A condition that increases the size of your thyroid is called a goiter. The thyroid gland is a small, butterfly-shaped gland located in the neck, below the Adam’s apple. It secretes hormones that help regulate bodily functions, including metabolism, the process that turns food into energy. It also regulates heart rate, respiration, digestion, and mood. A goiter may develop in anyone, but is more common in women.
Since many things can make your thyroid swell, there are lots of types of goiters. A few of them are:
• Simple goiters, which happen when your thyroid gland doesn’t make enough hormones. The thyroid grows larger to make up for this.
• Endemic goiters. Sometimes called colloid goiters. Endemic goiters occur in people in certain parts of the world who do not get enough iodine in their diet (iodine is necessary to make thyroid hormone). For instance, a lack of iodine in the diet is still a common problem in parts of central Asia and central Africa. Because iodine is added to table salt in the United States and other countries, this type of goiter usually does not occur in these countries.
• Sporadic or nontoxic goiters, which usually have no known cause. Certain drugs and medical conditions can trigger them. For example, the drug lithium, which is used to treat certain mental health conditions, as well as other medical conditions, can cause this type of goiter.
• Multinodular goiters, which happen when lumps called nodules grow in your thyroid.
The main symptoms of goiter include:
• A swelling in the front of the neck, just below the Adam’s apple
• A feeling of tightness in the throat area
• Hoarseness (scratchy voice)
• Neck vein swelling
• Dizziness when the arms are raised above the head
Other, less common symptoms include:
• Difficulty breathing (shortness of breath)
• Wheezing (due to squeezing of the windpipe)
• Difficulty swallowing (due to squeezing of the esophagus, or “food tube”)
Some people who have a goiter may also have hyperthyroidism, or overactive thyroid. Symptoms of hyperthyroidism can include:
• An increased resting pulse rate
• Rapid heartbeat
• Diarrhea, nausea, vomiting
• Sweating without exercise or increased room temperature
Some people with goiter may also have hypothyroidism, or underactive thyroid. Symptoms of hypothyroidism can include:
• Fatigue (feeling tired)
• Dry skin
• Weight gain
A goiter is described as “toxic” when it’s linked to hyperthyroidism. That means your thyroid makes too much thyroid hormone.
A “nontoxic” goiter doesn’t cause ether hyperthyroidism or hypothyroidism.
A number of factors that influence thyroid function or growth can result in a goiter.
• Iodine deficiency.
Iodine is essential for the production of thyroid hormones. If a person does not get enough dietary iodine, hormone production drops and the pituitary gland signals the thyroid to make more. This increased signal results in thyroid growth.
• Hashimoto’s disease.
Hashimoto’s disease is an autoimmune disorder, an illness caused by the immune system attacking healthy tissues. The damaged and inflamed tissues of the thyroid don’t produce enough hormones (hypothyroidism). When the pituitary gland detects the decline and prompts the thyroid to create more hormones, the thyroid can become enlarged.
• Graves’ disease.
Another autoimmune disorder called Graves’ disease occurs when the immune system produces a protein that mimics TSH. This rogue protein prompts the thyroid to overproduce hormones (hyperthyroidism) and can result in thyroid growth.
• Thyroid nodules.
A nodule is the irregular growth of thyroid cells that form a lump. A person may have one nodule or several nodules (multinodular goiter). The cause of nodules is not clear, but there may be multiple factors — genetics, diet, lifestyle and environment. Most thyroid nodules are noncancerous (benign).
• Thyroid cancer.
Thyroid cancer is less common than other cancers and generally treatable. About 5% of people with thyroid nodules are found to have cancer.
A hormone produced during pregnancy, human chorionic gonadotropin (HCG), may cause the thyroid gland to be overactive and enlarge slightly.
Thyroiditis is inflammation of the thyroid caused by an autoimmune disorder, bacterial or viral infection, or medication. The inflammation may cause hyperthyroidism or hypothyroidism.
Risk factors –
Anyone can develop a goiter. It may be present at birth or occur at any time throughout life. Some common risk factors for goiters include:
• A lack of dietary iodine.
Iodine is found primarily in seawater and in the soil in coastal areas. In the developing world in particular, people who don’t have enough iodine in their diets or access to food supplemented with iodine are at increased risk.
• Being female.
Women are more likely to develop a goiter or other thyroid disorders.
• Pregnancy and menopause.
Thyroid problems in women are more likely to occur during pregnancy and menopause.
