Goitre

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Goitre is a disease characterised by enlargement of the butterfly-shaped thyroid gland in the neck. The thyroid gland produces thyroid hormones such as thyroxine T3 and triiodothyronine T4, which are vital for metabolism, growth, and development in the body

Goitre is a disease characterised by enlargement of the butterfly-shaped thyroid gland in the neck. The thyroid gland produces thyroid hormones such as thyroxine T3 and triiodothyronine T4, which are vital for metabolism, growth, and development in the body

Causes of Goitre: 

Goitre can be caused by many factors, such as:

Congenital goitre: Infants with hypothyroidism or an underactive thyroid gland may develop this form of goitre. It can be caused by ingestion of anti-thyroid drugs by the mother, abnormal development of the thyroid during embryonic development, or ingestion of goitrogens (substances that disrupt the formation and production of thyroid hormones) which interrupt the production of thyroid hormones.

Autoimmune diseases: Autoimmune diseases such as grave disease are caused by overproduction of thyroid hormone that tends to affect young and middle-aged women.  Another autoimmune disease that attacks the thyroid gland is Hashimoto's disease. It is characterized by inflammation and hypofunction of the thyroid gland.

Nodular goitre: Iodine deficiency and elevation of TSH (Thyroid Stimulating Hormone) can result in nodular goitre. In this condition, the thyroid gland is enlarged by forming nodules on one or both sides. It has been documented that the factors causing nodular goitre are similar to those of further developing into thyroid cancer.

Neoplastic goitre: Goitre can be a result of a tumour in the thyroid gland, either benign or malignant. These tumours are present in the form of discrete nodules, but there are also types of thyroid cancer that cause significant swelling of the gland. Cancers such as infiltrating papillary thyroid cancer, lymphoma, and anaplastic thyroid cancer fall into this category]MEN syndrome 1 and 2 (Multiple Endocrine Neoplasia) can also result in goitre and cancer of the thyroid gland.

Iodine deficiency: A diet low in dietary iodine may lead to issues with the thyroid, which can progress to a goitre. Endemic goitre occurs when over 10% of a population suffers from iodine deficiency.

Causes of Goitre: 

1. Goitre can be caused by many factors, such as:
2. Congenital goitre: Infants with hypothyroidism or an underactive thyroid gland may develop this form of goitre. It can be caused by ingestion of anti-thyroid drugs by the mother, abnormal development of the thyroid during embryonic development, or ingestion of goitrogens (substances that disrupt the formation and production of thyroid hormones) which interrupt the production of thyroid hormones.
3. Autoimmune diseases: Autoimmune diseases such as grave disease are caused by overproduction of thyroid hormone that tends to affect young and middle-aged women.  Another autoimmune disease that attacks the thyroid gland is Hashimoto's disease. It is characterized by inflammation and hypofunction of the thyroid gland.
4. Nodular goitre: Iodine deficiency and elevation of TSH (Thyroid Stimulating Hormone) can result in nodular goitre. In this condition, the thyroid gland is enlarged by forming nodules on one or both sides. It has been documented that the factors causing nodular goitre are similar to those of further developing into thyroid cancer.
5. Neoplastic goitre: Goitre can be a result of a tumour in the thyroid gland, either benign or malignant. These tumours are present in the form of discrete nodules, but there are also types of thyroid cancer that cause significant swelling of the gland. Cancers such as infiltrating papillary thyroid cancer, lymphoma, and anaplastic thyroid cancer fall into this category]MEN syndrome 1 and 2 (Multiple Endocrine Neoplasia) can also result in goitre and cancer of the thyroid gland.
6. Iodine deficiency: A diet low in dietary iodine may lead to issues with the thyroid, which can progress to a goitre. Endemic goitre occurs when over 10% of a population suffers from iodine deficiency.

Causes of Goitre: 

Goitre can be caused by many factors, such as:

