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Causes, symptoms, diagnosis, treatment of goiter

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What is a goiter?

GOITER is an enlarged thyroid gland. In itself, the name "goiter" is taken from denote the extended region of the esophagus in birds. It also is called goiter and is a kind of sump for the food.

This disease is most common in countries where there is iodine deficiency (but may be caused by high content of iodine against the use of iodine preparations). Women affected by this disease 5 times more often than men. Educated nodes is not that other, as many fibrous scars that form in the tissues of the thyroid gland.

Thyroid (thyroid) – the control center of metabolism in the human body. It is often called the guardian of health, so she behaves accordingly, if a person has had some problems: possible irritability, mood swings, fatigue and drowsiness.

Problems with the thyroid more often in women at a Mature age, but for men, this problem is quite urgent.

The thyroid gland is one of the most important organs of our body. Despite its tiny size and weight (about 20 grams), it is truly a generator of vital energy. No wonder doctors call it "working bee". The thyroid gland produces thyroxine, triiodothyronine, and it is precisely those substances without which the body's production of energy needed is almost impossible. Moreover, this energy is directed to the operation of all systems and organs.

The thyroid also regulates the heart activity, brain activity, muscle tone ("muscular armor"). It is a health guardian. In women with age is hormonal changes before and after menopause. So the thyroid is very sensitive in this period, respond quickly to stress, weakening the immune system, infection, a deficiency or excess of iodine. Because of what is happening pathological activation of antibodies against healthy cells, with age the stronger woman's body undergoes an autoimmunediseases. These antibodies impair function of the thyroid gland. The result is weakness, degradation of memory, swelling, weight gain, dry skin, brittle hair, muscle aches and spasms, constipation.

Etiology

Worldwide the most common should be considered endemic goiter. It is caused by a deficiency of iodine in the diet. In countries that use iodized salt, most often formed goiter, Hashimoto, an alternative name of which is autoimmune thyroiditis.

Other causes can be divided into two conditional block:

  1. Hypothyroidism:

    • Genetic disorders of the processing of hormones endocrine glands (e.g., cretinism);

    • Use as a food chromogenic products, for example, cassava;
    • Side effects after the use of medicines.

    Symptoms of hypothyroidism – hair loss, dry and pale skin, brittle nails, thinning eyebrows, loss of appetite, weight gain. In diseases of the thyroid gland slowed speech, worsening memory, is an almost constant drowsiness, menstrual cycle slips. While it is not necessary that all these symptoms, usually two or three, but they are expressed more clearly.

  2. Hyperthyroidism:

    Hyperthyroidism is the increased production of hormones by the thyroid gland. Satellites of this disease – insomnia, weakness, irritability, palpitations, excessive sweating. Suffering from this disease may have a good appetite, but to lose weight. Plus – high blood pressure, increase the eyeballs, shaking hands (tremor).


Classification of thyroid diseases

To classify disease thyroid is possible for a variety of indications, the first of which is etiopatogenetice. It identifies factors and mechanisms of formation. On this basis allocate endemic (unique to a particular type of terrain) and sporadic goiter. First observed inendemic goiter geographic areas, and second, respectively, in all the others.

Morphology distinguish diffuse, nodular and mixed (diffuse-nodular) goiter. Location:

  • Located by default;
  • Located partially behind the breastbone;
  • Annular;
  • Distopian consisting of bookmarks embryonic type (for example, a crop root system of language or an extension of the TG lobes).

Goiter also differ in the degree of magnification. According to the who classification (world Health Organization) possible to distinguish three types:

  • Zero degree
  • First degree
  • Second degree.

In the first stage of the increase-no, the second – goiter may be palpated, but it is not visible in normal neck position, and the third – he's not only just being explored, but visible to the naked eye.

A more detailed classification according to the degree of increase was proposed by O. V. Nikolayev, in accordance with her disease without proper treatment through the following stages:

  • First degree — thyroid gland is palpated;
  • The second thyroid gland is visible.
  • The third significant thickening of the neck;
  • Fourth — changing the shape of the cervical;
  • Fifth — a huge goiter.

Symptoms of goiter thyroid

At the primary stages, patients may fail to note even the slightest manifestation of goiter. The formation of this disease over time, provokes an obvious bulging or swelling of the neck in the front part (the Adam's Apple). Enlarged endocrine gland begins to press on the trachea, nerve endings and blood vessels type, which are located in close proximity. Diffuse goiter, visual, identificireba uniform increase in TG. Speaking about nodular variety, it is most often increased much stronger on one side of the larynx. That is, when it is expressed not only uneven and heterogeneous but increasing.

Effect on those organs, which are located near, can manifest the following characteristics:

  • Shortness of breath;
  • Quickly progressive change of voice, accompanied by hoarseness;
  • Asthma, manifested during the night;
  • Fighting a cough;

  • Difficulties in swallowing food;
  • Dizziness, severe tightness in the head.

