With insufficient amount of iodine in the blood, the production of iodine-dependent hormones is significantly reduced. For this reason, the pituitary gland sends a signal to the thyroid gland to more actively synthesize hormones to compensate for the deficiency. Since the previous volume of cells cannot cope with the new demands of the body, the cells actively divide, and the thyroid gland grows.

Information about the disease

This type of goiter occurs in 1 out of 10 cases of goiter in general, which is by no means small. The greatest risk of developing this pathology is in people living far from the sea (the so-called regions of iodine deficiency). Endemic goiter occurs much more often (about 5 times) in women than in men. In terms of the age ratio of patients, there is a preponderance towards older people, although over the past 10 years the incidence among the child population has increased by 10%.

This condition requires immediate medical attention as it may cause serious complications(inflammation, goiter or cancer). If a child is susceptible to iodine deficiency, the rate of iodine deficiency may be significantly reduced. intellectual development, up to mental retardation.

Degrees and forms of pathology

An enlarged thyroid gland is called a goiter due to the external similarity of the bulging gland on the human neck to a bird's goiter. There are several degrees of goiter development:

• grade 0 goiter – there are already pathological changes in the gland, but it is impossible to notice externally and during physical examination;
• grade 1 goiter – the thyroid gland is slightly enlarged, this is noticeable only upon palpation or during swallowing;
• grade 2 goiter - the enlargement of the gland is more significant, can be detected by palpation, but does not appear externally, the patient’s neck is not deformed;
• grade 3 goiter – the patient’s neck greatly increases in transverse size, as the thyroid gland grows significantly;
• grade 4 goiter - there is a pronounced goiter on the large neck, coughing, sensation may occur foreign body in the throat, change in voice to more hoarse;
• Grade 5 goiter - an overgrown thyroid gland compresses the trachea, esophagus, nerves, blood vessels and other nearby organs.

Endemic goiter has three forms:

• Diffuse form - the thyroid tissue is evenly enlarged, there are no nodes or cysts.
• Nodular - such a goiter is enlarged unevenly, and some of its parts become fibrous tissue, forming nodes. Typically, this goiter occurs in older people (over 50 years old).
• Diffuse fibrous form - the thyroid gland is enlarged and has nodes.

The presence of thyroid pathology can be determined by its density and degree of mobility. If the consistency of the thyroid gland changes from elastic and pliable to too dense, this is a sign of an existing pathology, including thyroid cancer. The presence of cancer is also indicated by the lack of mobility of the thyroid gland when swallowing. If pain is noted on palpation of the thyroid gland, inflammation is suspected.

What causes the appearance of endemic goiter?

The causes of endemic goiter are always associated with a lack of iodine in the body. There are absolute and relative iodine deficiency.

Causal factors of relative iodine deficiency:

• genetically determined thyroid abnormalities (hypoplasia and aplasia);
• loss of iodine by the body due to prolonged use of certain medical supplies(sulfonamides, resorcinol, nitrates, aminosalicylic acid);
• malabsorption - pathology digestive system, in which nutrients (including iodine) are less well absorbed in the intestines;
• uncontrolled use of sorbents and laxatives;
• some types chronic failure kidneys (the removal of iodine from the body increases);
• prolonged emotional stress;
• hypovitaminosis D;
• damage to the thyroid gland by toxic substances from the air, water or soil;
• some infectious diseases bacterial nature;
• sedentary lifestyle;
• childhood, puberty, pregnancy (temporary deficiency);
• bad habits;
• helminthic infestations;
• eating turnips, peanuts, cauliflower and beans in large quantities(substances in these products bind to iodine and it does not enter the bloodstream);
• chronic hypoxia.

The cause of absolute iodine deficiency may be a lack of iodine supplied with food or water.

Iodine deficiency provokes the appearance of one of the syndromes due to which the thyroid gland increases in size:

• Euthyroidism - the thyroid gland increases in size with normal indicators concentrations of hormones in the blood. The body compensates for the lack of iodine through increased synthesis of TSH (thyroid-stimulating hormone) by the pituitary gland. This type of goiter is usually characteristic of pregnant women. Adolescents during puberty and women during menopause.
• Hyperthyroidism is characterized by increased secretion of thyroid hormones. This goiter occurs with Graves' disease, inflammation of the thyroid gland (thyroiditis), tumors of the thyroid gland, hypothalamus, and pituitary gland. In such patients, metabolism is significantly accelerated.
• Hypothyroidism is a lack of thyroid hormones, which is compensated by increased synthesis by the thyroid gland, which causes its growth. This condition can be primary or secondary. When the functioning of the thyroid gland itself is impaired, they speak of primary hypothyroidism, and in case of pathologies of the hypothalamus and pituitary gland, with a violation of the synthesis of TSH by the latter, they speak of secondary hypothyroidism.

Diagnosis of endemic goiter

When a patient contacts an endocrinologist, the first stage of diagnosis will be palpation. This is palpation of the diseased organ with your hands. Thus, the doctor can assess the structure of the organ, its size, and homogeneity. This is called the physical research method.

If, during the examination, the doctor detects signs of goiter, he directs the patient to undergo tests - blood for thyroid-stimulating hormone (TSH), T3, T4 + thyroglobulin and urine for iodine content. If the doctor’s assumption about the disease is correct, then the patient’s blood test will show high level thyroglobulin and imbalance of thyroid hormones, and low levels of iodine excretion in the urine. This research method is called laboratory.

To definitively confirm the diagnosis, an instrumental method is used - ultrasound. Thus, the shape of the goiter is determined - diffuse, nodular, diffuse-nodular. If a nodular goiter is detected, a biopsy of thyroid tissue is performed to determine the nature of the formations (benign or malignant).

Symptoms of an enlarged thyroid gland

If the thyroid gland is enlarged, this manifests itself in two groups of signs: local signs and symptoms of hormonal imbalance associated with thyroid hormones. In addition, there are also general signs that appear when the thyroid gland is enlarged.

General signs:

• the appearance of arrhythmia;
• weight fluctuations with unchanged lifestyle and diet;
• severe and rapid hair loss;
• decreased performance, fatigue, fatigue;

• thermoregulation anomalies: jumps in sensations from chills to fever;
• sleep disturbance, increased excitability and irritability;
• irregular cycles in women, and in men complete or partial impotence;
• dyspeptic disorders (diarrhea, vomiting, flatulence, constipation);
• sudden deterioration of vision.

In addition to general ones, there are also local signs:

• an increase in the size of the thyroid gland (not in the initial stages);
• sensation of a foreign body stuck in the throat;
• change in voice to hoarse (compression of the vocal cords by the gland);
• shortness of breath, dry cough, suffocation, respiratory failure(in the last stages of the disease);
• the act of swallowing is accompanied by pain (due to pressure of the thyroid gland on the esophagus);
• discomfort in clothes with a high collar, from a scarf, while sleeping on the stomach;
• compaction of the gland to the touch, auscultation of vascular murmurs above the gland.

