In the human body, the thyroid gland plays a very important role. Relating to the endocrine system, the body takes part in the regulation of energy metabolism. Two lobes of it are connected by an isthmus, located on the sides of the trachea. The energy entering the body is distributed between the cells, but if it is not enough, the thyroid hormones interfere. If the deficit is constant, a certain tissue change occurs and goiter disease develops. There are several forms and degrees of the disease that differ in causes and symptoms. Any type of pathology requires diagnosis and treatment.
Thyroid goiter
The mechanisms of the formation of neoplasms in the thyroid gland are still not well understood. The treatment methods known in medicine today can not always be effective enough and completely cure the pathology.
The tissue of the thyroid gland is follicles - spherical cells. Disturbances in the body associated with organ dysfunction lead to deformities. Multinodular goiter of the thyroid gland causes changes in individual areas, and diffuse - throughout the tissue. In addition to an increase in follicles, the disease can be characterized by the appearance of cystic formations (cystic-nodular goiter). The progression of pathology can lead to degeneration of nodes into malignant.
Causes
Goiter is a disease that includes various damage to the thyroid gland. There are several types, forms and degrees of pathology that differ in the nature of the course, causes and symptoms. The main reason for the development of toxic endemic goiter is the lack of iodine in the body, which reduces the secretory activity of the thyroid gland. Bad ecology also affects the functioning of the thyroid gland. Toxic substances from outside can slow down the activity of the thyroid gland, inhibiting the functioning of the endocrine system.
Inadequate consumption of iodine-containing foods (milk, fruit, fish) can also cause goiter. The causes of the development of the nodal type of the disease are the cancerous process of the thyroid gland or adenoma. Differentiation and cell division in this case occurs under the influence of toxic substances, radiation, and may be hereditary.
Bazedov’s pathology arises due to the influence of special antibodies of the immune system on the organ. Treatment consists in taking drugs that inhibit the production of hormones, sometimes the problem is solved by surgical intervention.
Symptomatology
Goiter is such a disease that it does not appear in the initial stages, and the patient may not even suspect its presence. Only in connection with a significant increase in the thyroid gland does a definite clinical picture develop. Symptoms of thyroid disease are characterized by its edema on the front of the neck and compression of adjacent tissues. At the same time, patients complain of the appearance of a dry cough, hoarseness, a sensation of a “coma in the throat,” difficulty breathing. When the head moves, a feeling of tension and dizziness occurs, which is associated with compression of the vessels of the neck. To some extent, swallowing is impaired due to compression of the esophagus. Different sized nodes appear on the thyroid gland. What to do in such situations is to consult a doctor at the first suspicion.
With the development of pathology due to iodine deficiency, the clinical picture is supplemented by other symptoms associated with hypothyroidism: flatulence, frequent respiratory diseases, low blood pressure. With thyroid adenoma or a basic disease, there are signs of hyperthyroidism: weight loss, irritability, trembling hands, hunger, fever.
Diffuse euthyroid goiter
Pathology develops as a result of iodine deficiency. The compensatory nature of hyperplastic and hypertrophic processes in the thyroid gland is aimed at providing the body with an adequate level of thyroid hormones. Adaptation mechanisms to iodine deficiency are associated with the utilization of endogenous iodine, decreased iodide secretion by the kidneys, synthesis of triiodothyrosine, and increased iodine uptake by the thyroid gland. In this way, the body compensates for iodine deficiency, but the development of thyroid hypertrophy occurs, which ensures the preservation of the functions of the thyroid gland. Euthyroid goiter can complicate its course as a result of factors such as excess calcium, lack of trace elements (molybdenum, copper, cobalt, selenium, zinc, manganese), taking certain medications, chronic infections, emotional stress, smoking.
In most cases, clinical manifestations do not develop, since with this disease the function of the thyroid gland practically does not suffer. Sometimes in a patient's condition, one can observe general weakness, fatigue, and increased fatigue. The enlargement of the thyroid gland is to a large extent accompanied by a visible cosmetic defect and a sensation of pressure in the neck. Other symptoms of thyroid disease are associated with organ hypertrophy, which can be the cause of serious complications: inflammation of the gland, hemorrhage, compression of the esophagus, trachea. Against the background of this pathology, other, more complex types of goiter may develop.
Diffuse toxic goiter
In middle-aged women, diffuse toxic goiter is predominantly found . This disease is much less likely to affect pediatric and elderly patients. It has not yet been established completely what factors influence the development of pathology, but most medical representatives consider genetic defects to be the main cause, as a result of which the regulation of antibody production is disrupted in the immune system. These disorders lead to the development of antibodies against the tissue of the patient’s own thyroid gland. Genetic defects in this case are not an absolute predisposition, but a statistical regularity, that is, not necessarily the child will be sick if one of the parents has the disease goiter.
Rarely enough, with this pathology, the thyroid gland increases in volume. Eye enlargement occurs in 30% of patients (Graves ophthalmopathy, endocrine ophthalmopathy, exophthalmos). The main symptoms in diffuse toxic goiter are associated with an excess of hormones produced by the thyroid gland. Due to excessive activity of hormonal effects, the patient's heart functions are disturbed, up to the development of arrhythmia. Strengthening metabolic processes lead to weight loss. Patients may experience symptoms such as decreased sleep, tearfulness and weakness, irritability, and tremors.