If the submitted tumor, which is accompanied byhypothyroidism can lead to an atypical form of pneumonia, bronchitis or influenza. In addition, most often, women found hypotension, painful and simply unpleasant sensations, like tightness in the heart area. All this as the progression of the disease is shortness of breath, decrease in habitual attraction to any meal, bloating, nausea and drowsiness. In the final stages worsening memory and increased weight, despite all the problems with the gastrointestinal tract.

The males on the basis of insufficient ratio of iodine in the blood is reduction of sexual desire, the destabilization of sexual function. For women, characterized by changes such as the menstrual cycle, which, in turn, is the catalyst of infertility and miscarriages.

In such varieties of goiter as Graves ' disease or hyperplasia of the thyroid gland benign type may show such signs as:

  • Long maintaining elevated body temperature;

  • The reduction of the total body weight;
  • Protrusion of the eyeball;
  • Permanent hunger;
  • Exhausting insomnia;

  • Sporadic irritability;
  • Progressive tremor of the upper extremities.

Causes of goiter

The factors directly influencing the formation of goiter should be considered in more detail. This is because the lesions of the endocrine glands and their reasons can be very different.

As noted earlier, the main cause provoking the emergence of endemic and toxic goiter is iodine deficiency in the body. Its insufficient quantity due to the lack of presented compounds in specific areas. It is the reason why, which causes a decrease in secretory activity.

In addition, a negative impact on her job due to the bad ecology of the environment. So, the substances of toxic origin, which are in the human body from the outside, unable to suppress the functioning of the endocrine system and slow down the activity of the thyroid.

Endemic goiter may also be formed with a relatively low use of products in the list of components which included iodine. We are talking about fish, fruit and milk.

In the casethe emergence of Graves ' disease or toxic goiter diffuse origin, an endocrine gland is under the influence of specific antibodies. They are manufactured by the human body and are an integral part of immune protection for its own tissue. In this case we are talking about the structure of the thyroid.

If, however, to mention the most important factors in the development of goiter of the nodular type, it is necessary to allocate:

  • Adenoma endocrine glands;
  • Neoplasms cancer of origin.

When such lesions observed a progressive disruption of cell division and differentiation. This can be caused radiological background, dangerous toxic point of view, substances, and also be genetic in nature.

Goiter in children

It is separately necessary to tell about goiter in children, because it is the most common iodine deficiency disease. In the vast majority of cases is formed by the diffuse form of the disease.

According to studies by the who over the last 10 years the frequency of occurrence of goiter in children increased by 6% and equal to not less than quarter of the children's endocrine diseases combined. Such high rates are associated with incorrect diet, as well as unfavorable situation in environmental terms. In 30% of cases of goiter in children was diagnosed after 14 years and beyond.

Typical signs of goiter are associated with more intense severity. In addition, exclusively in children the disease is often complicated by the formation of specific endemic cretinism. This form the characteristic delay is not only intellectual, but also physical development as well as disorders of the Central nervous system.

Diagnosis of goiter thyroid

In the context of diagnosis of goiter use urine and blood laboratory. The blood of a person with any clinical signs of tumors tested for the ratio of hormones such as TSH, T3, T4 and thyroglobulin. Diagnosis is determined on the assumption that those who are faced with the type of disease, there is typically an imbalance of the thyroid hormones and noted an increased ratio of thyroglobulin. The data about the release of iodine in urine remain reduced.

Instrumental methodthe resulting diagnosis of goiter should be considered an ultrasound. Thanks to him, it is possible to accurately define the form of development of disease, e.g., diffuse or nodular goiter. Using radioisotope scan is determined and the estimation of the functional state of endocrine glands.

At the nodal type of endemic goitre as an additional measure of survey specialists resort to biopsy of the prostate. This gives you the opportunity to determine the nature of the disease. So, it can be benign or malignant.

If the result of palpation was suspicious for a thyroid goiter, to establish a specific diagnosis, identify the etiology and stage of disease should be consistently to carry out such mandatory testing, such as:

  • To take a blood test on ratios and hormone levels (recommended to be tested several times during two to three months from start of treatment);
  • Electrocardiogram;
  • Examination of tendon reflexes type at a time;
  • Ultrasound of the thyroid gland.

Test to determine the level of iodine in the body

We can distinguish three the most accurate and easy test to determine the ratio of iodine in the body:

  • Test 1. The first one is this: take a standard (3 or 5% iodine). With it, you need to draw a grid on your body – preferably in the evening, when physical activity is finished. Special attention should be paid to the lower abdomen and thighs. After absolute drying of the iodine you need to go to bed. So, if in the morning it turned out that the mesh "gone" at least halfway, it is obvious the insufficient content of iodine in the body. If the shade nets lasted more than 12 and especially 24 hours, it indicates that there is a surplus of iodine and should be avoided.
  • Test 2. The second test is that you need to dip a cotton swab in a solution of iodine alcohol type. Then apply iodine containing mesh on any area of the body, in addition to the endocrine glands. The following day you need to carefully consider the place. If no trace of iodine left, so he needed the body, if, on the contrary, the figure remained, then there is no deficit.
  • Test 3. And finally, the third, a much more accurate test. For its implementation it is necessary before going to bed, apply on the skin in the area of the forearm three stripes with an iodine solution. This should be done sequentially: first a thin line, then a slightly thicker then the thickest. Ifthe morning it was found that disappeared the first line, this means that the ratio of iodine-all normal.

