Endemic goiter: symptoms, treatment and prevention
Unfortunately, for today thyroid pathologies occupy one of the leading places in the statistics of endocrine diseases.Moreover, experts say that the number of patients with thyroid gland grows from year to year.In this article, we will talk about one of two types of ailment characterized by pathological proliferation of glandular tissue - endemic goiter.Table of contents: Classification Symptoms of endemic goiter Reasons for the onset of the disease Complications of goiter Diagnosis of the disease Treatment of endemic goiter Prevention
Endemic goiter is a pathological enlargement of the thyroid gland caused by a small amount of iodine entering the body.Typically, the disease occurs in patients living in areas where there is a shortage of this element in running water and food.Iodine is needed for the production of thyroid hormones - T3( triiodothyronine) and T4( thyroxine).
Important: the maximum volume of the thyroid gland is approximately equal to 18 cm3 in women and 25 cm3 in men.Excess of the indicated sizes can speak about a pathology.
According to the modern classification, the following varieties of endemic goiter are distinguished:
- is euthyroid.
In hypothyroid goiter, there is a parallel decrease in the functional activity of the organ( ie, hypothyroidism takes place).
Euthyroid goiter is characterized by proliferation of the endocrine organ against a background of a normal level of biosynthesis of hormones.
The structure( consistency) distinguishes these types of goiter:
- diffuse( with a uniform growth of tissue);
- nodal( with the presence of one or more denser formations);
- mixed( evenly spaced with individual seals).
The pathology is localized as follows:
By the degree of magnification:
- 0 - goiter absent;
- 1 - goiter is determined by palpation, the size is slightly larger than the phalanx of the thumb;
- 2 - the growth is not only palpable, but also visibly.
Symptoms of endemic goiter
Pathology can be considered multifactorial, because in addition to the lack of iodine, a certain role in its development belongs to genetic factors.
The endemic goiter clinic is caused by thyroid dysfunction.
Among the most common symptoms are:
- increased fatigue;
- recurrent headaches;
- discomfort behind the sternum;
- feeling of squeezing in the throat area;
- complicated swallowing;
- breathing disorder;
- attacks of suffocation;
- dry cough( with significant growth).
Note: in women, this endocrine pathology is diagnosed on average 3-4 times more often than in men, which is due to the peculiarities of the hormonal background.
Causes of the onset of the disease
Endemic goiter develops due to a shortage of iodine in the body.The enlargement of the gland is a kind of compensatory reaction to a shortage of iodine, which does not allow the production of the right amount of thyroid-stimulating hormones.
The leading causes of the emergence and development of pathology include:
- low iodine content in drinking water of a certain region;
- unbalanced diet( low consumption of seafood, milk, some cereals and other iodine-rich foods);
- regular intake of pharmacological agents that impede the absorption of iodine;
- is a genetic predisposition( hereditary cause of a violation of the synthesis of thyroid hormones).
Important: to regions where drinking water contains little iodine, refers central Russia, the Urals, Altai region, almost the entire Caucasus region, as well as the Moscow region.
The World Health Organization recommends the intake of the following doses of drugs iodine:
|age period||need for iodine|
|Children under one year||90 mcg|
|Children 2-6s||110 - 130 mcg|
|children 7-12 years||130 - 150 mcg|
|Adolescents and adults||150 - 200 mcg|
|Pregnant and lactating women||250 - 300 mcg|
Increased thyroid gland caused by iodine deficiency, can be a cause of serious violations of other organs and systems.
Possible complications of endemic goiter include:
- malignancy( malignant transformation of pathological proliferation of body);
- inflammation of the gland;
- "thymus heart"( expansion of the right ventricle and atrium due to vasoconstriction);
- compression of the esophagus and swallowing disorder;
- compression of the trachea and difficulty breathing.
Note: differential diagnosis of endemic goiter conducted with sporadic goiter, autoimmune thyroiditis, diffuse toxic goiter and thyroid cancer.
The diagnosis is based on external examination data, as well as additional instrumental and laboratory studies.
The main method of instrumental diagnosis of endemic goiter is ultrasound examination of the gland.It allows to establish the form of pathology - to differentiate nodal goiter from diffuse.If a node is found during the study, the patient is additionally shown sonoelastography.This study provides an opportunity to establish the degree of density of neoplasms, and also to make an assumption about the presence of malignant nature of the nodes.If necessary, a biopsy of the organ can also be performed.
To clarify the diagnosis, the patient's blood is examined for thyroid hormone levels.In euthyroid goiter, the balance of these biologically active compounds is normal or somewhat disrupted( there may be an increase in T3 with a tendency to decrease in T4 level).
Against the background of hypothyroidism, the level of T3 and T4 is lowered and the concentration of thyrotropin is increased.
During the laboratory examination of blood in the diagnosis of endemic goiter, the concentration of thyroglobulin is necessarily determined.Its level varies inversely with the intake of iodine.Thus, the smaller the intake of a microelement, the higher the level of thyroglobulin.
Urine examination determines a decrease in the level of excreted iodine.
Treatment of endemic goiter
With a relatively small increase in the endocrine organ, in most cases, it is sufficient to conduct course treatment with iodine preparations( potassium iodide), as well as correction of the diet, which presupposes the consumption of foods rich in this element( in particular, "sea kale,Fish and other seafood).
If there is a complication of endemic goiter with hypothyroidism, then substitution therapy with the use of thyroid hormone preparations is necessary.
The nodular form at a late stage requires surgical intervention followed by replacement therapy.
Please Note: Traditional Medicine suggests applying for the treatment of uncomplicated forms of endemic goiter powder from the leaves of algae kelp.Powder of "sea kale" should be consumed for 1 tsp.In the evening before bedtime.The drug is prescribed for 20-30 days.
Prevention In regions where there is a deficiency of iodine, to prevent the development of endemic goiter are advised to take preventive measures.
For cooking, iodized table salt should be used instead of the usual one.It is advisable to add it already to ready meals, since the vital element has the property of breaking down during the heat treatment.
The following products should be included in the diet:
- fish( especially - marine);
- seafood( shellfish, crustaceans);
- kelp( "sea kale");
- seeds( pumpkin and sunflower seeds);
- cabbage( all kinds);
- sour-milk products( not less than 200 ml per day);
- cottage cheese;
- dried fruits;
- fruit and vegetable juices( required - freshly squeezed);
- rose hips;
- natural honey.
Vladimir Plisov, medical reviewer