Goiters are more common after age 40.
• Family medical history. Family medical history of goiters or other thyroid disorders increases the risk of goiters.
• Medications. Some medical treatments, including the heart drug amiodarone (Pacerone) and the psychiatric drug lithium (Lithobid), increase your risk.
• Radiation exposure.
Your risk increases if you’ve had radiation treatments to your neck or chest area.
A goiter itself usually doesn’t cause complications. The appearance may be troublesome or embarrassing for some people. A large goiter may obstruct the airway and voice box.
Changes in the production of thyroid hormones that may be associated with goiters have the potential for causing complications in multiple body systems.
Your doctor will check for neck for swelling. They’ll also order a number of diagnostic tests that include these below:
• Blood tests –
Blood tests can detect changes in hormone levels and an increased production of antibodies, which are produced in response to an infection or injury or overactivity of immune system.
• Thyroid scan –
Your doctor may order scans of your thyroid. This is usually done when your thyroid level is elevated. These scans show the size and condition of your goiter, overactivity of some parts or whole thyroid.
• Ultrasound –
An ultrasound produces images of your neck, the size of your goiter, and whether there are nodules. Over time, an ultrasound can track changes in those nodules and the goiter.
• Biopsy –
A biopsy is a procedure that involves taking small samples of your thyroid nodules if present. The samples are sent to a laboratory for examination.
Treatment for goiter depends on how large the thyroid has grown, symptoms, and what caused it. Treatments include:
• No treatment/”watchful waiting.”
If the goiter is small and is not bothering you, your doctor may decide that it doesn’t need to be treated. However, the goiter will be closely watched for any changes.
Levothyroxine (Levothroid®, Synthroid®) is a thyroid hormone replacement therapy. It is prescribed if the cause of the goiter is an underactive thyroid (hypothyroidism). Other medications are prescribed if the cause of the goiter is an overactive thyroid (hyperthyroidism). These drugs include methimazole (Tapazole®) and propylthiouracil. The doctor might prescribe aspirin or a corticosteroid medication if goiter is caused by inflammation.
• Radioactive iodine treatment.
This treatment, used in cases of an overactive thyroid gland, involves taking radioactive iodine orally. The iodine goes to the thyroid gland and kills thyroid cells, which shrinks the gland. After radioactive iodine treatment, the patient usually has to take thyroid hormone replacement therapy for the rest of his or her life.
A biopsy is the removal of a sample of tissue or cells to be studied in a laboratory. A biopsy may be needed if there are large nodules in the thyroid gland. A biopsy is taken to rule out cancer.
Surgery is performed to remove all or part of the thyroid gland. Surgery may be needed if the goiter is large and causes problems with breathing and swallowing. Surgery is also sometimes used to remove nodules. Surgery must be done if cancer is present. Depending on the amount of thyroid gland removed, the patient may need to take thyroid hormone replacement therapy for the rest of his or her life.
Ayurvedic Perspective –
In Ayurveda, Goiter is known as Galaganda. It is for the most part caused by vitiated kapha however some of the time vata may be likewise included. Vitiated kapha blends with meda dhatu (fat tissue) causing a stationary, overwhelming swelling before throat which is then called galaganda.
▪︎ Ayurvedic Formulations
• Kanchnar Guggulu
• Arogyavardhini Vati
▪︎ Lifestyle Advice
Adequate amount of iodine ought to be taken each day. For grown-ups every day prerequisite of iodine is 150 mcg.
Seaweeds, cod fish, drain, yogurt, potato, privately developed organic products, vegetables and eggs are rich wellsprings of iodine. They ought to be taken in satisfactory amount.
Iron rich nourishment (like onion, garlic, carrot), sustenance containing Vitamin A (papaya, mango, sweet potato), organic products containing vitamin B (like guava, okra, nuts) ought to be taken.
Foods, for example, soybean, spinach and peanuts ought to be limited, particularly by the individuals who are more in danger.
▪︎ Best Yoga Postures –
• Sarvangasana – shoulder stand
• Viparita Karani – inverted pose
• Sethubandhasana – bridge pose
• Ushtrasana – camel pose
• Matsyasana – fish pose
• Halasana – plough pose
• Bhujangasana – cobra pose
• Dhanurasana – bow pose
• Urdhwa Dhanurasana – upward bow pose
• Shirshasana – supported headstand pose
• Navasana – boat pose
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