Thyroid nodular goiter: degrees, symptoms and treatment

Nodular goiter - a term under which different thyroid diseases are combined, accompanied by the formation of nodes. These rounded tissue growths can have different shapes and sizes. In this case, pathology in the initial stages can be asymptomatic, but in the absence of treatment, there is a likelihood of developing dangerous complications. Of course, many people are interested in additional information on this issue. In the article, we will talk about how the symptoms and treatment of nodular goiter of the thyroid gland look, as well as what are the causes of their appearance.

The main causes of the development of the disease

In fact, it is far from being possible to determine the causes of the development of pathology in all cases. Nevertheless, some risk factors are known, and they are worth paying attention to:

• To begin with, it is worth noting that there is a genetic predisposition - some people are more likely to develop such a disease (of course, if there are other conditions).
• Risk factors also include age - a change in the structure and functioning of the thyroid gland is often associated with natural aging processes.
• If we are talking about colloidal goiter, then almost always its development to one degree or another is associated with iodine deficiency in the human body.
• Sometimes a similar problem is recorded in patients who suffer from autoimmune and genetic diseases (for example, people with Down syndrome are at risk).
• Violations of the thyroid gland may be associated with the use of certain drugs.
• The risk factors include the adverse effect of the environment (goiter may be associated with exposure to radiation).
• Acute and chronic infectious diseases (both viral and bacterial) can trigger thyroid problems.
• Risk factors also include endocrine diseases, constant stress, unhealthy diet (it leads to vitamin deficiency and micronutrient deficiency), smoking and other bad habits.

Unfortunately, it is far from always possible to find out the reasons for the development of nodular goiter. Nevertheless, it is important to provide the doctor with complete information for the medical history.

Nodular goiter: symptoms

Symptoms in this case directly depend on the stage of development of the disease, the number of nodes, their location and size:

• A greatly enlarged thyroid gland protrudes under the skin of the neck, creating a cosmetic defect.
• Enlarged nodes often squeeze the larynx, trachea and esophagus, which leads to a constant sensation of a lump in the throat.
• In addition, patients experience difficulties during conversation, swallowing.
• Other symptoms include dry cough, asthma attacks, persistent hoarseness.
• If the thyroid gland compresses blood vessels, then patients may suffer from periodic headaches, dizziness, and tinnitus.
• Some of them complain of pain on palpation of the nodes. As a rule, unpleasant sensations in this case are associated either with hemorrhage or with inflammation of the thyroid gland tissues.

According to statistics, in most cases, nodular goiter does not cause functional impairment. Nevertheless, sometimes the formation and growth of nodes is accompanied by an increase or decrease in the level of hormones.

Hypothyroidism is characterized by a decrease in blood pressure, drowsiness, eating disorders, hair loss, dry skin, and a decrease in body temperature. In women, a decrease in the level of thyroid hormones causes menstrual irregularities, and men often complain of problems with potency and decreased libido.

Signs of thyrotoxicosis

Often, nodular goiter of the thyroid gland is accompanied by an increase in the level of thyroid hormones, which in the absence of correction leads to the development of thyrotoxicosis. A similar condition is accompanied by very characteristic symptoms:

• problems with sleep, constant insomnia;
• an increase in body temperature to subfebrile values;
• the appearance of trembling in the hands;
• increased irritability;
• tachycardia, increased heart rate;
• constant hunger;
• weight loss, even with a large amount of food.

The degree of development of the disease

If we take into account the classification scheme of O. V. Nikolaev, then the following degrees of nodular goiter are distinguished:

• Zero - there are no symptoms, the disease is rarely diagnosed at this stage.
• The first degree - during the examination, the doctor can feel the thyroid gland, although some noticeable physiological disturbances are still missing.
• The second - the thyroid gland increases in size and is well palpable, patients complain of difficulty swallowing, discomfort with tilting the head, swelling, irritability, and loss of appetite.
• Third, the patient’s neck increases in size, appetite decreases, and weight, on the contrary, increases, chest pains, shortness of breath appear.
• Fourth - thyroid nodes are enlarged, goiter appears on the neck.
• Fifth degree - an enlarged gland compresses adjacent organs.

Types and forms of goiter

Depending on the size, number of nodes, as well as the degree of change in the functional activity of the thyroid gland, several forms of the disease are distinguished:

• Colloidal nodular goiter - accompanied by proliferation of the epithelium and an increase in the number of follicles in which hormones are synthesized.
• Solitary goiter - there is a single, single formation in the tissues of the gland.
• Diffuse-nodular form - is accompanied by a uniform change in the structure of tissues.
• Multinodular goiter is a pathology that is accompanied by the formation of two or more catches.
• Nodular non-toxic goiter - characterized by the formation and gradual increase in nodes, but there are no changes against the background of the hormonal process.
• Nodular toxic goiter is accompanied by a sharp increase in the level of thyroid hormones, which is fraught with serious complications, up to oncological diseases.

What can the disease lead to?

Thyroid nodular goiter is a very dangerous and unpleasant disease, which requires treatment. An increase in organ size can lead to compression of the trachea and esophagus. In addition, rapidly growing nodes can compress blood vessels, which violates the trophic tissue of the gland. There is a possibility of inflammation of the structures of the organ, which can lead to serious consequences (for example, to a violation of hormonal activity). Do not exclude the possibility of malignant degeneration of thyroid tissue.

