Sporadic goiter is a common ailment that is associated with a violation of the structure of the thyroid gland, namely with its increase. Despite the fact that the disease is considered relatively safe, you should not ignore it - the patient needs qualified help.
Of course, faced with a similar problem, patients are interested in additional information. What is a disease? What symptoms should I look for first? What can modern medicine offer in terms of treatment? Answers to these questions will be useful to many readers.
What is an ailment?
Quite often in medical practice, terms such as endemic and sporadic goiter are used. Both of these diseases are accompanied by nodular or diffuse enlargement of the thyroid gland along with the preservation of its functional activity. Nevertheless, there is still a difference between them.
Endemic goiter is an ailment that is associated with a lack of iodine in the body, which is so important for the normal functioning of the thyroid gland. This form of the disease is recorded in residents of areas with iodine deficiency in food and water. According to statistics, the disease is common in Brazil, India, some regions of the USA and Russia, Egypt, Switzerland. The disease is much more common among residents of highlands.
Sporadic goiter of the thyroid gland is accompanied by the same symptoms and structural changes. Nevertheless, the disease is in no way associated with living in areas with a low iodine content.
The main causes of the development of the disease
Far from always, specialists manage to find out why sporadic goiter develops. Nevertheless, several risk factors are distinguished:
- To begin with, it is worth mentioning genetics, since a hereditary predisposition to such a disease is proved. In most cases, it is a violation of the processes of iodine metabolism and the formation of hormones in the thyroid gland.
- Risk factors also include negative environmental impacts.
- Nutrition is important, as together with food, substances that interfere with the normal synthesis of thyroid hormones (for example, flavonoids, thiocyanide) can enter the human body.
- Often the cause of this disease is taking medications that interfere with the absorption of thyroid hormones by body tissues.
- Sporadic goiter can develop during periods when the body's need for thyroid hormones is increased, for example, during puberty or pregnancy.
- The cause of the development of the disease sometimes becomes an adenoma or a tumor that grows in the tissues of the thyroid gland.
Insufficient synthesis of hormones, impaired iodine metabolism, decreased body sensitivity to thyroid hormones - all this triggers compensatory mechanisms. The pituitary gland begins to secrete more thyroid-stimulating hormone, which provokes hyperplasia of the thyroid tissue.
Sporadic goiter: classification
There are many classification systems for such a disease. For example, depending on the functional activity of the thyroid gland, there are:
- euthyroid form (hormonal levels within normal limits, thyroid function is not impaired);
- hyperthyroid goiter (characterized by increased activity of the gland and an increase in the level of thyroid hormones);
- hypothyroid form (thyroid function decreases, the amount of hormones decreases).
The location of the goiter is also taken into account - it can be cervical, partially sternal, sternal and posterior-esophageal. Goiter of the tongue root is also isolated.
Depending on the structure, the goiter can be diffuse (the thyroid gland is hypertrophied, the tissues are homogeneous), nodular (denser nodules form in the thickness of the gland) and mixed.
Stages of the development of the disease and a brief description
Sporadic goiter is accompanied by a gradual enlargement of the thyroid gland. Depending on the size of the organ, several degrees of development of the disease are distinguished :
- Zero degree - the gland is not palpable, its size is still within normal limits.
- The first degree - at this stage, the gland does not visually stand out, but its isthmus is visible during swallowing, it can be felt during palpation.
- The second degree - the thyroid gland is well palpable and visible during swallowing.
- The third degree - during this period, the thyroid gland is already clearly visible not only during swallowing, but also at rest. It is possible to note a change in the contours of the neck (it looks thicker, a "second" chin appears).
- The fourth degree - the goiter is clearly visible, the shape of the neck changes.
- The fifth degree is a neglected form of the disease in which the thyroid gland reaches enormous size. Often, an enlarged organ compresses the trachea and esophagus, preventing swallowing and breathing.
The doctor, drawing up a treatment regimen, must pay attention to the degree of enlargement of the gland.