Nodular goiter
Nodular goiter is a series of pathologies with one common feature - the formation of nodes in the thyroid gland. After a suspicion of the development of the disease, the patient needs to undergo a series of examinations to determine the degree and type. If more than one node is found in a patient, then a multinodular goiter of the thyroid gland is diagnosed. The most common manifestation of the pathology is colloidal euthyroid goiter. Symptoms as such do not occur, but defects appear in the neck, up to deformation. Complications appear along with pain, which indicates a rapid growth of formations: hemorrhage in the node, the appearance of inflammation, while the thyroid gland increases even more. Large nodes can compress the trachea or esophagus, which is accompanied by respiratory and swallowing disorders.
The development of nodular goiter is promoted by such factors as a genetic predisposition, chronic viral and bacterial infections, drugs, goiter food factors, environmental factors. The main reason is the lack of iodine in the body. Do not bring the disease to a neglected state. See your doctor right away if you feel knots on the thyroid gland. What to do next, how to get rid of them and avoid complications - this can be found in a specialized consultation after a full range of examinations. Only after this can you take some measures and prescribe treatment.
Degrees
The degree of nodular goiter is determined based on how large the thyroid gland is. Nodes can be of different sizes and in different quantities. To date, there are two classifications of nodular goiter in degrees. The first - according to Nikolaev. 5 groups are distinguished here. At a zero degree, the thyroid gland is not visible and it is not felt on palpation. At the first - not visible, but palpable. The second degree is characterized by a visible manifestation of the gland during swallowing. With the third, the contour of the neck increases and thickens. The fourth manifests itself already in a clear goiter, which violates the configuration of the neck. The fifth, last, degree of the disease is fraught with complications. The huge size of the thyroid gland leads to compression of neighboring organs, which violates the functions of the respiratory, cardiovascular systems and the gastrointestinal tract.
According to the WHO classification, there are three (zero, first and second) degrees of the disease. If there is no goiter, the first one is not visible, but is palpated and in the second degree, the goiter is felt, and it can be seen with the naked eye. If the initial stages of the development of pathology do not pose a visible danger to the body, then the progression of the disease can lead to serious consequences, because goiter is a fairly serious disease, which, in addition to external changes, negatively affects the work of all systems and organs.
Diagnostic Methods
An initial examination of the patient is carried out using palpation. If a neoplasm has been detected, an ultrasound is prescribed to determine the thyroid gland volume and the exact size of the neoplasm. A fine-needle aspiration biopsy is performed when the size of the formation exceeds 1 cm, or there is a suspicion of a malignant tumor. Ultrasound in combination with biopsy increases the information content of research.
The thyroid goiter, when located sternum and with large sizes, can shift towards the respiratory tract, which causes complications. To prevent this, an x-ray is prescribed with contrasted barium of the chest and esophagus. Magnetic resonance imaging is used for the detailed study of sternal goiter. In normal cases, it is not prescribed.
How to treat goiter
Treatment of goiter can be conservative and prompt. The first option is used if a diffuse, nodular, multinodular thyroid goiter has been diagnosed. An absolute contraindication to surgery is also the reason for the use of conservative treatment. It consists of several steps. First, you need to review your diet and replace it with a balanced one. Still need to improve sanitary conditions. Here they can prescribe treatment at a specialized resort. Important components of conservative treatment are: normalization of the liver and intestines, rehabilitation of foci of chronic infections, normalization of iodine metabolism in the body. The latter is achieved by taking such drugs: "Triiodothyronine", "Thyroidin", "Tireotom", "Tireocomb."
Surgical treatment is prescribed if there is an indication for surgery: diffuse goiter of IV and V degree, diffuse goiter of III degree, which does not respond to conservative therapy, mixed and nodular goiter, if the thyroid gland is enlarged. Goiter is removed in two ways: hemistrumectomy and lobe resection. Surgery is performed by a surgeon under the close supervision of an endocrinologist. It is also possible to treat goiter with folk remedies. The most tested and effective way is the use of elecampane herb. An infusion of vodka is prepared from it and used to gargle until completely cured.
Goiter Prevention
In order not to encounter the disease goiter, you need to provide yourself with the conditions under which the disease can not develop. We are talking about prevention, which in this case can be mass, group, individual. Bulk is the use of iodized salt, which per 1 ton contains 25 grams of potassium. This technique is especially important in areas of increased risk of iodine deficiency. Group prophylaxis is carried out with the help of the drug "Antistrumin." Use it in military units, children's and school groups at a dose of 1 tablet per week. Patients who arrived in the zone with iodine deficiency are also prescribed the drug "Antistrumin."
Specific prophylaxis should be carried out in conjunction with the elimination of aggravating factors with the help of a number of sanitary and hygienic and social measures (the fight against intestinal infections, sanitary culture of the population, the prevention of hypovitaminosis, a balanced diet, improving living conditions).