Goiter is abnormal enlargement of the thyroid gland, a butterfly shape gland located at the base of the neck just below the Adam’s apple. Although goiter is usually painless, a large goiter may cause coughing or difficult breathing or swallowing.

The most common cause of goiter worldwide is a lack of iodine in the diet.


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Goiter does not always cause symptoms and symptoms, but when it does they may include: a visible swelling at the base of the neck, a hard feeling in the throat, coughing, hoarseness, difficulty swallowing, shortness of breath.




The thyroid gland produces two main hormones – thyroxine (T -4) and triiodothyronine (T 3). These hormones circulating in the blood and help regulate metabolism. They define the rate at which your body uses fats and carbohydrates, help control body temperature, influence heart rate and help regulate the production of proteins. The thyroid gland also produces calcitonin – a hormone that helps regulate the amount of calcium in the blood.

The pituitary gland and the hypothalamus controls the speed with which these hormones are produced and released .
The process begins when the hypothalamus – the area at the base of the brain that acts as a thermostat for the entire system – signals the pituitary gland to produce a hormone known as thyroid stimulating hormone (TSH). Pituitary (located in the base of the brain) secrets TTG certain amount, depending on how much thyroxine and T-3 in the blood. The thyroid gland, in turn, regulates its production of hormones based on the amount of TSH, which it receives from the pituitary gland.
The presence of goiter does not necessarily mean that the thyroid gland is not working properly. Even when he expanded the thyroid can produce normal amounts of hormones. It can also produce too much or too little thyroxine and T-3.


To increase the thyroid gland can cause a number of factors. Among the most common are:

Iodine deficiency. Iodine, which is required for the production of thyroid hormones is basically in sea water and in the soil in coastal areas. In developing countries people who live in the country or at high altitudes often have iodine deficiency, and they can develop goiter, when the thyroid increases in an attempt to get more iodine. Initial iodine deficiency may be further aggravated a diet high in hormones inhibiting foods such as cabbage, broccoli and cauliflower.

Although the lack of iodine in diet is the main cause of goiter in many parts of the world, this does not happen in countries where iodine is added to regular table salt and other products.
Graves’ disease. Goiter may sometimes occurs when the thyroid gland produces too much thyroid hormone (hyperthyroidism). Graves’ disease, antibodies produced by the immune system mistakenly attacks the thyroid gland, causing it to produce excess thyroxine. This causes swelling of the thyroid gland.
Hashimoto’s disease. Goiter can also result from an underactive thyroid (hypothyroidism). As Graves’ disease, Hashimoto’s disease is an autoimmune. But instead, the thyroid gland produces too much hormone.
Feeling low levels of the hormone, the pituitary gland produces more TSH to stimulate the thyroid gland, which leads to gland enlarging.
Multinodular goiter. In this condition, a more solid or liquid-filled nodules developed in both sides of the thyroid gland, resulting in an overall expansion of cancer.

Solitary thyroid nodules. In this case, one nodule develops in one part of the thyroid gland. Most nodules are benign and do not lead to cancer.
Thyroid cancer. Thyroid cancer appears much less than benign nodules of the thyroid gland. Thyroid cancer often appears as an extension of one side of the thyroid gland.

Pregnancy. A hormone produced during pregnancy, human chorionic gonadotropin (hCG), can lead to thyroid gland slight increase.

Inflammation. Thyroiditis is an inflammatory disease, which can cause pain and swelling in the thyroid gland. It may also lead to greater production or underproduction of thyroxine.



Risk factors

Goiter can affect anyone. It may be present at birth as occur at any time throughout life, although they most often it occurs after 40 years. Some common risk factors for the appearance of goiter include:

Lack of iodine in the diet. People living in areas where iodine deficiency or they do not have access to iodine, have a high risk of goiter. Women are more prone to thyroid disease, they are also more prone to the development of goiter.

Age. There is an increase in the likelihood of goiter with age.
History. Personal or family history of autoimmune disease increases the risk.
Pregnancy and menopause. For reasons that are not entirely clear thyroid problems often occur during pregnancy and menopause.

Some medicines. Some medical procedures, including receiving immunosuppressants, antiretrovirals, cardiac drug amiodarone (Cordarone, Pacerone, etc.) and lithium (Lithobid, etc.) increases the risk.

Radiation exposure. The risk increases after radiation therapy to the neck or chest, or in the case of exposure to radiation from a nuclear facility, testing or accident.



Small goiter does not cause physical or cosmetic problem. But large goiter may cause difficulties in breathing or swallowing, coughing and hoarseness. Goiter, which is a result of other conditions, such as hypothyroidism or hyperthyroidism may be associated with a number of symptoms ranging from fatigue and weight gain, and ending with unintentional weight loss, irritability, and problems with sleep.


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Goiter diagnosis and treatment

Doctor can detect an enlarged thyroid gland just tested the neck and check the swallowing reflex during a routine physical examination. In some cases, doctor may also detect nodules. (more…)
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