Similar symptoms

Signs of hormonal imbalance depend on its type. Symptoms of endemic goiter are sometimes similar to hypothyroidism due to a lack of thyroid hormones:

• change in hair structure to dry and brittle;
• sudden weight gain due to slow metabolism;
• the person begins to feel cold all the time and often feels chills;
• loss of appetite;
• feeling of dryness in the mouth;
• swelling, especially of the face and limbs;
• bradycardia – pulses below 60 beats/min;
• increased cholesterol levels in the blood;
• low blood pressure;
• decreased hearing, difficulty breathing, hoarse voice;
• depressive disorders;
• skin yellow or pale, dry;
• tingling sensation in the limbs;
• unstable menstrual cycle;
• decreased memory and performance.

Signs of an endemic thyroid gland may well resemble hyperthyroidism if the hormones are synthesized in excess. It looks like:

• hair and nails become brittle and thin, premature gray hair may occur;
• sudden weight loss;
• increased feeling of thirst and, as a result, increased urination;
• increased appetite;
• muscle weakness and tremors in the hands;
• thin and moist skin, which easily becomes red and itchy;
• heavy sweating during high sensitivity to ambient temperature;
• tachycardia – pulse not lower than 90 beats/min;
• development of photophobia, increased dryness of the eyes and, as a result, lacrimation, in severe cases of bulging eyes and exophthalmos (not closing the eyelids);
• male infertility, arbitrary abortions and premature birth in women;
• high degree of excitability and irritability;
• sleep disorders.

Treatment of endemic goiter

Endemic goiter must be treated immediately after detection, since this condition has many dire consequences. It must be remembered that the symptoms and treatment of an enlarged thyroid gland are closely intertwined with each other.

Since endemic goiter refers to endocrine diseases, if you suspect its presence, you should visit an endocrinologist. Treatment for an enlarged thyroid gland will be prescribed by a specialist, after which the patient’s condition will return to normal and he will be able to live a normal life again.

Drug treatment

Treatment of endemic goiter varies depending on the symptoms, but has one thing in common - the drugs are very toxic if taken incorrectly and do not have a standard dosage, since it is selected individually by the doctor. For hypothyroidism against the background of endemic goiter, patients are prescribed medications that contain thyroid hormones (Liothyronine, Eutirox or Triiodothyronine).

Since the doctor calculates the dosage based on test results, self-administration of these drugs is prohibited and can lead to even more disastrous consequences. It's pretty strong drugs, since they are also used to suppress tumor activity in thyroid tumors.

Hyperthyroidism against the background of endemic goiter is treated by taking medications, resection of the gland or some part, and the use of a radioactive isotope of iodine. As medicinal substances use thyreostatics (Propylthiouracil, Mercazolil, Propicil, Thiamazol), lithium-containing medicines to correct hyperfunction of the thyroid gland.

Iodine-based medications interfere with the release of T3 and T4 hormones from the thyroid gland, and also completely suppress their synthesis, prevent iodine from reaching the cells of the thyroid gland and the occurrence of active form T3 and T4. These drugs are contraindicated in nursing women, patients with leukopenia and serious liver pathologies.

A radioactive isotope of iodine is used to treat endemic goiter only in older patients, since this is too new a method, and no one can accurately predict how the thyroid gland will behave in the future. Quite often, the first successes in normalizing the patient’s condition are followed by a drop in the level of hormones in the blood. As a result, the patient ends up on maintenance therapy.

Nutrition and daily routine

Prevention of endemic goiter involves avoiding bad habits, building a normal sleep and wakefulness pattern. And also in the use of iodine-containing preparations, replacing salt with ordinary salt fortified with iodine and its proper storage (in glass or tightly closed iron jars). You should eat more foods that contain great content Yoda:

• kelp (sea kale);
• bran and bread from them;
• seafood (fish, shellfish, squid, crabs, shrimp);
• nuts;
• sprouted grains;
• any seeds;
• greens, except dill;
• beef;
• apples and pears;
• plums and dried apricots;
• raw carrots and pumpkin, beets, celery stalk;

When preparing food from these products, remember not to get carried away heat treatment, since during it iodine evaporates from the products.

You should not eat too much or frequently foods that reduce the body’s absorption of iodine:

• turnip;
• rape;
• radish;
• Brussels sprouts;
• beans;
• dill.

Dreamweed juice perfectly replenishes iodine reserves in the body. One tablespoon of this juice per day is a real salvation for a person with iodine deficiency. The content of this substance in dream juice is so high that it is recommended that children reduce the norm by half to avoid excess iodine in the body.

Causes and treatment methods for Graves' disease

Causes of the appearance of colloidal nodes in the thyroid gland and methods of dealing with them

About diffuse toxic goiter or why the immune system needs to fight the thyroid gland

Diagnosis and treatment of multinodular thyroid goiter

How to restore hair growth with hypothyroidism?

Why does the thyroid gland enlarge?

An enlarged thyroid gland can occur due to a number of diseases endocrine system, in which, based only on symptoms, it is impossible to accurately prescribe treatment.

To take adequate medical measures, a correct diagnosis is required.

Normal state of the gland

IN in good condition The gland has a homogeneous consistency and is practically not palpable during palpation.

It is located in the central part of the neck and has the shape of a butterfly. The size of each lobe should not exceed the size of the upper phalanx thumb patient.

Under the influence of certain factors, the organ may begin to enlarge.

Increased gland volume

How to determine an enlarged thyroid gland? The growth of gland tissue can be noticed at home if you stand in front of a mirror, throw your head back and swallow.

With a normal size of the gland, you can see the movement of the Adam's apple. With an enlarged thyroid gland, the movement will be imperceptible.

An enlarged thyroid gland can also be determined by palpating the neck area on both sides. Even if there are no visible signs of enlargement yet, when palpating, you can feel some compaction. If it is painful, you should postpone everything and immediately make an appointment with an endocrinologist.

Magnification levels

According to modern treatment standards adopted by WHO, three stages of endocrine organ enlargement are distinguished:

1. At the first stage, there are no visual changes in the contours of the neck, and the gland cannot be palpated during palpation.
2. The second degree is characterized by palpation of the thyroid gland, but it is still not visible.
3. The third degree is a clear visual change in the outline of the neck, its deformation when turning the head to the sides.

In addition, if during palpation the patient feels some pain, and also feels a constant lump in the throat, this already indicates at least the second stage of development of the pathology, which requires precise setting diagnosis and taking adequate treatment measures.

It is important not to forget that the thyroid gland can grow to truly monstrous sizes, blocking the trachea and esophagus, making it difficult to breathe, speak and eat. Only timely and properly selected help from an endocrinologist will help protect against a growing goiter.

Causes of pathology

Doctors name many reasons for an enlarged thyroid gland, the most popular are the following:

• lack of iodine in water and food;
• exposure to adverse environmental factors;
• avitaminosis;
• hereditary factors;
• severe mental condition, prolonged depression or overwork.

The cause of an enlarged thyroid gland in women may be a general restructuring of the hormonal system during menopause.

Women over the age of 50 are more susceptible to changes in the endocrine system than anyone else. The consequences of thyroid disease in them are osteoporosis or atherosclerosis.

Types of thyroid enlargement

In medicine, two forms of enlarged thyroid gland are classified: the solitary form, that is, single-nodular, and multinodular. The second option is also called goiter.

