Goiter is a disease that occurs as a result of abnormal growth of the thyroid gland. The thyroid gland is a butterfly-like organ located in the front of our neck. The thyroid gland is the place where thyroid hormones, which have very important roles in metabolism and brain functions, are secreted.
The most common cause of goiter worldwide is iodine deficiency. Iodine is very effective in producing thyroid hormone, so in the absence of iodine, sufficient thyroid hormone cannot be produced and stimulates the brain thyroid gland to make hormones continuously. This causes the thyroid gland to grow. Like iodine deficiency, excess iodine intake in the diet can also cause goiter.
The second common cause of goiter is the Hashimoto thyroid. In Hashimoto’s thyroid, the thyroid gland is destroyed by the immune system. The damaged thyroid gland cannot produce enough hormones and in this case the pituitary gland stimulates the thyroid gland to make hormones continuously. As a result, an enlarged thyroid gland, in other words goiter develops.
In Graves’ disease, the immune system causes the secretion of thyroid stimulating immunoglobulin. Goiter and hypertroitis develop depending on this.
Goiter is available in two types, with and without nodules. In non-nodule goiter, the thyroid gland is enlarged symmetrically and is soft. Goiter without nodules occurs when the thyroid gland cannot produce enough thyroid hormone. In nodular goiter, it is also possible to produce insufficient hormone, but cells in some regions respond to stimuli from the brain. Consequently, nodules develop in the thyroid gland. There is a risk of thyroid cancer in 4-20% of thyroid nodules.
Pregnancy is another cause of goiter. HCG hormone secreted during pregnancy causes growth in the thyroid gland. Thyroid cancer may give its first symptom as goiter.
While goiter does not give any symptoms in some patients, it may cause swallowing difficulty, cough, shortness of breath and pain in addition to swelling in the neck. In goiter, symptoms related to the secretion of more or less hormone by the thyroid gland are also observed. In case of insufficient hormone secretion, weight gain, drowsiness, lethargy, dry and rough skin, constipation, weakness and hair loss may occur. When more hormones are secreted than normal, diarrhea, palpitations, headache, tremors, nervousness and nausea may occur.
Who is the goiter more common?
Goiter can occur in patients of all ages. However, it is more common in people of middle age and women. Iodine deficiency, heredity, viral infections, lithium use, radiation, pregnancy, menopause and smoking are the most common causes of goiter.
One or more of drug therapy, radioactive iodine therapy and surgical treatment methods can be used in the treatment of goiter. If hormone deficiency is detected in the patient, hormone drugs are used. On the contrary, if there is an excess of hormones, drugs to suppress thyroid hormone and radioactive iodine therapy are applied. Surgical treatment can be applied in nodular goiter. In surgical treatment, some or all of the thyroid gland can be removed. The decision of surgery in goiter is made based on the patient’s hormone level, presence of cancer, presence of swallowing or respiratory disorders, or cosmetic reasons. Some complications may occur in goiter operations. After the operation, hoarseness occurs as a result of damage to the vocal cords. If the parathyroid glands are accidentally removed during the surgical operation, the patient develops calcium deficiency. In this case, the patient should be given calcium as a medicine.
When to go to the doctor
If you notice a swelling in your neck while shaving or looking in the mirror; However, if you have symptoms such as palpitations, irritability, persistent diarrhea, constipation, insomnia or excessive sleepiness, shaking hands, weight gain, difficulty in swallowing and breathing, you should consult your nearest internal medicine specialist.