What Deficiency causes Goitre and How to treat it?
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What Deficiency causes Goitre and How to treat it?

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Aman Bindlish

What is Goitre?

Goitre is the enlargement of the thyroid resulting in swelling in the neck. The thyroid gland needs iodine to produce thyroid hormone that controls how every cell uses energy. In India, nearly 2% of women suffer from the disease, and less than 1% of men are reported to suffer from goitre. 

As per ancient texts, records of the disease can be found dating back to as far as 2700 BC, where it has been mentioned in ayurvedic texts as “galaganda” which roughly translates to a “dirty throat”. 

 

What can cause Goitre?

The thyroid size gets larger in an attempt to capture as much iodine as possible if the diet is deficient. A goitre is a sign that the thyroid gland is unable to make enough thyroid hormone. Goitres can also be caused by autoimmune issues which are the immune system attacking the thyroid gland, certain medicines such as lithium and amiodarone, in some cases cigarettes and infections, and even eating large amounts of vegetables in the cabbage family.

Other causes include:-

  • Graves’ disease is an autoimmune disease in which the immune system attacks the thyroid gland, resulting in it growing larger.
  • Hashimoto’s disease is an autoimmune disease that causes inflammation of the thyroid gland. Some people with Hashimoto’s disease develop a compensatory increase in the size of the thyroid gland, which usually tends to get better on its own over time. In some cases, the enlargement requires treatment with thyroid hormone.
  • Thyroid cancer often enlarges the thyroid gland resulting in a goitre.
  • Even during pregnancy, one can develop a goitre. Human chorionic gonadotropin, a hormone that is produced during pregnancy, can cause an enlargement in the thyroid gland.
  • Thyroiditis, which is an inflammation of the thyroid gland itself results in the gland’s enlargement, resulting in goitre.

Types of Goitre

Goitres are commonly classified on the basis of two main causes, that is how the thyroid gland enlarges and the thyroid hormone levels. The types of Goitre on the basis of how the gland enlarges are:-

  • Simple or Diffuse goitre: this happens when the entirety of the thyroid gland swells and feels relatively smooth to the touch.
  • Nodular goitre: this happens when a nodule (solid or fluid-filled lump) develops within the thyroid gland making it feel lumpy.
  • Multinodular goitre: this happens when there are many nodules within the thyroid. The nodules in most cases are visible or can be discovered only through examination or scans.

Classifications of goitres on the basis of thyroid hormone levels include:-

  • Toxic goitre: this happens when the thyroid gland is enlarged and produces too much of the thyroid hormone.
  • Nontoxic goitre: this happens when even with normal thyroid levels, one develops an enlarged thyroid gland.

Another cause of goitre can in many cases be drugs such as lithium. Sporadic goitres, even though in many cases have no known causes, can be triggered by drugs.

 

How is it treated?

Treatment of goitre can be done by thyroid hormone replacement pills if the goitre is due to an underactive thyroid, small doses of Lugol’s iodine or potassium iodine solution if the goitre is due to a lack of iodine, radioactive iodine to shrink the gland if the thyroid is producing too much thyroid hormone or in rare cases even surgery to remove either a part or in some cases the entire gland. This surgery is called a thyroidectomy.

If not treated in time, the enlargement can result in pressure being put on the windpipe and trachea resulting in breathing issues, bad coughs and issues with swallowing food and some scenarios, even death.

Disclaimer: This article is only for information purposes.

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