One nodule can occur in any part of the thyroid gland: in the right or left lobe, and very rarely on the isthmus.

A goiter is a collection of several nodes located throughout the parenchyma of the gland. They may also be grouped in one part of the thyroid gland.

There are three types of goiter:

1. Diffuse goiter is a uniform increase in the parenchyma of the endocrine gland.
2. Nodular goiter is determined by the presence in healthy thyroid tissue of foci of inflammation and neoplasms that have clear boundaries.
3. Mixed, that is, diffuse-nodular - the occurrence of multifocal neoplasms with a uniform increase in the entire volume of the endocrine organ.

An increase in the form of a goiter, according to its effect on a person’s hormonal status, is divided into 2 types:

• toxic (thyroid);
• non-toxic (euthyroid) increase.

The most common types of goiter are diffuse thyroid goiter and nodular goiter.

About diffuse toxic goiter

This type of goiter is called Graves' disease. It attacks most often at a young age, mainly women. Developing toxic goiter with pronounced symptoms.

External signs, in addition to an enlarged thyroid gland, most often include the following:

• nervousness;
• lack of sleep;
• increased sweating;
• heat intolerance;
• change in eye shape, bulging;
• rapid heartbeat.

The reasons for this development of the disease are:

• genetic or autoimmune disorders;
• past infection.

Most dangerous complication diffuse goiter can become a thyrotoxic coma, during which the concentration of thyroid hormones in the blood increases sharply.

In most cases, it is possible to save the patient, but if the ambulance is late, or the person is elderly, then there is a risk of death.

Nodular goiter

Pathology that occurs in more than 57% of cases. By their nature, nodes are capsules with different contents; inside there may be pus, blood or infiltrate.

They are well felt when palpated, and are also visible during diagnostics using ultrasound. Such nodes are not always the result of hormonal disorders.

There are nodular forms of benign neoplasms and malignant ones. As they increase, they provoke symptoms such as a sore throat and a change in the timbre of the voice.

Effect on hormonal levels

The hormonal causes of an enlarged thyroid gland are considered to be hypothyroidism and hyperthyroidism, that is, states of decreased or increased production of hormones.

In addition, an increase in parenchyma may occur due to euthyroidism, a condition in which hormonal levels remain normal with anatomical enlargement of the organ.

Symptoms of hypothyroidism

A decrease in the production of T3 and T4 hormones can lead to the following changes:

• weight gain with lack of appetite;
• swelling and drowsiness;
• bradycardia and apathy;
• constipation

An important symptom will be a constantly low body temperature. In women, the menstrual cycle may be disrupted.

Symptoms of hyperthyroidism

Oversaturation of the body with thyroid hormones entails the opposite symptoms of hypothyroidism:

• weight loss with strong appetite;
• insomnia and nervousness;
• tachycardia and rapid speech;
• frequent stool incontinence.

Hyperthyroidism in 75% of cases is accompanied by toxic diffuse goiter, as well as Hashimoto's goiter.

What parameters are used to make a diagnosis?

When making a diagnosis, they look at the structure and volume of the enlarged thyroid gland and its function.

During an examination with an endocrinologist, pain on palpation and any lumps may be revealed. After which the patient is sent for advanced instrumental diagnostics.

To clarify the form of the disease, use:

• ultrasound examination;
• organ palpation;
• magnetic resonance therapy;
• taking a puncture.

If the thyroid gland is enlarged, a biopsy can be used to study nodular neoplasms and to determine their oncogenicity.

To understand what is happening on hormonal level, are undertaking following methods examinations:

• taking blood for hormones;
• thermography;
• scintigraphy.

Treatment for enlarged endocrine gland tissue occurs in different ways, depending on the hormonal status of the person suffering from this disease, as well as on the established forms of the disease.

Therapy for enlarged thyroid gland with hypothyroidism

In case of decreased gland function, hormone replacement drugs are prescribed, which help in 80% of cases to completely return to normal.

In some cases, for example, if hormone deficiency and gland enlargement are caused by AIT, levothyroxine drugs are prescribed for hypothyroidism for the rest of life.

If the disease is endemic, additional iodine-containing medications are prescribed.

Definite positive result gives proper nutrition and yoga, sports or physical work.

Therapy for enlarged thyroid gland with hyperthyroidism

To eliminate the cause of increased hormone levels, three treatment methods are used:

1. To normalize the function of the endocrine gland, thyreostatics are used. They help restore balance hormonal levels.
2. For quick solution To solve this problem, the tactic of using radioactive iodine is sometimes used. Iodine molecules enter exactly the gland cells and destroy them. You can get back to normal very quickly.
3. Surgical intervention is used for pronounced forms of goiter, or if medication treatment has not been effective. The operation is carried out using general anesthesia. Most often, either one lobe of the gland or the entire organ is removed.

Preventive measures for goiter consist in correctly assessing your hormonal status and starting to eat rationally.

First of all, you need to understand that what is useful for hypothyroidism is contraindicated for hyperthyroidism. So in the first case, it is necessary to consume iodized salt and seafood.

Walnuts help increase iodine content well.

And in the case of hyperthyroidism, it is necessary to limit iodine intake, since its intake can be dangerous, but the diet should also be complete, with high calorie content and with increased content proteins.

There are cases when patients, simply by normalizing their diet and taking medications prescribed by a doctor, were cured of goiter without surgery.

Symptoms of goiter in women

What is a goiter?

The term "goiter" is used in two main meanings:

• various pathological conditions thyroid gland;
• enlarged thyroid gland.

Many diseases of the thyroid gland are manifested by an increase in its size, and it begins to protrude above the surface of the neck, deforming its contours. Such a hypertrophied gland is called a “goiter.”

It is impossible to make a diagnostic conclusion based on an enlarged thyroid gland, since such hypertrophy can be the cause of both increased and insufficient hormonal activity. If hormonally active cells grow, hyperthyroidism occurs. If the number of cells increases connective tissue– hypothyroidism develops.

Therefore, signs common to all forms of goiter include only an increase in the size of the gland. All other symptoms may be diametrically opposed.

Common signs of goiter in women

Degrees of enlargement of the thyroid gland:

• the isthmus is palpable between the lobes;
• the entire gland is palpable, the isthmus is noticeable when swallowing;
• gland increases the circumference of the neck (“thick neck”);
• a large goiter that changes the configuration of the neck;
• a very large crop, sometimes hanging down like a bag.

Goiter and increased hormonal activity of the gland

Let us mention such a pathology as diffuse toxic goiter, or Graves' disease. It is accompanied by the production of large amounts of thyroid hormones and its enlargement. Increased production of thyroid hormones is called “hyperthyroidism”, and the symptoms caused in the body are referred to as thyrotoxicosis.

Women get sick about 10 times more often than men. Classic signs are an enlarged thyroid gland, bulging eyes (exophthalmos) and rapid heartbeat (tachycardia).

Characterized by trembling of the limbs and the whole body, sweating, and loss of body weight. Patients are irritable, tearful, and fussy. They become conflicted and quarrelsome. Insomnia is common. Patients often do not notice changes in their personality. Against, the world around us seems fussy and fast-changing to them.

