Endemic goiter is characterized by an increase in the thyroid gland amid iodine deficiency in the body. This trace element is necessary for the normal functioning of the thyroid gland, the formation of hormones. The main clinical sign is an enlarged gland. Other symptoms of endemic goiter, as well as the treatment of endemic goiter, are discussed in detail in this article.

Etiology of the disease

Causes of iodine deficiency:

• unbalanced diet (lack of diet of fish, seaweed, meat, shrimp, oat and buckwheat, dairy products, etc .; a person receives about ninety percent of the daily need for iodine with food);
• diseases of the gastrointestinal tract (pathologies of the stomach or intestines lead to poor absorption of iodine, even with sufficient consumption of iodine-containing products);
• living in regions with a low content of trace elements of iodine in the environment (about ten percent of the daily requirement for iodine is received by a person from water and air);
• living in regions with increased radiation background;
• the systematic use of drugs that suppress the absorption of iodine;
• hereditary predisposition (endemic goiter may develop due to a genetic defect in the production of thyroid hormones).

Classification of endemic goiter

Pathology is classified according to the following parameters.

• By degree of increase:
  • lack of goiter (0 degree);
  • endemic goiter of 1 degree (the gland is palpated during palpation during swallowing, noticeable with an elongated neck and head thrown back);
  • endemic goiter of the 2nd degree (the thyroid gland is visible during swallowing, is well palpated, but does not change the shape of the neck);
  • grade 3 endemic goiter (symptom of a “thick neck”);
  • 4 degree endemic goiter (goiter acts as a tubercle);
  • 5 degree endemic goiter (an enlarged gland compresses the trachea, blood vessels, nerves, esophagus and other nearby organs).
• By location:
  • unilateral goiter (one lobe of the thyroid gland is affected);
  • bilateral (both lobes are affected).
• In shape:
  • diffuse endemic goiter (uniform enlargement of the thyroid gland);
  • nodular endemic goiter (the presence in the tissue of an organ of nodes, one or more (multinodal endemic goiter);
  • mixed endemic goiter (uniform increase with the formation of individual nodes).

Symptoms of endemic goiter

The clinical picture is due to violations in the functioning of the thyroid gland.

• A low concentration of iodine leads to a deficiency of thyroid hormones. Trying to compensate for it, the thyroid gland increases in size. A lack of thyroid hormones is manifested by the following symptoms:
  • decreased physical stamina;
  • feeling of weakness;
  • headaches;
  • heart problems.
• Thyroid growth leads to compression of neighboring organs. Especially the esophagus and trachea. Symptoms of compression:
  • difficulty breathing and swallowing;
  • asthma attacks;
  • dry cough;
  • hoarseness of voice;
  • violation of sweating (due to pressure on the nerves);
  • tension in the head during bending and puffiness of the face (due to pressure on the veins of the neck);
  • “Goiter heart”, characterized by an increase and hyperfunction of its right departments (this symptom is characteristic of the last stage of endemic goiter).

Endemic goiter in children is more pronounced and intense. In addition, the disease in childhood is often complicated by endemic cretinism (disorders of the central nervous system, delayed physical and mental development).

Treatment of endemic goiter

Tactics depend on the degree of thyroid enlargement.

• With minor hyperplasia shown
  • taking Iodide Potassium (courses);
  • diet therapy with iodine-containing products.
• With complications of hypothyroidism, hormone replacement therapy is prescribed.
• In the later stages of the disease, an operative treatment method is used. In the postoperative period, hormone replacement therapy is performed.

Prevention of endemic goiter consists in the regular consumption of iodine-containing foods (iodized salt; seafood; persimmons; walnuts, etc.). The prophylactic intake of potassium iodide also helps to reduce the risk of the disease.