1. Congenital goitre: Infants with hypothyroidism or an underactive thyroid gland may develop this form of goitre. It can be caused by ingestion of anti-thyroid drugs by the mother, abnormal development of the thyroid during embryonic development, or ingestion of goitrogens (substances that disrupt the formation and production of thyroid hormones) which interrupt the production of thyroid hormones.
2. Autoimmune diseases: Autoimmune diseases such as grave disease are caused by overproduction of thyroid hormone that tends to affect young and middle-aged women.  Another autoimmune disease that attacks the thyroid gland is Hashimoto's disease. It is characterized by inflammation and hypofunction of the thyroid gland.
3. Nodular goitre: Iodine deficiency and elevation of TSH (Thyroid Stimulating Hormone) can result in nodular goitre. In this condition, the thyroid gland is enlarged by forming nodules on one or both sides. It has been documented that the factors causing nodular goitre are similar to those of further developing into thyroid cancer.
4. Neoplastic goitre: Goitre can be a result of a tumour in the thyroid gland, either benign or malignant. These tumours are present in the form of discrete nodules, but there are also types of thyroid cancer that cause significant swelling of the gland. Cancers such as infiltrating papillary thyroid cancer, lymphoma, and anaplastic thyroid cancer fall into this category]MEN syndrome 1 and 2 (Multiple Endocrine Neoplasia) can also result in goitre and cancer of the thyroid gland.
5. Iodine deficiency: A diet low in dietary iodine may lead to issues with the thyroid, which can progress to a goitre. Endemic goitre occurs when over 10% of a population suffers from iodine deficiency.

Causes of Goitre: 

Goitre can be caused by many factors, such as:

1. Congenital goitre: Infants with hypothyroidism or an underactive thyroid gland may develop this form of goitre. It can be caused by ingestion of anti-thyroid drugs by the mother, abnormal development of the thyroid during embryonic development, or ingestion of goitrogens (substances that disrupt the formation and production of thyroid hormones) which interrupt the production of thyroid hormones.
2. Autoimmune diseases: Autoimmune diseases such as grave disease are caused by overproduction of thyroid hormone that tends to affect young and middle-aged women.  Another autoimmune disease that attacks the thyroid gland is Hashimoto's disease. It is characterized by inflammation and hypofunction of the thyroid gland.
3. Nodular goitre: Iodine deficiency and elevation of TSH (Thyroid Stimulating Hormone) can result in nodular goitre. In this condition, the thyroid gland is enlarged by forming nodules on one or both sides. It has been documented that the factors causing nodular goitre are similar to those of further developing into thyroid cancer.
4. Neoplastic goitre: Goitre can be a result of a tumour in the thyroid gland, either benign or malignant. These tumours are present in the form of discrete nodules, but there are also types of thyroid cancer that cause significant swelling of the gland. Cancers such as infiltrating papillary thyroid cancer, lymphoma, and anaplastic thyroid cancer fall into this category]MEN syndrome 1 and 2 (Multiple Endocrine Neoplasia) can also result in goitre and cancer of the thyroid gland.
5. Iodine deficiency: A diet low in dietary iodine may lead to issues with the thyroid, which can progress to a goitre. Endemic goitre occurs when over 10% of a population suffers from iodine deficiency.

The main symptoms of goitre include:

1. Swelling of the neck: A multinodular goitre (MNG) or a thyroid goitre resulting from hyperthyroidism can cause significant swelling in the neck.
2. Nervousness and anxiety: Although these symptoms are more prevalent in grave's disease (A disease caused by an overactive thyroid gland), they can also be seen frequently in patients with multinodular goitres.
3. Increased tolerance to cold: Due to vasomotor changes, patients with goitre experience high tolerance to cold, with no tolerance for heat at all. In hot environments, they sweat excessively. They require fewer blankets on cold nights and prefer lighter clothes at all times.
4. Irregular menstruation: Women often experience improper menstruation periods, infertility, and secondary amenorrhoea as symptoms of goitre and thyroid issues.
5. Tightness in the neck region: Most patients feel pressure in the neck, followed by difficulty swallowing foods and liquids. Some also can experience dyspnea, a condition characterized by shortness of breath.
6. Fluctuations in weight: Patients with goitre often experience weight gain despite poor appetite and diet.[6] Occasionally these patients may also experience weight loss due to goitre.
7. Tiredness, palpitations, irregular pulse,  tremor, and insomnia can also be the symptoms of goitre and hyperthyroidism.

The main symptoms of goitre include:

1. Swelling of the neck: A multinodular goitre (MNG) or a thyroid goitre resulting from hyperthyroidism can cause significant swelling in the neck.
2. Nervousness and anxiety: Although these symptoms are more prevalent in grave's disease (A disease caused by an overactive thyroid gland), they can also be seen frequently in patients with multinodular goitres.
3. Increased tolerance to cold: Due to vasomotor changes, patients with goitre experience high tolerance to cold, with no tolerance for heat at all. In hot environments, they sweat excessively. They require fewer blankets on cold nights and prefer lighter clothes at all times.
4. Irregular menstruation: Women often experience improper menstruation periods, infertility, and secondary amenorrhoea as symptoms of goitre and thyroid issues.
5. Tightness in the neck region: Most patients feel pressure in the neck, followed by difficulty swallowing foods and liquids. Some also can experience dyspnea, a condition characterized by shortness of breath.
6. Fluctuations in weight: Patients with goitre often experience weight gain despite poor appetite and diet.[6] Occasionally these patients may also experience weight loss due to goitre.
7. Tiredness, palpitations, irregular pulse,  tremor, and insomnia can also be the symptoms of goitre and hyperthyroidism.