Memory deteriorates, handwriting changes, and physical and mental fatigue quickly occurs.

Women often have a youthful appearance, warm, moist skin with few wrinkles.

A common complication of thyrotoxicosis in women is atrial fibrillation.

The menstrual cycle is disrupted, and amenorrhea (lack of menstruation) may occur. Symptoms of hyperthyroidism are somewhat more common during puberty and menopause.

Goiter with hyperthyroidism can also manifest another pathology - toxic adenoma. It is characterized by the formation of a node in one of the lobes of the gland.

Goiter and decreased hormonal activity of the gland

Hypothyroidism occurs in diseases such as myxedema and autoimmune thyroiditis. This condition occurs 5 times more often in women than in men. It is manifested by an enlargement of the thyroid gland. Rest clinical symptoms“opposite” of hyperthyroidism.

Patients experience lethargy, slow movements, slow-wittedness, weakening of memory and mental abilities. Patients complain of weakness, fatigue, lack of appetite, constipation, irritability and drowsiness. Their face, eyes, neck, and hands swell. The skin is dry, flaky, cold to the touch. The voice becomes low and muffled. Hair falls out, including on the outer third of the eyebrows. Nails become thinner. Due to fluid retention in the body, weight increases.

A characteristic symptom of hypothyroidism is the absence of an increase in body temperature during infections, such as pneumonia.

Goiter and normal hormonal activity of the gland
With a lack of iodine in the body, endemic goiter can develop. It is manifested by an enlarged thyroid gland without signs of hypo- or hyperthyroidism. Hypothyroidism occurs only when severe forms of this disease.

Sporadic goiter (without iodine deficiency in external environment) can develop during conditions in women such as puberty, pregnancy, lactation, and menopause. Even if the euthyroid state remains, patients are concerned about decreased blood pressure, dizziness, weakness, fatigue and other signs of dysfunction nervous system. Often girls are delayed puberty, the menstrual cycle is disrupted, infertility occurs.

Instructions

Since the disease does not manifest itself in any way at first, you will not be able to determine its appearance on your own. But the doctor can easily do this using palpation. Even first degree goiter and, when it is not yet visible, a specialist can easily palpate it.

If your endocrinologist suspects that there is something wrong with your thyroid gland, you will be prescribed hardware examination methods. First of all, an enlarged thyroid gland is detected using ultrasound (ultrasound). In addition, an electrocardiogram is done, the time of tendon reflexes (they are slowed down during illness) and the amount of hormones produced by this gland are determined.

When the thyroid gland becomes enlarged, a person feels as if there is a lump in his throat. This sensation intensifies if he lies on his back, leans forward, or is simply agitated. He notices that he has difficulty wearing a turtleneck sweater or a shirt with a narrow collar.

If the thyroid gland has reduced function and does not produce enough hormones, a person usually gains weight, although his appetite is poor, he often eats, and gases are actively formed in the intestines. Patients in this case are also susceptible to frequent colds and bronchitis, complain of pain in the heart and shortness of breath even with little physical exertion. Such people have low blood pressure, they do not tolerate cold well, they are always cold, they often want to sleep during the day, but at night, on the contrary, they cannot fall asleep. Externally, hypofunction of the thyroid gland is also manifested by hair loss and brittle nails, dry skin, and puffiness of the face. Due to swelling (especially around the lips and eyes), the face becomes like a mask. This disease is also reflected at work. genitourinary system. Y , as a rule, decrease and sexual desire, and menstrual periods are disrupted, spontaneous abortions or infertility are often possible.

If the function of the thyroid gland, on the contrary, is increased, then signs goiter and there will be a prolonged increase in temperature (up to 37-38oC), almost constant feeling hunger and weight loss, although the person eats well, insomnia and irritability. The patient's pulse quickens and a feeling of anxiety appears. In addition, your hands may tremble slightly and your eyes may bulge out. The skin becomes dry and hot to the touch. The patient does not tolerate heat well.

The appearance of any unexpected symptoms in the body should be a signal to contact a doctor. Consult an endocrinologist, get tested for hormones, undergo an ultrasound. Remember that all illnesses are necessary without delay.

Related article

According to the latest data World Organization healthcare, almost every inhabitant of the planet experiences hidden insufficiency of the thyroid gland - hypothyroidism. Normally, the mass of the thyroid gland is only 25-30 g, while it is invisible and impalpable. But due to unfavorable factors (heredity, stress, iodine deficiency), its growth may begin - up to 150 g or more. Goiter begins, often with the formation of compactions (nodules).

You will need

• - iodine preparations;
• - rose hips;
• - black currant berries;
• - chokeberry berries;
• - nettle leaves;
• - pharmacy tincture Eleutherococcus;
• - chamomile flowers;
• - yarrow herb.

Instructions

Start treatment by visiting an endocrinologist, who, by prescribing a blood test for the content of the thyroid gland, will reveal the degree of disruption of its activity. If it is slightly impaired, the doctor may recommend taking iodine preparations and solutions. Electrophoresis, UHF or physiotherapy with decimeter microwaves (UHF), etc. may also be prescribed.

In combination with those prescribed by the endocrinologist, apply the methods traditional medicine to combat. Prepare three different herbal mixtures, which you alternate every two to three days.

First collection: rose hips and black currants, taken in equal quantities. After chopping 2 tablespoons of berries, brew them with half a liter of boiling water and leave for an hour in a warm place. After straining, take half a glass, adding a teaspoon of honey, 4 times a day after meals.

Goiter is the general name for various painful conditions in which the thyroid gland is abnormally enlarged, which is often clearly visible and causes considerable aesthetic inconvenience to the sick person. Pathology is often associated with a lack or excess of iodine.

Women are more susceptible to it, which is often associated with age-related hormonal changes (men get sick five times less often). With goiter, nodes of fibrous tissue form in the organ, in in rare cases they may be malignant.

– thyroid gland pathologies are registered more often than other pathologies in the world, which is caused by deficiency necessary microelements for synthetic activity, the organ enlarges, trying to capture as much iodine as possible from the blood. In those countries where all consumed salt is iodized, it is common to diagnose autoimmune pathologies that are the cause. The main factors for enlargement of the thyroid gland are given in the table below.

Table 1. Why a goiter forms:

Name	Reasons	Characteristic signs of pathology
	, inflammatory processes and cancerous tumors.	Sleep disturbance, arrhythmias, increased heart rate, high blood pressure, fatigue, weakness, disruption of the usual emotional background, irritability, increased sweating, weight loss (without reducing food intake), bulging eyes, hand tremors.
	Genetic pathologies (cretinism and others), excess goitrogenic foods (for example, cabbage slows down the absorption of iodine), iatrogenic effect of certain medications.	Dermatological problems (dry skin and its derivatives, brittle nails and hair, thinning eyebrows), loss of appetite, but at the same time the person gains weight, fatigue, drowsiness, decreased mental activity, women have problems menstrual cycle.

Please note. With hypothyroidism, of the listed symptoms, as a rule, only a few are very pronounced (usually 2 or 3 characteristic signs).