Sporadic goiter: clinic and main symptoms
At the initial stages, the ailment often does not appear in any way - the person feels quite normal. But as the disease develops, the thyroid gland begins to increase in size. At first, it can be seen only during swallowing, but the organ is constantly growing, which is accompanied by a change in the contours of the neck.
An increase in thyroid gland affects the work of nearby organs. Squeezing of the trachea is observed, which is accompanied by the appearance of a dry cough, difficulty breathing. Patients complain of problems with swallowing. In some cases, hoarseness appears, which is associated with compression of the nerve endings.
At the initial stages, the level of thyroid hormones is normal. But as the disease progresses, the amount of biologically active substances released can decrease or, conversely, increase. Hormonal disorders are fraught with the appearance of other disorders. For example, some patients develop tachycardia, hypertension, arrhythmia. Many patients complain of constant fatigue and drowsiness, irritability, muscle pain, swelling around the eyes. Symptoms include night sweats, poor tolerance of heat or cold, increased skin sensitivity, constipation, which do not disappear even after changing the diet.
Diagnostic procedures
In most cases, patients go to the doctor at a later stage of the disease. On palpation, a specialist can feel an enlargement of the thyroid gland. It is extremely important to collect a complete medical history (does the patient live in a region with iodine deficiency, are there any more cases of goiter in the family) and determine the cause of the disease, because the success of therapy depends on this in many respects.
An ultrasound of the thyroid gland is necessarily performed. This simple study makes it possible to determine the presence of nodes and cysts, to find out the exact dimensions of the organ, etc. An X-ray of the neck and chest is also performed, and sometimes computed tomography (makes it possible to see the degree of compression of the organs). The patient donates blood to determine the level of thyroid hormones. A biopsy is performed if there is a suspicion of malignant neoplasms (most often with a nodular form of goiter).
What is the treatment for the disease?
What to do to a patient who was diagnosed with sporadic goiter? Treatment depends on many factors. As a rule, suppressive thyroid therapy is performed. Patients are prescribed Levothyroxine or another drug containing L-thyroxine. The dose and duration of therapy are determined individually.
In case of iodine deficiency or a violation of its metabolism, the doctor additionally prescribes iodide ("Antistramin"). An important part of therapy is a proper diet. It is necessary to include in the diet foods rich in iodine and proteins, while limiting the number of products that contribute to the development of goiter (in particular radishes, rutabaga, peanuts, radishes, beans, cauliflower).
When is surgery indicated?
Taking medications helps to normalize the thyroid gland, prevent its further growth and eliminate other disorders that accompany sporadic goiter. Surgery, however, is the only way to eliminate existing deformities. The decision to perform the operation is made by the attending physician if the overgrown organ compresses the trachea, blood vessels and nearby tissues. During the procedure, the surgeon removes excess tissue, restores the normal shape of the gland and neck.
Complications and Possible Consequences
In most cases, the disease is well treatable. Nevertheless, the danger exists. For example, sporadic goiter in children is fraught with impaired physical development and cretinism. If we are talking about the nodal form of hypertrophy, then there is always the possibility of malignant degeneration of cells.
An enlarged thyroid gland compresses blood vessels, nerve endings, and airways, significantly impairing the patient's quality of life. For example, people with hypertrophy of the VI and V degrees are considered partially unworkable - classes that require physical stress are contraindicated.
Preventive actions
Sporadic goiter is a fairly common problem. And in this case, it’s much easier to prevent the development of the disease than then to worry about treatment. Since the disease is sometimes associated with iodine deficiency, it is necessary to monitor the diet, include iodized salt, seaweed and other foods rich in this useful trace element in the diet.
Other risk factors should be avoided, in particular taking potentially dangerous drugs. Periodically, doctors recommend taking iodine-containing medications for prevention (in the event that the ailment can be triggered by a deficiency of this substance in water and food). 1-2 times a year, it is necessary to undergo examinations by an endocrinologist. When the slightest symptoms appear, you should immediately consult a specialist.