The main symptoms of goitre include:

1. Swelling of the neck: A multinodular goitre (MNG) or a thyroid goitre resulting from hyperthyroidism can cause significant swelling in the neck.
2. Nervousness and anxiety: Although these symptoms are more prevalent in grave's disease (A disease caused by an overactive thyroid gland), they can also be seen frequently in patients with multinodular goitres.
3. Increased tolerance to cold: Due to vasomotor changes, patients with goitre experience high tolerance to cold, with no tolerance for heat at all. In hot environments, they sweat excessively. They require fewer blankets on cold nights and prefer lighter clothes at all times.
4. Irregular menstruation: Women often experience improper menstruation periods, infertility, and secondary amenorrhoea as symptoms of goitre and thyroid issues.
5. Tightness in the neck region: Most patients feel pressure in the neck, followed by difficulty swallowing foods and liquids. Some also can experience dyspnea, a condition characterized by shortness of breath.
6. Fluctuations in weight: Patients with goitre often experience weight gain despite poor appetite and diet.[6] Occasionally these patients may also experience weight loss due to goitre.
7. Tiredness, palpitations, irregular pulse,  tremor, and insomnia can also be the symptoms of goitre and hyperthyroidism.

Diagnosis:

In diagnosing goitre and other diseases related to thyroid, the following investigations are performed:

1. Test of TSH (Thyroid Stimulating Hormone): This test reveals the levels of T3 and T4 hormones in your body. If your thyroid hormone levels are high or low, you may be diagnosed with hypothyroidism or hyperthyroidism, respectively. . 
2. Nodule hot scan: This type of scan utilizes radionuclides (radioactive chemicals) to observe the gland. The test involves swallowing or injecting a radioactive tracer, whereas a special camera examines thyroid function. The result will indicate whether the nodules are hot or cold based on how much tracer they absorb.
3. Thyroid ultrasound: A sound wave is transmitted into the neck to provide images of the thyroid and surrounding tissues. In this test, even small nodules as small as 2-3 mm can be seen. It distinguishes cystic thyroid nodules (fluid-filled nodules) from solid nodules. Using ultrasound, physicians can now identify nodules that are more likely to be cancerous.
4. Fine needle aspiration: Fine needle aspiration (FNA) is done if nodules are observed in the ultrasound. In this method, a needle is inserted within the nodule to extract a sample and check for thyroid cancer. In diagnosing nodular thyroid disease and thyroid cancer, fine-needle aspiration biopsy is the most accurate, safe, and non-invasive method.

Diagnosis:

In diagnosing goitre and other diseases related to thyroid, the following investigations are performed:

1. Test of TSH (Thyroid Stimulating Hormone): This test reveals the levels of T3 and T4 hormones in your body. If your thyroid hormone levels are high or low, you may be diagnosed with hypothyroidism or hyperthyroidism, respectively. . 
2. Nodule hot scan: This type of scan utilizes radionuclides (radioactive chemicals) to observe the gland. The test involves swallowing or injecting a radioactive tracer, whereas a special camera examines thyroid function. The result will indicate whether the nodules are hot or cold based on how much tracer they absorb.
3. Thyroid ultrasound: A sound wave is transmitted into the neck to provide images of the thyroid and surrounding tissues. In this test, even small nodules as small as 2-3 mm can be seen. It distinguishes cystic thyroid nodules (fluid-filled nodules) from solid nodules. Using ultrasound, physicians can now identify nodules that are more likely to be cancerous.
4. Fine needle aspiration: Fine needle aspiration (FNA) is done if nodules are observed in the ultrasound. In this method, a needle is inserted within the nodule to extract a sample and check for thyroid cancer. In diagnosing nodular thyroid disease and thyroid cancer, fine-needle aspiration biopsy is the most accurate, safe, and non-invasive method.