The thyroid gland, in the presence of the reasons indicated in Table 1, begins to increase in size, areas with heterogeneous synthetic activity are formed in its functional tissue, which leads to the formation of nodes.

Classification

Ranking of thyroid diseases can be carried out according to several principles. The broader one is etipathogenetic, which implies division according to the mechanism of formation and causes.

There are endemic and sporadic goiter. The first is confined to a specific area (for example, regions with iodine deficiency), the second is not tied to a geographic location.

According to morphological characteristics, goiter is:

• nodal;
• diffuse;
• diffuse-nodular or mixed.

The table describes the main types of thyroid goiter.

Main types of goiter according to morphological changes
View	Description	How it manifests itself
Nodular goiter	For pathological process characteristic manifestation of nodes in the homogeneous structure of the organ. Types of nodular goiter of the thyroid gland are: single; multiple; isolated; grouped. The main reason for the manifestation of the disease is identified as a lack of iodine concentration in the patient’s environment; however, it is worth emphasizing that throughout Russia, nodular goiter appears with the same frequency. It has been suggested that thyroid tissue may grow as a result infectious processes in the human body and stressful circumstances. Types of nodular goiters are presented in the form of a classification according to the type of functioning of the thyroid gland and the degree of the pathological process.	Protruding nodes appear on the lower part of the patient's neck. Possible compression of certain areas of nearby organs. As a result of such exposure, a person experiences discomfort, hoarseness, and difficulty swallowing. Patients with hypothyroidism may experience the following symptoms: excess weight (due to excess fluid accumulation in cells); heart rhythm disturbances; an apathetic state and a significant decrease in performance; development of VSD, accompanied by hypertension; constant feeling of cold; decreased sex drive; increased concentration of cholesterol in the blood serum. Patients with hyperthyroidism may experience the following symptoms: increased excitability and irritability; weight loss; trembling of limbs; increased heart rate; increased sweating.
Cystic goiter	Thyroid nodules have the ability to transform into cysts. Such formations are formations with a cavity inside. Most often they are benign in nature. The following factors can provoke tissue changes: hemorrhage; gestation period; lack of iodine in the human body; hereditary factor; structural anomalies. Cysts may not appear on initial stages development of pathology. However, we must not forget about the risk of the tumor degenerating into malignant.	Among the list of main symptoms manifested in cystic goiter are: constant weakness; feeling of pain and sore throat; difficulty swallowing; pain when bending and turning the head; change in speech quality; increase lymph nodes(such a symptom may indicate the development of thyroid cancer); increased sweating; difficulty breathing; increased blood pressure.
Diffuse goiter	This definition means uniform growth of thyroid tissue. Types of diffuse goiter can be as follows: toxic diffuse goiter of the thyroid gland - manifested by symptoms of hyperthyroidism; non-toxic diffuse goiter of the thyroid gland - the intensity of production of thyroid hormones decreases. The main causes of the disease have not been determined.	Often the only symptom that worries the patient is the appearance of uniform lumps in the neck area. Describe clinical picture pathology is quite difficult, because the function of the gland itself can be preserved, increased or decreased.
Mixed goiter	The pathology may be mixed. In hypertrophied thyroid tissues, nodular compactions and cystic inclusions may appear.	The clinical picture is blurred - the patient may experience various symptoms, manifested in diffuse, nodular and cystic goiter.

Fact! There are other types of thyroid goiters, but they are less common.

By location relative to location in the organ or neck:

• ordinary;
• annular;
• retrosternal;
• dystopic, usually formed during intrauterine development (accessory lobe of the thyroid gland).

• zero– the beginning of the formation of pathogenesis, there are no visible changes;
• first – abnormal increase it is possible to palpate, but visually in the normal state of the neck the goiter is not noticeable;
• third– the pathology is noticeable even from a long distance.

A Russian doctor and scientist proposed a more detailed version of the distribution of the disease; this classification is shown in the second table.

Table 2. Degrees of goiter according to O. V. Nikolaev:

Clinical manifestations

At the beginning of formation, pathogenesis does not manifest itself in any way. As the disease progresses, the thyroid gland begins to grow and bulge, while a characteristic protrusion in the area of ​​the Adam's apple is noticeable on the neck.

The goiter begins to compress the esophagus, trachea, and nerve cords, which causes the appearance of specific symptoms:

• suffocation, shortness of breath;
• changes in voice production, hoarseness and hoarseness appear;
• cough not associated with colds;
• difficulty swallowing;
• headaches, dizziness, heaviness in the head, which is associated with hypoxia due to weakened blood flow to the brain and incomplete filling of the lungs with inhaled air.

Please note. If it is clear that the protrusion is formed evenly, then it is most likely a diffuse type goiter. With nodal forms, the deformation on one side will be greater.

If goiter is caused by insufficient synthetic activity of the thyroid gland, then the development of diseases of the upper and lower respiratory tract, for example, bronchitis or pneumonia. Representatives of the fairer sex experience a decrease in blood pressure, a feeling of rawness or pressure in the heart area, delayed menstruation, and an increased risk of miscarriage or inability to get pregnant. In men, libido and potency decrease, and erection problems may occur.

Let us consider separately the symptoms of each type of goiter:

1. Symptoms of toxic goiter of the thyroid gland, which occurs diffusely and is associated with excessive levels of thyroid hormones in the blood, which is expressed in endocrine ophthalmopathy, tachycardia, increased blood pressure, palpitations in the throat or chest, increased heart rate, arrhythmia. Also, with DTG, a sharp weight loss occurs, appetite increases, weakness, muscle wasting are observed, and a constant feeling of heat occurs. Symptoms of thyrotoxic goiter also appear on the face - it has an angry or frightened appearance, swollen eyelids, conjunctivitis, decreased visual acuity, painful sensations in the eyes. Skin hot and humid, hair is brittle and falls out a lot.

In addition, with diffuse toxic goiter, there is increased excitability and irritability, fussiness, abrupt change mood, acceleration of thought processes, depression and insomnia. With a more severe course of the disease, tremors occur, speech and writing deteriorate, and tendon reflexes increase. When there is an excessive amount of thyroxine, calcium and phosphorus are washed out of the bones, which leads to the destruction of bone tissue and osteopenia, bone pain and finger deformity like “drumsticks” appear.

The function of the gastrointestinal tract undergoes the appearance of abdominal pain, diarrhea, nausea and vomiting, and fatty liver. From the outside reproductive system In women, the menstrual cycle is disrupted and develops fibrocystic mastopathy, fertility decreases; Men experience erectile dysfunction and gynecomastia.

