Goiter



Types of Goiter?

Goiters are classified into 3 main types: euthyroid, hypothyroid and thyrotoxic.
  ♦ Diffuse goiters are smooth and uniformly large
  ♦ Nodular or multinodular goiters are lumpy and characterized by the presence of one or more nodules
  ♦ Thyrotoxic goiter or toxic goiter happened with hyperthyroidism
  ♦ Nontoxic goiter which does not involve abnormalities in thyroid hormone production or malignancy
  ♦ Toxic multinodular goiter consists of numerous nodules and cause hyperthyroidism
  ♦ Sporadic nontoxic goiter occurs in people with healthy thyroid function
  ♦ Euthyroid goiter is a goiter occur on its own with absence of any malfunction of the thyroid gland
 

Foods for Goiter

  • Vitamin A for proper metabolism of iodine and better manage of pituitary gland function
  • Vitamin E increases iodine absorption
  • Use of iodized salt may help to eliminate goiter in many locations where iodine does not occur naturally in foods
  • Seaweed - source of iodine
  • Kelp - source of iodine and low in sodium
  • Others: bugleweed, bladderwrack, bayberry root bark
  • Foods that interfere iodine absorption:

  • Turnips
  • Cassava root
  • Cabbage
  • Mustard
  • Soyabeans
  • Millet
  • Peanuts
  • Pine nuts

Goiter Diagnosis

  • Physical examination - Doctor may ask the patient to stand and face him then ask the patient to raise both arms straight into the air with both arms near the ears.
  • If the patient's neck turns red, the veins in the patient's neck bulge, and they will start to have difficult breathing, the test will suggest an obstructive goiter, one that is big enough to block the area between the neck and chest and interfere with breathing, swallowing and blood flow.
  • TSH test - blood test to measure the patient's TSH level to determine whether is hyperthyroidism or hypothyroidsm.
  • Ultrasound - to display the goiter size whether it contains nodules and whether those nodules are soild or cysts; whether nodulas getting bigger; whether a goiter has formed.
  • RAIU and scan - to detect where iodine is being taken up. This test often done in patients with toxic multinodular goiters

Treatment for Goiter:

Depends on the goiter size and symptoms:
  • Small goiters cause no problem do not require treatment
  • Goiter that is bigger will require medical attention
  • Large goiter may require cosmetic surgery to improve the patient's appearance
  • Levothyroxine suppressive therapy - suppresses TSH levels
 

Reference:

  • The Everything Health Guide to Thyroid Disease: Professional Advice on Getting the Right Diagnosis, Managing Your Symptoms, and Feeling Great by Theodore Friedman, Theodore C. Friedman, Winnie Yu
  • The Thyroid Sourcebook By M. Sara Rosenthal
  • Nutrition Almanac By John D. Kirschmann, Nutrition Search, Inc

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