What is a Goiter?
A Goiter is an enlargement of any gland that is producing too much (hyperthyroidism), too little (hypothyroidism), or just enough hormone (euthyroidism). Typically, when speaking of a goiter, we often refer to the thyroid gland. When a goiter has been noted, it basically means that there is something going on with the gland to make it grow bigger than normal.
Causes?
The number one cause of goiters worldwide today is iron deficency. This is rarely seen today in the U.S. simply for the fact that the salt we intake has iodine added to it. The Morton salt company was the first to add iodine to their salt in 1924. Without iodine the thyroid gland is unable to produce the proper amount of hormone. The pituitary gland in the brain then senses this difficency and sends the thyroid a signal to produce TSH (thyroid stimulating hormone) which is basically telling the thyroid to produce more thyroid hormone. This is what causes the enlargment or abnormal growth of the thyroid gland.
Another cause of a goiter more commonly seen in the U.S. today is called Hashimoto's thyroiditis. This is an autoimune disease where one's own body basically attacks itself or the thyroid gland which causes a difficency in the production of thyroid hormone. Again, the pituitary gland senses this abnormality and tells the thyroid to produce more TSH in order to produce more thyroid hormone causing the gland to enlarge.
Diagnosis?
The diagnoisis of a goiter is usually found on physical examination. Once found it is important to find the cause. Initially a thyroid functioning test will be performed to determine if the thyroid gland is overactive or underactive in producing hormone. Depending on the activity of the thyroid other tests are performed to determine the type of goiter the patient has. Tests like radioactive iodine scans and thyroid ultrasounds are performed to determine the causes of goiters.
Treatment?
Treatment is specific to the type of goiter one has. If the cause is due to an iron deficency, then the patient would be given iron supplements orally. Iron supplements will reduce the size of the goiter but they will not completely resolve the goiter.
If the goiter is due to Hashimoto's thyroiditis or an autoimmune issue the patient would receive a hormone pill that would be taken daily to regulate the thyroid hormone to a normal level. This treatment would most likely cause the goiter to reduce in size, but again would probably not reduce it completely. Thyroid hormone treatment will keep the goiter from becoming larger in size.
References
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