1. Endemic goiter– the symptoms are not associated with hormonal activity, since with endemic (diffuse non-toxic) goiter the function of the thyroid gland does not change. The disease manifests itself as weakness, headaches, and chest discomfort. As the goiter grows, a feeling of constriction in the neck area occurs, breathing and swallowing become difficult, shortness of breath, reflex coughing, and sore throat appear.
2. Hashimoto's goiter– symptoms may not appear for a long time. This autoimmune pathology eventually leads to the development of hypothyroidism, therefore, the symptoms depend not only on an enlarged thyroid gland, but also on its reduced function. As the disease progresses, weakness appears, the thyroid gland enlarges and changes shape. There is a feeling of discomfort in the neck area; due to compression of the blood vessels and nearby organs, there is shortness of breath, slight coughing, a feeling of a lump in the throat, and swallowing is impaired. In addition, there is a decrease in memory, the condition of the skin worsens, the hair becomes duller and brittle, and falls out profusely. Sexual desire decreases, potency in men is impaired, and problems occur in women menstrual function. There is also swelling of the face, especially the eyelids, cheeks and mouth. Due to impaired metabolism, a sharp weight gain occurs, one constantly feels chilly, and the tendency to constipation increases.
3. Colloid goiter– no symptoms appear at all for quite a long time, especially if the nodules with colloid are small in size. With the further development of the disease, pressure is felt in the neck area, it becomes difficult to swallow, a sore throat appears, breathing is impaired, and the voice changes. If a goiter compresses blood vessels or nerves, headaches and dizziness occur. If there are many nodes and their size is more than 1 cm, then deformation of the contours of the neck occurs and the patient can feel the nodes with his own hands.
4. Symptoms of mixed goiter manifested by a change in voice, attacks of suffocation, difficulty swallowing, a feeling of a lump in the throat and soreness, a feeling of heaviness in the head. In addition to these symptoms, others may be present, depending on whether the thyroid gland is overactive or underactive.
5. Symptoms of non-toxic nodular goiter of the thyroid gland, both single-nodular and multinodular mainly consist in manifestations that are caused by increased iron nodes. It is extremely rare that non-toxic nodular goiter is accompanied by mild symptoms of hypothyroidism. There is difficulty breathing and swallowing, a feeling of a lump in the throat, a sore throat, and a change in voice. Chilliness increases, a person becomes slower and more lethargic, the menstrual cycle in women is disrupted, and libido in men decreases. The skin becomes drier, body temperature decreases, and minor swelling is observed.
6. Uninodular or multinodular toxic goiter- the symptoms are almost identical. The only difference is the number of nodules in the thyroid gland. Most often, if toxic nodular goiter occurs, symptoms may not appear for a long time. As the nodes enlarge, the contours of the neck become deformed, making it difficult to breathe and swallow food. In addition, irritability increases, moodiness and apathy occur. Weight drops sharply, heart rate increases, and arrhythmia appears. The condition of hair and nails also worsens, the skin becomes damp and hot. Important! If a multinodular goiter of the thyroid gland occurs, symptoms endocrine ophthalmopathy absent.

With nodular toxic goiter, increased sweating is observed, sleep is disturbed, appetite increases, and tremors of the limbs can also be observed.

Reasons for education

Factors that negatively affect the activity of the thyroid gland can be very diverse.

The main ones are the following:

• natural iodine deficiency;
• unfavorable environmental factors environment;
• disruptions in the endocrine system;
• autoimmune processes;
• poisoning by toxins;
• exposure to radiation.

Important. The main causes of the formation of nodular goiter are adenomas and thyroid cancer, when cells rapidly divide, which poses a health risk. Oncological pathologies in this case are effectively treated (especially in the early stages), so you should not delay diagnostics, the price of which is not high.

This disease is autoimmune in nature and occurs due to defects in the immune system.

Predisposing factors to the appearance of DTZ may be:

• burdened hereditary history;
• irradiation of the neck and/or head;
• infectious and inflammatory diseases;
• endocrine pathologies;
• frequent stressful situations;
• brain injuries and diseases.

Diffuse nontoxic goiter

Diffuse nontoxic (euthyroid) goiter occurs due to insufficient quantity iodine in the body. In addition, the development of the disease can be affected by a general lack of vitamins and microelements, as well as the use of drugs that have a goitrogenic effect.

Hashimoto's goiter

It is an autoimmune pathology, the development of which is influenced by:

• surgical manipulations on the thyroid gland;
• existing DTZ;
• inflammatory and infectious diseases;
• presence of autoimmune thyroiditis in relatives.

Colloid goiter

Colloid goiter occurs when the outflow of colloid from the follicles in the thyroid gland is disrupted.

Factors that can contribute to the development of colloid goiter include:

• insufficient intake of iodine into the body;
• age over 40 years;
• burdened heredity;
• radiation exposure;
• toxic effects of various substances;
• strong psychological trauma and stress;
• frequent hypothermia and infectious diseases.

Mixed goiter

Mixed goiter is a disease in which the thyroid gland increases in size evenly, but with the formation of nodes in it.

Mixed goiter appears due to:

• genetic predisposition;
• poor environmental situation;
• living in endemic regions of the country;
• presence of chronic infections;
• autoimmune processes in the body;
• insufficient intake of vitamins and minerals from food.

Nodular nontoxic goiter

This disease develops when there is insufficient intake of iodine into the body from food and the environment. In addition, frequent nervous strain and radiation exposure can affect the occurrence of nodular goiter.

Nodular toxic goiter

With nodular toxic goiter, a sharp decrease in sensitivity to TSH occurs in the receptor mechanism of the cellular structures of the nodes.

Factors predisposing to this pathology may be:

• iodine deficiency in the body;
• deficiency of minerals and vitamins;
• exposure to radiation;
• intoxication with various substances;
• smoking;
• frequent exposure to stress.

Goiter in children

A child may experience iodine deficiency even at the stage of intrauterine development. Such a violation is quite serious, and the baby may significantly lag behind generally accepted norms in development. First of all, the nervous system suffers.

Attention! If a mother is determined to have a lack of iodine in her body during pregnancy, the likelihood of spontaneous miscarriage increases. There is also the possibility of having a premature baby or a child with developmental abnormalities.

Children born in conditions of iodine deficiency are faced with manifestations of neonatal goiter. The function of the gland decreases. Juvenile goiter may be detected in children and adolescents.

The course of the pathology is accompanied by the following symptomatic picture:

• delayed sexual development;
• increased fatigue;
• tendency to develop infectious pathologies(such children have reduced immunity);
• increased fatigue.

Toxic goiter rarely develops in children and adolescents, but is quite acute. Against the background of intoxication, confirmation of all organs occurs.

Attention! Pathologies of the endocrine system leave a special imprint on the development process of the baby. This is why parents should pay special attention prevention of the manifestation of the disease and constant monitoring of the child’s condition.

Diagnostics

The doctor collects anamnesis, listens to the patient’s complaints, conducts a physical examination (appearance, skin condition, palpation of the neck, auscultation chest, pulse measurement). A biochemical blood examination shows the level of the hormones TSH, T3, T4 and thyroglobulin, which makes it possible to assess the functional activity of the thyroid gland.

Most often, an imbalance of thyroid hormones and an increase in thyroglobulin are recorded. Urinalysis shows a decrease in the concentration of excreted iodine.

Laboratory signs of hormonal disorders in goiter:

To diagnose autoimmune pathologies, the doctor may prescribe additional tests for:

• – antibodies to one of the key enzymes in the synthesis of thyroid hormones;
• anti-rTSH– antibodies to receptors on the surface of thyrocytes responsible for binding thyrotropin;
• anti-TG– antibodies to the thyroid protein – thyroglobulin.