If you can not see the first two, so you should pay close attention to the condition. In the same case, if there is not a single strip, it is possible to speak about the obvious lack of iodine. What are the treatments for goiter endocrine glands?


Treatments

Timely recognition of symptoms is key to successful treatment, which will help in the fastest possible time to cope with the disease. So, if signs of increasing goiter, you need to see a specialist-endocrinologist. Appeal to him very important, because any other professionals can refer simply to the exhaustion.

The main method of treatment of goiter should be considered replacement therapy hormonal type. For this purpose, the most active derivatives of tyrosine. This is because they are characterized by physiological parameters those hormones that are produced by the endocrine glands. It is extremely important to choose not just sufficient dosage of the drug, but one that will not lead to negative results. Treatment, periodic use of medications, often must go on until the end of life. It is recommended not to forget about controlling the ratio of hormones.

Hypofunction of the thyroid gland also can be corrected through hormonal therapy. Much harder everything is hyperactive. So, if there is a real danger of the emergence of tumors of any origin or complications of the cardiovascular type, there is a sense to resort to surgery (about it later). This will allow to change the situation for the underactive thyroid. In turn, this will enable more easy and accessible adjustments due to hormonal therapy.

In more severe hypofunction of the endocrine glands, the person may fall into a coma. Hyperthyroidism is characterized that a toxic crisis may lead to death. In this regard, you must comply with a strict diet and intake of necessary ratio of iodine in the body. Thus the absolute is the necessity of specialist consultation and testing for the amount of iodine in the body. As is known, a large amount of iodine also affects the thyroid.

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Surgery and radioactive iodine

Surgicalintervention on the body is extremely difficult because endocrine gland contains a significant amount of blood vessels. This makes the operation much more problematic. However, in some cases it is indispensable, therefore, surgery for goiter is one of the most frequently used treatment methods.

So, when it is administered a local anesthetic and remove the large nodular or potentially dangerous areas. In the most complex and advanced cases may remove one of the lobes of the thyroid gland. It may also, in turn, provoke Hypo - or hyperthyroidism. However, even with resection of one or more nodes there is a need of drug recovery.

An alternative way to treat thyroid is the use of radioactive iodine. This solution is used for the purpose of destruction of tissues of the endocrine gland. To find the optimal dosage is extremely difficult. This also hosts additional groups of tests. While in the first year 25% of people begins to form hypothyroidism. However, radioactive iodine is a unique tool, analogues to date does not exist. What are the preventive methods in the detection of a goiter?


Prevention of goiter

Prevention of goiter can be carried out in three variants and be mass, group and individual. The most effective is the first method, its implementation in those products that somehow each person consumes, add a small amount of iodine. We are talking about regular table, but iodized salt.

The advantages of this method are that it is a very inexpensive product, but the effect of this impact are obvious. According to who, as a result of such prevention of the formation of goiter is reduced each year by 20%. For preventive mass iodization apply and other foods, say, bread or water.

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Prevention of goiter in the group type involves the use of drugs which contain iodine by persons belonging to the category of risk for such a diagnosis. It is, first and foremost, children and adolescents in institutions such as kindergartens and schools.

The closest in physiological terms means is potassium iodide, which is produced in various dosages, and is used by a particular algorithm. Such prevention also may be used food,which contain iodine.

A separate category of risk group in relation to the formation of goitre are women at any period of pregnancy. They have the highest need for this component is 200 mg per day. In this connection it is necessary to carry out individual prevention. In addition, even at the planning stage of pregnancy the expectant woman recommended identification of thyroid status.

Prevention of goiter in individual type also implies the use of drugs with iodine. The desired dose is determined individually, depending on age category. Without prior visit to the endocrinologist such prevention is desirable to carry out people who have a history of problems with the endocrine gland.

Many people believe that requirement of iodine per day will be recovered through a special diet that contains some products. However, it's not 100% true, because to compensate for an existing deficiency required significant changes in the diet. Second, such changes are rather expensive. In addition, the use of iodine has to be strictly dosed. After all, any fluctuations from surplus to shortage has significant problems with the endocrine glands and overall health.

Thus, the goiter endocrine glands is one of the most common health problems. This condition is virtually impossible absolute cure, because you need constant prevention and use iodine. This will help to maintain optimal functioning and health status.