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a woman with a goitre
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Goiter
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A (
BrE ), or '''goiter''' (
AmE ) (
Latin ''struma''), also called a '''bronchocele''', is a swelling in the neck (just below
Adam's Apple or
Larynx ) due to an enlarged
Thyroid Gland .
They are classified in different ways:
- A "diffuse goitre" is a goitre that has spread through all of the thyroid (and can be a "simple goitre", or a "multinodular goitre").
- "Toxic goitre" refers to goitre with Hyperthyroidism . These most commonly due to Graves Disease , but can be caused by Inflammation or a multinodular goitre.
- "Nontoxic goitre" (associated with normal or low thyroid levels) refers to all other types (such as that caused by Lithium or certain other Autoimmune diseases).
Other causes are:
Iodine is necessary for the synthesis of the thyroid
Hormone s
Triiodothyronine and
Thyroxine (T3 and T4). In conditions producing endemic goitre, when iodine is not available, these hormones cannot be made. In response to low thyroid hormones, the
Pituitary Gland releases
Thyroid Stimulating Hormone (TSH). Thyroid stimulating hormone acts to increase synthesis of T3 and T4, but it also causes the thyroid gland to grow in size by increasing cell division.
Goitre is more common among women, but this includes the many types of goitre caused by autoimmune problems, and not only those caused by simple lack of iodine.
Treatment for goitre may not be necessary if the goitre is small.
Hypothyroidism should be treated, and this treatment often leads to a substantial reduction in the size of the goitre. Removal of the goitre may be necessary if it causes difficulty with breathing or swallowing. There is now an alternative to surgery in large goitres. Radioiodine therapy with or without the pre-injection of a synthetic thyroid stimulating hormone, TSH, can relieve obstruction and reduce the size of the goitre by 30-65%. But removal of a goitre requires removing the thyroid. The complete removal of the thyroid gland removes the body's ability to produce thyroid hormone. In this case, supplements of oral
Thyroxine are necessary to avoid harm from
Hypothyroidism .
Goitre was previously common in many areas that were deficient in iodine in the ''
Central Asia and
Central Africa .
Some health workers fear that a resurgence of goitre might occur because of the trend to use
Rock Salt and/or
Sea Salt , which has not been fortified with
Iodine .
New research indicates that there may in fact be a tendency to inherit an increased vulnerability to goitre.