Pay attention! After establishing a clinical diagnosis, constantly monitoring the level of anti-TPO or anti-rTSH does not make sense, since therapy for autoimmune thyroid diseases is aimed primarily at correcting hormonal disorders, and not at eliminating pathological antibodies. Much more important has the concentration of TSH and T4 in the blood.

Instrumental diagnostic methods:

• Ultrasound. Allows you to examine the shape of the organ, determine the presence of nodes and neoplasms by changing the echogenicity of tissue structures.
• ECG– assessment of cardiac activity, which is affected by all endocrine changes in the body;
• Examination of tendon-type reflexes for a time;
• Fine needle aspiration biopsy – tissue sampling under ultrasound guidance for histological analysis. An important method if you suspect the presence of an oncological process.

Please note. Important role self-diagnosis plays a role in identifying thyroid diseases: examining and palpating the neck, measuring heart rate, iodine tests (applying iodine to the body and measuring the time it is absorbed), adequate assessment changing well-being and emotional state.

Treatment methods

The main choice of therapeutic technique is hormone replacement therapy(tyrosine derivatives) for hypothyroidism. Often the patient will have to take medication for the rest of his life. The patient should be constantly monitored and dosages adjusted according to indications.

It is much more difficult to deal with an overactive thyroid gland. If there is a risk of neoplasia formation or performance impairment cardiovascular system, doctors are resorting to a radical solution to the problem, which will further simplify therapy with hormonal drugs.

Important. With hyperthyroidism, a toxic crisis cannot be ruled out, which can lead to coma and even death of a person, so it is extremely important to follow all instructions given by the doctor and follow a diet, avoiding excessive consumption of iodine.

An alternative technique is the use of radioactive iodine, which, when injected into the thyroid gland, can provoke lysis of its cells. The procedure is quite complex and toxic.

The difficulty lies in selecting the optimal dose, so an additional series of specific tests is required. At the moment, the procedure is considered a unique technique that is constantly being improved, but already in the first year of therapy, a stable state of hypothyroidism can be achieved in a third of patients.

Surgical intervention

The possibility of surgical intervention. Traces from surgery, subject to use modern technologies are practically invisible, and the price of services is relatively low. The procedure is widely used in medical practice.

The following circumstances may be indications for its implementation:

• detection malignant neoplasm in the structure of thyroid tissues;
• the presence of large nodes or cysts;
• intensive increase in neoplasms over a short period of time;
• discomfort and pressure on adjacent tissues;
• aesthetic aspects of the problem.

The operation is performed through a small incision in the neck or by opening the tracheal area if the organ is difficult to access.

There are several options for further manipulations:

• removal of the node - the changed section of the organ is cut out;
• partial resection - removal of one lobe of the thyroid gland while preserving the second half and isthmus;
• thyroidectomy – complete removal thyroid and parathyroid glands, which is necessary when detecting malignant processes in tissues.

In case of cystic goiter, a simpler solution to the problem is possible - colloid is pumped out of the cyst through puncture, without carrying out large-scale invasive manipulations.

Consequences and risks

Since the pathology is predominantly benign, it does not pose significant risks to the patient’s life. However, the problem cannot be ignored, since the proliferation of altered tissues will continue. This phenomenon is fraught not only with aesthetic problems, which is important for women, but can also be harmful to health.

The increase in goiter occurs in several stages, which in medicine are divided into degrees from 0 to 5. Final stages characterized by a significant enlargement of the thyroid gland.

At this time, the organ exerts significant pressure on neighboring tissues: blood vessels, nerve endings, esophagus and trachea, vocal cords. As a result, discomfort arises, the voice changes, it becomes difficult to swallow, and attacks of suffocation become more frequent.

In addition, it is necessary to normalize the functioning of the organ and restore the balance of hormones. In rare cases, a benign tumor may transform into cancer.

Preventive measures

In medicine, a whole complex has been developed to prevent the development of thyroid diseases, including goiter. They can be divided into three types.

Mass prevention

It consists of informing the population about the likelihood of developing pathology, measures to prevent it and characteristic signs. The most effective is considered to be the addition of microscopic doses of potassium iodide to consumer products, for example, salt (typical packaging is shown in the photo), bread and mineral waters. The advantage of this approach is that the cost is low, and this (according to WHO) reduces overall morbidity by 20%.

Group prevention of goiter

In this case, people at risk are advised to use drugs containing potassium iodide. Typically, this practice is common in educational institutions. It is recommended to use such medications for children, adolescents and women (pregnant, menopausal and post-menopausal). Lastly, it is important to confirm the identification of thyroid status.

Individual goiter prevention

Therapy is selected by an endocrinologist for each patient according to indications and needs.

As a rule, these are people:

• who are in the early stages of the disease;
• with a significant risk of their occurrence;
• who have undergone recommended therapy.

Thyroid goiter is a common pathology in endocrinological practice. It is better to prevent a disease than to treat it. Getting rid of it completely is quite a problematic task, so the importance of prevention in this case is difficult to overestimate.

It should be understood that it is not always possible to adjust the amount of iodine through nutrition. Compensating for a pathological deficiency of a microelement (if diagnosed) only with the help of diet is expensive and not always possible, because in this way it is difficult to maintain the required dosages. Better to use medications and undergo regular check-ups with your doctor.

Questions for the doctor

Examination plan for endemic goiter

Hello! Six months ago, I was examined about problems with the thyroid gland (there were complaints), had an ultrasound and donated blood for hormones. Based on the results, the endocrinologist diagnosed me with “endemic goiter”, told me to drink Iodomarin for 1-2 months, and then come for examination again. Then I never got to the appointment. Now I feel good, no complaints. I continue to take iodine preparations - as I understand, this is the standard treatment for goiter: what tests should I take now to make sure that everything is fine with the thyroid gland.

Hello! Unfortunately, you did not indicate the exact results initial examination. However, to monitor your endocrine status, I would advise you to repeat the TSH and T4 tests, as well as undergo an ultrasound of the thyroid gland.

Tests for diarrhea

For several months now I have been noticing that my character has changed, not for the better: everything annoys me, sometimes there are real outbursts of rage. I often can’t sleep, replaying the day’s events in my mind. I have also lost a lot of weight, my face has become sharper, my hands are shaking. What could it be? My wife says it has to do with the thyroid gland. How can I get checked?

Hello! Based on your complaints, we can assume that you have a diffusely toxic goiter: tests for this pathology must necessarily include a definition TSH level, free T4 and antibodies to rTSH.

A small nodule on the neck, which normally is not even palpable and weighs no more than 20 g, is called the thyroid gland. This gland, like others, produces hormones - biologically active substances affecting work individual organs and systems. The thyroid gland produces two main hormones: triiodothyronine (T3) and thyroxine (T4). Their production is closely related to the work of the pituitary gland and its thyroid-stimulating hormone. With sufficient amounts of T3 and T4 in the body, they:

• regulate the functioning of the central nervous system (CNS);
• control metabolism in the body, production of proteins and vitamin A;
• provide metabolism of fat cells and gluten;
• regulate the functioning of the cardiovascular system, or rather, affect the heart muscle;
• ensure coordinated work gastrointestinal tract,
• control the muscular system;
• In children, they promote the growth of the entire body.

