Diffuse non-toxic goiter is a fairly common disease, which is accompanied by an increase in the size of the thyroid gland. It affects women and men of any age (often it is diagnosed in children). Of course, patients should familiarize themselves with information about this ailment, because a not entirely clear diagnosis often causes a person only panic. So how dangerous can a disease be and how to avoid its development? What symptoms are worth paying attention to?
Diffuse non-toxic goiter: ICD code and the main characteristics of the disease
This disease is characterized by hyperplasia and hypertrophy of thyroid tissue. Simply put, the thyroid gland begins to increase in size. This pathology is numbered E04.0 and is described in ICD-10.
Diffuse non-toxic goiter is not accompanied by functional disorders. Against the background of the disease, hyper- or hyposecretion of the thyroid gland is not observed, therefore, the hormonal background remains normal. The prevalence of the disease is 4-5%. By the way, women are more susceptible to it than the stronger sex. Often there is diffuse non-toxic goiter in children, but more often it is diagnosed in people of mature age, after 30 years.
Classification: varieties and forms of the disease
In most cases, non-toxic goiter develops against a background of iodine deficiency in the body. If we are talking about the lack of this element in the territory of residence, then the disease is called endemic - most of the population is affected by it.
But there are cases in which goiter develops in the absence of iodine deficiency in the area of residence. This is a sporadic form of the disease, which is associated with an insufficient level of secretion of thyroid hormones.
Non-toxic goiter can be diffuse, nodular (dense benign nodules form in the tissues of the thyroid gland) and mixed. In addition, a hypertrophied gland can have a different consistency - tissues to the touch can be soft, elastic, dense, and sometimes small hollow cysts develop in them.
Stages of the development of the disease
Non-toxic diffuse goiter in most cases develops slowly. In modern medicine, it is customary to distinguish three stages, guided by external signs:
- At the so-called zero stage, there are no visual changes - the contours of the neck remain the same, and it is difficult to determine the presence of an ailment upon palpation.
- Diffuse non-toxic goiter of the 1st degree cannot be determined during examination, but during palpation an experienced doctor may notice an enlargement of the gland.
- At the second stage of development, the goiter can not only be felt with fingers, but also seen - the enlarged thyroid gland is visualized as a large tubercle under the skin.
This classification scheme has important diagnostic value.
What are the causes of the development of the disease?
An increase in the thyroid gland with a similar disease is compensatory in nature. Tissue overgrowth is associated with iodine deficiency. Against the background of a lack of this element, thyroid cells, thyrocytes, begin to actively capture iodine. The number of cells increases in order to accumulate as much of this element as possible, respectively, the mass of tissues increases.
A similar phenomenon is associated either with iodine deficiency (it does not enter the body in sufficient quantities) or with an insufficient amount of thyroid hormones secreted by the gland.
The reasons for the development of goiter are not always clear. It is known that there is a certain hereditary predisposition. For example, in some patients, genetic diseases are found that are associated with impaired functioning of enzyme systems.
On the other hand, there are some risk factors. For example, the gender and age of the patient is important (women of a mature age are more prone to illness). Diffuse non-toxic goiter often develops against the background of nervous overstrain and prolonged stress. Risk factors also include vitamin deficiencies and a deficiency of certain trace elements in the body, in particular zinc, manganese, molybdenum, selenium, cobalt and copper. Excess calcium can also lead to goiter. The same list includes smoking, chronic infectious diseases, as well as taking certain medications.
The clinical picture and main symptoms
Diffuse non-toxic goiter develops slowly, and at the initial stages, which can last for months or years, the disease does not appear at all. Occasionally, patients complain of weakness and dizziness, headaches. But the symptoms occur sporadically, so people simply do not pay attention to them.
As the disease develops, the size of the thyroid gland increases - you can notice the appearance of a tubercle, a change in the contours of the neck. Hypertrophy of the gland is often caused by compression of nearby organs, such as blood vessels, trachea, esophagus, etc. Sometimes patients complain of a constant sensation of a coma in the throat. Patients may experience breathing problems (especially when lying down), as well as swallowing. Constant shortness of breath in the most severe conditions leads to an attack of suffocation. Upper vena cava syndrome in patients is the result of vascular compression (squeezing).
What complications can an ailment cause?
As already mentioned, diffuse non-toxic goiter is a non-dangerous ailment, especially if it was diagnosed in time and the patient received the necessary help. Nevertheless, the disease is associated with some possible complications.
Sometimes the thyroid gland enlarges so much that it compresses nearby structures, in particular, nerve endings and blood vessels that carry blood to the brain. In addition, an increase in endocrine gland volume can lead to airway compression. Occasionally, the disease is complicated by the inflammatory process and the appearance of small hemorrhages in the gland tissue.
Unfortunately, there are cases when patients develop diffuse / nodular toxic goiter, which is already accompanied by severe hormonal disorders.
What does modern diagnostics look like?
Diagnosis in this case is very important, because thyroid hypertrophy can indicate many disorders. To begin with, of course, the doctor collects an anamnesis and palpates the thyroid gland - in the later stages of development, its increase can be noticed during a visual examination.
Further, it is necessary to donate blood in order to determine the level of thyroid hormones (with non-toxic goiter, the hormonal background is normal). An obligatory part of the diagnosis is an ultrasound examination of the thyroid gland, during which the doctor can accurately determine the size of the gland, establish the presence or absence of nodules, cysts and other neoplasms.
Sometimes an X-ray is additionally performed - this allows you to determine the degree of compression of the esophagus and respiratory tract. If there are nodules, patients are advised to undergo a biopsy.
Non-toxic diffuse goiter: treatment
Therapy for this disease largely depends on the patient's condition and the degree of enlargement of the gland. For example, at the zero stage, specific treatment may not be required at all - the patient is advised to adjust the diet, avoid stress and undergo regular checks.
At the second and third stages, patients are prescribed iodine preparations (the daily dose of potassium iodide is about 200 mcg). To gradually reduce the gland, patients sometimes need replacement therapy, namely, taking drugs containing levothyroxine. Quite often, doctors recommend drugs such as Eutirox, Levothyroxine and Iodothyrox.
Surgical excision of parts of the gland is carried out only in the most serious cases, if the patient has noticed serious compression. In such situations, there is a high risk of suffocation and vascular problems, so surgery is simply necessary.
Are there preventative measures?
Of course, it is much easier to prevent the development of the disease than then to look for ways to effectively eliminate it. There is no specific prophylaxis, but patients should follow some simple rules. As you know, in regions with a fixed iodine deficiency, the population is recommended to periodically replenish the reserves of this element in the body, taking iodine-containing drugs. As a prophylaxis, the same drugs are prescribed for children during periods of intensive growth and for pregnant women.
For normal thyroid function, it is important that the body receives vitamins, in particular, retinol, tocopherol, vitamin B12 and D. Therefore, it is useful for people to take vitamin complexes 1-2 times a year.
Of course, an important preventive measure is diet. The menu should definitely include products containing iodine, including seafood, fish and caviar. Butter, liver, carrots and fish oil will saturate the body with the necessary vitamins. But such products as broccoli, radish, turnip, horseradish, cauliflower and white cabbage slow down the process of assimilation of iodine in the body. Of course, they should not be completely abandoned, because they contain a lot of other useful substances, but their quantity must be limited. Of course, it is worth avoiding stress, adhering to the correct sleep and rest regimen, spending more time outdoors and abandoning bad habits. All this will help prevent the development of a disease such as diffuse / nodular non-toxic goiter.