Diagnosis:

In diagnosing goitre and other diseases related to thyroid, the following investigations are performed:

1. Test of TSH (Thyroid Stimulating Hormone): This test reveals the levels of T3 and T4 hormones in your body. If your thyroid hormone levels are high or low, you may be diagnosed with hypothyroidism or hyperthyroidism, respectively. . 
2. Nodule hot scan: This type of scan utilizes radionuclides (radioactive chemicals) to observe the gland. The test involves swallowing or injecting a radioactive tracer, whereas a special camera examines thyroid function. The result will indicate whether the nodules are hot or cold based on how much tracer they absorb.
3. Thyroid ultrasound: A sound wave is transmitted into the neck to provide images of the thyroid and surrounding tissues. In this test, even small nodules as small as 2-3 mm can be seen. It distinguishes cystic thyroid nodules (fluid-filled nodules) from solid nodules. Using ultrasound, physicians can now identify nodules that are more likely to be cancerous.
4. Fine needle aspiration: Fine needle aspiration (FNA) is done if nodules are observed in the ultrasound. In this method, a needle is inserted within the nodule to extract a sample and check for thyroid cancer. In diagnosing nodular thyroid disease and thyroid cancer, fine-needle aspiration biopsy is the most accurate, safe, and non-invasive method.

Treatment:

Home remedies: 

1. Tulsi (Ocimum sanctum) can be used as a home remedy for goitre. The rosmarinic acid present in tulsi has an anti-inflammatory effect  which can be used to reduce swelling caused by goitres.
2. Belladonna tincture is an effective treatment for exophthalmic goitre. 

However, when considering the use of herbal supplements, seek the advice of your doctor

1. Other than home remedies, the treatment you receive from your doctor will depend on:
2. The size of your goitre

symptoms you are experiencing

1. Whether you have underlying thyroid disease
2. Over-the-counter medications:
3. To reduce the swelling, your doctor might prescribe OTC (over the counter) medicine such as Ibuprofen or Aspirin.
4. The doctor might recommend Levothyroxine supplementation, which is used primarily to treat congenital hypothyroidism.
5. Methimazole and Propylthiouracil are the drugs that will be recommended if the goitre is caused by an overactive thyroid.

Radioactive Iodine Therapy: This treatment involves taking radioactive iodine orally. The iodine kills thyroid cells and shrinks the thyroid gland. Most patients have to take thyroid hormone replacement therapy after radioactive iodine treatment for the rest of their lives.

Surgery:

The surgery for goitre is a thyroidectomy. The aim of the surgery is to remove all or a part of a thyroid gland. It includes the following steps:

To make you unconscious, you will be given a general anaesthetic. Then, you are positioned with special pillows beneath your neck with your head tilted back.

In Thyroidectomy, the surgeon will create a 4 to 5-centimetre incision on the front neck. Your surgeon may extract a portion of the thyroid gland (lobectomy), the majority of the gland (subtotal), or the entire gland (total thyroidectomy) (total thyroidectomy), depending upon your condition.

Additional surgery may be required in some circumstances, including the excision (removal) of lymph nodes and other structures. The incision is closed by using stitches and is subsequently covered with steri-strip tapes (wound closure tapes) and a dry gauze dressing.

The procedure takes place for two to three hours. You will spend several hours in the recovery room following surgery. As you recover from anaesthesia, you will be continuously observed.

Treatment:

Home remedies: 

1. Tulsi (Ocimum sanctum) can be used as a home remedy for goitre. The rosmarinic acid present in tulsi has an anti-inflammatory effect  which can be used to reduce swelling caused by goitres.
2. Belladonna tincture is an effective treatment for exophthalmic goitre. 

However, when considering the use of herbal supplements, seek the advice of your doctor

1. Other than home remedies, the treatment you receive from your doctor will depend on:
2. The size of your goitre

Symptoms you are experiencing

1. Whether you have underlying thyroid disease
2. Over-the-counter medications:
3. To reduce the swelling, your doctor might prescribe OTC (over the counter) medicine such as Ibuprofen or Aspirin.
4. The doctor might recommend Levothyroxine supplementation, which is used primarily to treat congenital hypothyroidism.
5. Methimazole and Propylthiouracil are the drugs that will be recommended if the goitre is caused by an overactive thyroid.

Radioactive Iodine Therapy: This treatment involves taking radioactive iodine orally. The iodine kills thyroid cells and shrinks the thyroid gland. Most patients have to take thyroid hormone replacement therapy after radioactive iodine treatment for the rest of their lives.

Surgery:

The surgery for goitre is a thyroidectomy. The aim of the surgery is to remove all or a part of a thyroid gland.