The importance of proper functioning of the thyroid gland cannot be overestimated. This is a kind of regulator of life activity, and at the same time, its activity itself depends on other systems and organs.

What is a goiter and its types

Triiodothyronine (T3) and thyroxine (T4) are based on 3 or 4 (hence the numbers in the name) iodine atoms. With a deficiency of this element, the thyroid gland produces less hormones, and this primarily affects the central nervous system; a person feels weakness, fatigue, or, if there is an excess of them, on the contrary, irritability.

All organs suffer from imbalance, as metabolism is disrupted. The thyroid gland itself also suffers, and the consequence of this is the formation of nodules in it or its increase in size.

A goiter is an enlargement of the thyroid gland due to pathological changes occurring in it, the formation of tumors or nodes. This is a disease that affects all aspects of life.

There can be many reasons for the enlargement of the thyroid gland and the formation of a goiter, and depending on them, they distinguish different types this pathology.

So, geographically, a goiter can be:

• Endemic, when there is an enlargement of the thyroid gland, characteristic only of a certain area.
• Sporadic is all other species that occur regardless of geographic location.

Enlargement of the thyroid gland is divided according to Nikolaev’s classification into degrees:

1. First degree: the gland is felt upon palpation.
2. Second degree: you can see an enlarged thyroid gland.
3. Third degree: significant thickening of the neck.
4. Fourth: changing the shape of the cervical spine.
5. The fifth degree involves a huge goiter.

When considering the structure of the thyroid gland, the following are distinguished:

• diffuse goiter;
• nodal;
• diffuse-nodular.

When classifying goiter according to its location on the neck, the following are distinguished:

• a standard goiter covering only the lobes of the thyroid gland;
• ring-shaped, enclosing the trachea in a ring;
• dystopic, involving the root of the tongue or the accessory lobe of the thyroid gland.

In addition, a goiter can be benign, when it grows very slowly, or malignant.

Test for the presence of iodine in the body. In the evening you need to apply (with a cotton swab) an alcohol solution of iodine 3 stripes: the thinnest, medium and thick. Let them dry and then go to bed. If after 12 hours a thin strip disappears, this is normal; if two stripes disappear, you need a preventive dose of iodine. If all three lines disappear, you should immediately go to the doctor: your body does not have enough iodine.

Symptoms of an enlarged thyroid gland

In the first degree of goiter, the symptoms are washed away, and the patient attributes them to overwork or mild malaise. These manifestations are associated with hyperfunction of the thyroid gland, in which the production of hormones increases significantly, or hypofunction, when the body suffers from a lack of T3 and T4.

Among the first symptoms observed:

• irritability or, conversely, lethargy;
• constant fatigue, dizziness, heaviness in the head;
• constriction of breathing, difficulty;
• voice changes, hoarseness, hoarseness;
• cough, dry and scratching the throat;
• attacks of suffocation at night;
• difficulty swallowing food.

Advice! If these symptoms occur, you should contact an endocrinologist, as the therapist may attribute them to other diseases.

Treatment of the initial stage of goiter is considered the most effective, but detecting it is very difficult. Therefore, it is important to be attentive to your health and the health of your loved ones.

The iodine network applied to the skin is clearly visible after 24 hours - this means that there is an excess of iodine in the body. It is necessary to contact an endocrinologist: too much iodine is just as harmful as its lack.

Features of the manifestation of the disease in men and women

Goiter occurs 5 times more often in women than in men. Menopausal women are most susceptible to this disease.

Among the symptoms of goiter, women often experience low blood pressure, weakness, and fatigue. Goiter is characterized by frequent acute respiratory viral infections, bronchitis, and pneumonia; there is a feeling of constriction in the heart area, pain behind the sternum.

With the second degree of enlargement of the thyroid gland, shortness of breath appears, subsequently loss of appetite, drowsiness occurs, digestive disorders, and bloating occur. Women are characterized by menstrual irregularities, miscarriages, and infertility.

Stages 4 and 5 of goiter are characterized by symptoms such as weight gain and memory loss.

Advice. Carry out individual prophylaxis with iodine-containing drugs only after consulting an endocrinologist.

In men, sexual desire decreases to the point of complete impotence.

Other symptoms characteristic of an enlarged thyroid gland appear in men the same way as in women.

The presence of grade 3 goiter negatively affects the ability to get pregnant. In this case, this is impossible.

Pregnancy and iodine deficiency

Among all population groups, pregnant women need the greatest number Yoda. They require 200 mg per day. T4 deficiency due to an iodine-poor diet in the first trimester of pregnancy can lead to birth defects fetus

Medical monitoring of the functioning of the thyroid gland and its production of hormones during this period is very strict. It is necessary that the pregnant woman receives required quantity iodine with food or with additional treatment.

Why is iodine deficiency dangerous for children?

The occurrence of endemic goiter in children, and today this is about 25% of all childhood diseases of the endocrine system, entails the development of endemic cretinism. This is not typical for adults, but in children goiter is accompanied by retarded growth, physical and intellectual development.

The most common form of goiter in children is diffuse goiter.

Why does goiter appear?

Scientists believe main reason goiter formation, lack of iodine in the body. A deficiency of this element occurs when there is a small amount of iodine-containing foods in the diet. In many geographic regions, there is not enough iodine in the soil, and therefore there is little iodine in the water.

Another cause of goiter formation is heavy metal poisoning (diffuse goiter), as well as a number of other poor environmental factors.

Among the reasons for the formation of nodular goiter:

• genetic predisposition,
• pituitary tumors,
• thyroid adenoma,
• oncological neoplasms.

Diagnostics

The home rapid test described above may cause a trip to the endocrinologist, but it is impossible to say with certainty that this is a sign of an enlarged thyroid gland.

To determine the presence of a thyroid goiter, you need to undergo a number of tests and examinations:

1. First, you should come to an appointment with an endocrinologist and tell about all the present symptoms that bother the patient.
2. The doctor will prescribe a number of tests: urine and blood, including tests for hormones.
3. Most likely, an ultrasound of the thyroid gland, possibly a CT or MRI, will also be prescribed.
4. In the future, a biopsy of the thyroid goiter may be necessary.

Important! To prevent an enlarged thyroid gland, include iodine-rich foods in your diet, but always use moderation in everything.

Goiter treatment

Treatment of thyroid goiter involves several options:

• If the thyroid gland is slightly enlarged, when the production of hormones is slightly reduced, hormone replacement therapy is performed. drug treatment. This therapy is used for life after surgery to remove a lobe of the thyroid gland or after therapy radioactive iodine. Actually treatment hormonal drugs- This is the main treatment for thyroid goiter.
• Nodular goiter is treated surgically. Here, resection of nodes or damaged lobe is possible, if one lobe is damaged diffuse goiter it is also removed. This complex operation, since there are many blood vessels in the area of ​​the thyroid gland.

If tumor resection is not possible, treatment with radioactive iodine is performed. Today this is a unique procedure; there are no substitutes for it. In many cases, it leads to hypofunction of the gland, and then constant correction of hormonal levels with the help of medications is required.