Diagnostic measures

Treatment of nodular goiter is directly related to the type of disease and the cause of its occurrence. That is why diagnosis is so important - the success of therapy depends on it.

First, an examination by an endocrinologist is necessary. If the doctor determined the presence of nodes during palpation, then an ultrasound examination is performed - during the procedure, the specialist can more accurately determine the number, size and location of neoplasms in the tissues of the thyroid gland. If the diameter of the node exceeds 1 cm, then a fine-needle aspiration biopsy is performed (this procedure allows you to determine whether the structure is malignant).

Of course, they do a blood test for the level of thyroid hormones. To assess the functional activity of an organ, a radioisotope scan is performed. Sometimes an x-ray of the esophagus and chest with barium is prescribed - this allows you to determine the degree of compression of the esophagus and / or trachea. To obtain more accurate information, the patient is sent for tomography.

The main methods of treatment

Treatment of nodular goiter directly depends on the form and stage of development of the disease. If the patient has one small neoplasm, and there are no malfunctions of the endocrine system, then doctors usually decide on dynamic observation. The patient regularly undergoes examinations and passes tests - this allows the specialist to timely detect the further development of the disease.

Treatment of diffuse nodular goiter, which is associated with hormonal disorders, includes the use of synthetic thyroid hormones - often this is what helps to reduce the size of the thyroid gland. Effective is considered therapy with radioactive iodine. According to statistics, through such treatment, it is sometimes possible to reduce the volume of the gland by 30-80%. Unfortunately, sometimes it is impossible to do without surgical intervention.

Indications for the operation are as follows:

• nodes in the tissues of the thyroid gland grow rapidly;
• there is a suspicion of malignant degeneration of tissues;
• serious violations in the functioning of the gland take place (the level of hormones is sharply reduced or increased);
• the patient has a retrosternal location of the node;
• multiple cysts formed in the tissues of the thyroid gland, inside which a large amount of fluid accumulates;
• goiter grows rapidly, compresses the trachea and esophagus, significantly affects the quality of life of the patient.

Sometimes during surgery, the doctor carefully removes the node or cyst, without affecting the tissue of the thyroid gland. Sometimes a partial resection of the organ is required, which may affect its endocrine activity. In the most severe cases (for example, if there is a malignant degeneration of tissues), complete removal of the thyroid gland is required. In this case, the patient requires lifelong hormone therapy in order to maintain the normal functioning of the body.

As you can see, the symptoms and treatment of nodular goiter are interrelated: the choice of therapeutic procedures depends on the presence of certain disorders.

Diet for ailment

Treatment of nodular goiter of the thyroid gland is necessarily supplemented by a proper diet. The diet directly depends on the level of thyroid hormones. So, if hypersecretion takes place, then daily food should be high-calorie, a sufficient amount of vitamins and mineral salts should enter the body. With hypothyroidism, you need to add products with a high iodine content to the menu. Useful in this case are fish, seaweed, millet, buckwheat, cheese, cottage cheese, milk, nuts and fruits. It is necessary to refuse alcohol, smoked meats, coffee, chocolate, rich broths and spicy dishes.

Treatment of nodular goiter folk remedies

Of course, drug therapy can be supplemented with some other activities. Traditional medicine offers a lot of recipes. These funds favorably affect the thyroid gland, help normalize the hormonal background:

• Many healers say that walnuts are effective for goiter. 40 peeled nuts must be thoroughly washed, dried, then pour a liter of honey (it is important to choose a natural product). The mixture is infused for forty days in a dark place. You need to take a teaspoon of the medicine with a glass of milk (once a day).
• For the treatment of nodular goiter, walnut partitions are also suitable. A glass of partitions is poured into 500 ml of vodka. The mixture is insisted in a dark, cool place for a month. Herbalists recommend taking a tablespoon of tincture daily.
• Walnut is also suitable for compresses. It is necessary to take the walnut shell and oak bark in equal amounts, add water, bring to a boil and keep on low heat for thirty minutes. In the cooled broth, gauze is moistened, which is then applied to the skin of the neck (in the area of ​​the goiter). The compress is left for 30 minutes.
• If there is hyperthyroidism, then you can prepare an herbal collection. First you need to mix 100 g of nettle leaves, corn stigmas, burdock roots, licorice root, tricolor violet grass and 50 g of horsetail. All ingredients must be mixed thoroughly. Two tablespoons of the mixture is poured with three glasses of boiling water. The container is covered and left for 30 minutes. The infusion should be filtered and taken 100-150 ml three times a day.
• It is also recommended to use a small amount of seaweed every day (this will help saturate the human body with iodine).
• Some folk healers recommend doing an iodine net on the skin of the neck before going to bed.
• A plant such as horse sorrel is also useful: 50 g of crushed roots need to be poured with 500 ml of vodka and left in a dark place for a week. Take the medicine three times a day for a tablespoon.

Of course, the above funds can only be used as auxiliary - they can not replace full-fledged drug therapy. In no case should you take any medication without the knowledge of a doctor.

Predictions for patients and preventive measures

Nodular goiter is a serious disease that should not be ignored. Forecasts directly depend on the form of the disease and the stage of its development. For example, with euthyroid goiter, the function of the thyroid gland can be normalized. But the presence of malignant neoplasms can result in very dangerous complications. As for prevention, patients are advised to eat right, to include products containing iodine in the diet, and also to take vitamin complexes periodically (vitamins of group B are especially important). Physical activity, hardening and other general strengthening procedures will be useful.