The term “goiter” is understood as a whole group of pathological conditions of the thyroid gland, which are manifested by a significant change (increase) in its size. The etiology, mechanism of development and principles of treatment of an enlarged thyroid gland may differ in each individual case. Every patient who has symptoms of damage to this endocrine organ should remember that any goiter of the thyroid gland, the treatment of which does not begin in a timely manner, can cause the development of severe disorders of internal organs.
REASONS OF A GOITER
Since goiter is not a single pathology, but includes a number of different lesions of the thyroid gland, the causes of its occurrence may be different.
So, the main factor that provokes the development of endemic toxic goiter – iodine deficiency, is due to the lack of this compound in certain areas , which becomes the reason that causes a decrease in the secretory activity of the thyroid gland.
In addition, poor environmental ecology has a certain negative effect on the functioning of the thyroid gland, since toxic substances that enter the human body from the outside can suppress the endocrine system and slow down the activity of the thyroid gland.
This type of goiter can also develop with insufficient consumption of foods that contain iodine (fish, fruits, milk).
In the event of Graves’ disease (diffuse toxic goiter), the thyroid gland falls under the influence of special antibodies, which are produced in the body as an integral part of the immune defense on its own tissues, in this case on the structures of the thyroid gland. In cases where diffuse goiter of the thyroid gland develops , treatment includes taking drugs that inhibit the production of hormones, sometimes radioactive iodine or surgical methods of therapy should be used.
If we talk about the reasons for the development of nodular goiter, then it should be noted an adenoma of the thyroid gland or a cancerous process in it . With such lesions of the thyroid gland, cell division and their differentiation are disrupted, which can be provoked by radiation, toxic substances, or be hereditary. In cases where a nodular goiter of the thyroid gland is formed, treatment includes taking iodomarin , L-thyroxine for a long time. If the nodular formations continue to increase in size, the question of surgical treatment is being resolved.
MAIN CLINICAL MANIFESTATIONS OF A GOITER
At the initial stages of goiter development, the patient may not even suspect that he has this pathology. Only later, when the size of the thyroid gland increases significantly, symptoms of compression of adjacent tissues appear, and the thyroid gland itself becomes noticeable in the form of edema on the front of the neck.
Often, patients begin to complain of shortness of breath, a feeling of “lump in the throat”, hoarseness and dry cough. In the case when an enlarged thyroid gland occurs , treatment helps to eliminate compression of the esophagus and impaired swallowing, as well as dizziness and a feeling of tension when moving the head that appears when the neck vessels are clamped.
If a goiter develops due to a lack of iodine, then symptoms of hypothyroidism join a similar clinical picture: low blood pressure, frequent respiratory diseases, flatulence. If goiter occurs due to Graves’ disease or thyroid adenoma, signs of hyperthyroidism will appear (fever, hunger, hand tremors, irritability, weight loss).
NB! It should be noted that an enlarged thyroid gland (goiter) needs treatment , regardless of the etiology of the development of the lesions.
PRINCIPLES OF THYROID STATE TREATMENT
MULTI-NODED GOITER
The treatment of goiter is prescribed by an endocrinologist, taking into account the reasons for its development. So, in the case of a multinodular goiter of the thyroid gland, treatment is carried out with thyreostatics and B-blockers, radioactive iodine or surgical methods. It should be noted that, provided that formations that function autonomously appear in the thyroid gland, thyrostatics are not able to provide long-term remission. In addition, their appointment in high doses can provoke iodine-induced thyrotoxicosis.
Colloidal goiter
In the case of nodular colloid goiter of the thyroid gland, treatment should be carried out after excluding the malignant nature of the formed nodes, it should also include an assessment of the risk of a compression syndrome or a significant cosmetic defect. Treatment of such patients should be carried out only in specialized endocrinological clinics that have the equipment necessary for conducting a comprehensive examination of patients, experienced personnel and the ability to carry out all types of necessary therapy.
In general, in case of goiter, which is combined with hypofunction of the thyroid gland, substitution therapy is prescribed, with an increase in the thyroid gland due to its hyperfunction, they try to suppress its functional activity with special drugs, in cancer processes, subtotal resection of the thyroid gland is most often used. In each case, a patient who has a thyroid goiter should be prescribed treatment for each patient individually – depending on the clinical picture, complaints, laboratory test results (clinical blood, thyroid hormone test) and instrumental diagnostics. For some patients, in this case, only ultrasound examination of the thyroid gland and neck organs is sufficient. In other cases, it is necessary to perform the entire complex of studies, which includes X-ray examination, radioisotope scanning and scintigraphy of the bones of the skeleton and the thyroid gland itself, histological and cytological examination of organ tissue obtained during a fine-needle biopsy or thyroid surgery.