SIMPLE GOITER

 SIMPLE GOITER

fig 1.0 Thyroid gland

OBJECTIVES; -

1. Describe what is simple goiter.
2. Etiology and risk factors for simple goiter.
3. How simple goiter classified.
4. Describe the clinical characteristics of simple goiter. 
5. Investigations.
6. Management of simple goiter.
7. How to prevent simple goiter?

1.SIMPLE GOITER.

A simple goiter is a thyroid gland hypertrophy. Typically, it's not a tumor or cancer. The thyroid gland, which is situated at the junction of your collarbones at the front of your neck, generates hormones that regulate how each and every cell in your body uses energy.

2.RISK FACTORS AND AETIOLOGY FOR SIMPLE GOITER; -

• Iodine deficiency in the diet: Iodine is necessary for the synthesis of thyroid hormones. The thyroid gland grows in an attempt to absorb more iodine from the blood when there is insufficient iodine in the diet.
• Being a woman: Especially during pregnancy and menopause, when hormonal changes impact thyroid function, women are more prone than males to develop goiter.
• Age: Goiter is more common in individuals over 40 since ageing may cause the thyroid gland to become less effective.
• Family or personal history: The risk of goiter is increased if there is a history of thyroid disease, autoimmune disease, or nodules in the family.
• Certain medications: A few medications, including amiodarone, lithium, and interferon alpha, have the potential to interfere with thyroid function and result in goiter.
• Smoking: Smoking, particularly in those with poor iodine consumption, can have an adverse effect on the thyroid gland and raise the incidence of goiter.
• Consuming particular foods in high quantities: Certain foods, like soy, cassava, cauliflower, broccoli, and cabbage, have ingredients that can affect thyroid function and the body's ability to absorb iodine. Generally, these foods pose no health risks unless they are ingested in excess or in conjunction with iodine shortage.

3.CLASSIFICATION OF SIMPLE GOITRE; -

Simple goiter, or an enlargement of the thyroid gland without thyroid dysfunction or malignancy, is classified in various ways. The thyroid hormone levels influence the enlargement of the gland in one way, and the gland's enlargement in another. Depending on the pattern of enlargement, simple goiter can be: 

1. Diffuse: The thyroid gland swells from top to bottom and becomes smooth to the touch.
2. Nodular: The thyroid becomes lumpy when a nodule, which can be solid or fluid-filled, forms inside it.
3. Multinodular: The thyroid contains several lumps, or nodules.

Simple goiter can depend on thyroid hormone levels;-

1.Excessive production of thyroid hormone1 is produced by an enlarged thyroid; normal thyroid hormone production is produced by an enlarged thyroid at normal levels.

2.Some forms of simple goiter can be described by combining these classes. For instance, a toxic multinodular goiter results from many thyroid nodules that overproduce thyroid hormone.

4.CLINICAL CHARACTERISTICS OF SIMPLE GOITER.

• A noticeable growth or swelling near the base of the neck, which can vary in size from a single little nodule to a big mass.
• A sense of tightness or suffocation in the throat.
• Breathing difficulties, throat problems, hoarseness, or coughing (in extreme situations).
• Signs of either an overactive thyroid (hyperthyroidism) or an underactive thyroid (hypothyroidism), depending on the thyroid hormone level and the underlying reason.

5.INVESTIGATIONS;-

• Tests for thyroid function (TSH, T3, and T4).
• Ultrasound of the thyroid. 
• Complete needle aspiration biopsy to exclude out cancer antibodies, serum cholesterol.
• Chest x- ray.

6.MENAGEMENTS OF SIMPLE GOITER; -

• Observation: There may be no need for therapy if the goiter is small, benign, and causes no issues.
• Frequent monitoring and check-ups might be suggested.
• Iodine supplementation: If an iodine deficit is the source of the goiter, taking supplements or consuming foods high in iodine will help shrink the goiter and stop it from getting bigger.
• Replacement of thyroid hormones: If hypothyroidism is the source of the goiter, levothyroxine or liothyronine supplements can help restore normal thyroid function and reduce the size of the goiter.
• Anti-thyroid medication: If hyperthyroidism is the cause of the goiter, then anti-thyroid medications such propylthiouracil or methimazole may help decrease thyroid hormone production and goiter size.
• Treatment with radioactive iodine: If hyperactive thyroid nodules are the cause of the goiter, administering a dose of radioactive iodine may help kill the aberrant thyroid cells and reduce the goiter.
• Surgery: Part or all of the thyroid gland may need to be removed if the goiter is big, cancerous, or causing symptoms like trouble swallowing or breathing. Hypothyroidism could potentially arise from this, in which case thyroid hormone replacement might be necessary.

7.PREVENTION OF SIMPLE GOITER;-

• Make sure your diet has the right amount of iodine in it; The synthesis of thyroid hormones requires iodine. Iodized salt, shellfish, dairy products, and seaweed are good sources of iodine.
• Eat a healthy; well-balanced diet, Steer clear of foods like soy, peanuts, and broccoli and cabbage family plants that could disrupt thyroid function.
• Avoid caffeine, gluten, and processed foods that are heavy in sugar and spice as well.
• Regularly check your thyroid hormone levels; You could require medicine to control your thyroid function if you exhibit signs of either hyperthyroidism (an overactive thyroid) or hypothyroidism (an underactive thyroid).
• Smoking; Smoking can exacerbate thyroid gland inflammation and raise the risk of goiter.