs that slow thyroid gland activity. The radioactive iodine treatment destroys some or all thyroid hormone producing cells. If it fails to cure thyroid defect, then the thyroid gland is surgically removed.

Goitre caused due to hypothyroidism is treated with lifelong thyroid hormone replacement therapy. Iodine rich foods, such as seafood and iodized salt help to treat goitre caused due to iodine deficiency.  Medications help to reduce the size of benign thyroid nodules and radioactive iodine treatment or remove using surgical methods. Thyroid cancer is removed surgically which is then followed by radioactive iodine treatment.  Surgical removal of the thyroid refers to thyroidectomy. It relieves the compression of the nearby structures because of the enlarged gland, thereby improving symptoms relating to difficulty in swallowing, cough or shortness of breath. 

Prevention of Goitre

To prevent goitre add only iodized salt in your food. Seafood such as sea weed, shrimps and shell fish help to reduce iodine deficiency. Avoid over exposure to radiation.

Health tips

Simple exercises, like neck stretches for thyroid gland should be performed on a daily basis. Oats, seafood, carrots, lettuce, garlic, strawberries, eggs, onions, citric fruits, pineapples, bananas, Vitamin A rich food, meat , dairy products, pulses, watermelons, grapes and dates should also be included in your diet.