It includes the following steps:

1. To make you unconscious, you will be given a general anaesthetic. Then, you are positioned with special pillows beneath your neck with your head tilted back.
2. In Thyroidectomy, the surgeon will create a 4 to 5-centimetre incision on the front neck. Your surgeon may extract a portion of the thyroid gland (lobectomy), the majority of the gland (subtotal), or the entire gland (total thyroidectomy) (total thyroidectomy), depending upon your condition.
3. Additional surgery may be required in some circumstances, including the excision (removal) of lymph nodes and other structures. The incision is closed by using stitches and is subsequently covered with steri-strip tapes (wound closure tapes) and a dry gauze dressing.
4. The procedure takes place for two to three hours.
5. You will spend several hours in the recovery room following surgery. As you recover from anaesthesia, you will be continuously observed.

Treatment:

Home remedies: 

1. Tulsi (Ocimum sanctum) can be used as a home remedy for goitre. The rosmarinic acid present in tulsi has an anti-inflammatory effect  which can be used to reduce swelling caused by goitres.
2. Belladonna tincture is an effective treatment for exophthalmic goitre. 

However, when considering the use of herbal supplements, seek the advice of your doctor

1. Other than home remedies, the treatment you receive from your doctor will depend on:
2. The size of your goitre

Symptoms you are experiencing

1. Whether you have underlying thyroid disease
2. Over-the-counter medications:
3. To reduce the swelling, your doctor might prescribe OTC (over the counter) medicine such as Ibuprofen or Aspirin.
4. The doctor might recommend Levothyroxine supplementation, which is used primarily to treat congenital hypothyroidism.
5. Methimazole and Propylthiouracil are the drugs that will be recommended if the goitre is caused by an overactive thyroid.

Radioactive Iodine Therapy: This treatment involves taking radioactive iodine orally. The iodine kills thyroid cells and shrinks the thyroid gland. Most patients have to take thyroid hormone replacement therapy after radioactive iodine treatment for the rest of their lives.

Surgery:

The surgery for goitre is a thyroidectomy. The aim of the surgery is to remove all or a part of a thyroid gland.

It includes the following steps:

1. To make you unconscious, you will be given a general anaesthetic. Then, you are positioned with special pillows beneath your neck with your head tilted back.
2. In Thyroidectomy, the surgeon will create a 4 to 5-centimetre incision on the front neck. Your surgeon may extract a portion of the thyroid gland (lobectomy), the majority of the gland (subtotal), or the entire gland (total thyroidectomy) (total thyroidectomy), depending upon your condition.
3. Additional surgery may be required in some circumstances, including the excision (removal) of lymph nodes and other structures. The incision is closed by using stitches and is subsequently covered with steri-strip tapes (wound closure tapes) and a dry gauze dressing.
4. The procedure takes place for two to three hours.
5. You will spend several hours in the recovery room following surgery. As you recover from anaesthesia, you will be continuously observed.

1. These treatments may decrease the size of the goitre.  
2. Respite from the fluctualtion in weight 
3. The treatment helps in the problem of irregular period

1. These treatments may decrease the size of the goitre.  
2. Respite from the fluctualtion in weight 
3. The treatment helps in the problem of irregular period

1. These treatments may decrease the size of the goitre.  
2. Respite from the fluctualtion in weight 
3. The treatment helps in the problem of irregular period

Risk of delaying treatment/ surgery:

The risk of delaying the treatment or surgery in cases of goitre can result in severe outcomes such as:

1. Hypothyroidism (underactive thyroid gland).
2. Growth of thyroid nodules.
3. Hyperthyroidism (overactive thyroid gland).
4. Thyroid cancer.
5. Metastasis of cancer
6. Grave's disease.
7. Toxic multinodular goitre (MNG)
8. Death, in rare cases.

Risk of delaying treatment/ surgery:

The risk of delaying the treatment or surgery in cases of goitre can result in severe outcomes such as:

1. Hypothyroidism (underactive thyroid gland).
2. Growth of thyroid nodules.
3. Hyperthyroidism (overactive thyroid gland).
4. Thyroid cancer.
5. Metastasis of cancer
6. Grave's disease.
7. Toxic multinodular goitre (MNG)
8. Death, in rare cases.

Risk of delaying treatment/ surgery:

The risk of delaying the treatment or surgery in cases of goitre can result in severe outcomes such as:

1. Hypothyroidism (underactive thyroid gland).
2. Growth of thyroid nodules.
3. Hyperthyroidism (overactive thyroid gland).
4. Thyroid cancer.
5. Metastasis of cancer
6. Grave's disease.
7. Toxic multinodular goitre (MNG)
8. Death, in rare cases.