Nodular goiter - a term that combines various diseases of the thyroid gland, accompanied by the formation of nodes. These rounded growths of tissue can have different shapes and sizes. In this case, the pathology at the initial stages can be asymptomatic, but if left untreated, there is a possibility of developing dangerous complications. Of course, many people are interested in additional information on this issue. In this article, we will talk about what the symptoms and treatment of thyroid nodular goiter look like, as well as what causes them.
The main causes of the development of the disease
In fact, it is not possible to determine the causes of the development of pathology in all cases. However, some risk factors are known and worth paying attention to:
- To begin with, it is worth noting that there is a genetic predisposition - some people are more prone to developing such a disease (of course, if there are other prerequisites).
- Risk factors include age - a change in the structure andThe functioning of the thyroid gland is often associated with the natural aging process.
- If we are talking about colloid goiter, then almost always its development is to some extent associated with iodine deficiency in the human body.
- Sometimes a similar problem occurs in patients who suffer from autoimmune and genetic diseases (for example, people with Down syndrome are at risk).
- Thyroid disorders may be associated with certain medications.
- The risk factors also include the adverse effects of the external environment (goiter may be associated with exposure to radiation).
- Acute and chronic infectious diseases (both viral and bacterial) can cause thyroid problems.
- Risk factors also include endocrine diseases, constant stress, malnutrition (which leads to beriberi and micronutrient deficiencies), smoking and other bad habits.
Unfortunately, it is not always possible to find out the reasons for the development of nodular goiter. However, it is important to provide the doctor with complete information for the history.
Nodular goiter: symptoms
Symptoms in this case directly depend on the stage of development of the disease, the number of nodes, their location and size:
- A greatly enlarged thyroid gland protrudes under the skin of the neck, creating a cosmetic defect.
- Enlarged nodes often compress the larynx, trachea and esophagus, resulting in a constant feeling of a lump in the throat.
- In addition, patients have difficulty speaking, swallowing.
- Other symptoms include dry cough, choking attacks, constant hoarseness.
- If the thyroid gland compresses the blood vessels, then patients may suffer from periodic headaches, dizziness, tinnitus.
- Some of them complain of pain on palpation of the nodes. As a rule, discomfort in this case is associated with either hemorrhage or inflammation of the thyroid tissue.
According to statistics, in most cases nodular goiter does not cause functional disorders. However, sometimes the formation and growth of nodes is accompanied by an increase or decrease in hormone levels.
Hypothyroidism is characterized by a decrease in blood pressure, drowsiness, eating disorders, hair loss, dry skin, and a decrease in body temperature. In women, a decrease in thyroid hormone levels causes menstrual irregularities, and men often complain of problems with potency and decreased libido.
Signs of thyrotoxicosis
Often, nodular goiter of the thyroid gland is accompanied by an increase in the level of thyroid hormones, which, if not corrected, leads to the development of thyrotoxicosis. This condition is accompanied by very characteristic symptoms:
- sleep problems, constant insomnia;
- an increase in body temperature to subfebrile values;
- appearance of trembling in the hands;
- increased irritability;
- tachycardia, palpitations;
- constant feeling of hunger;
- weight loss, even with large meals.
Degrees of development of the disease
If we take into account the classification scheme of O. V. Nikolaev, then the following degrees of nodular goiter are distinguished:
- Null - no symptoms, the disease is rarely diagnosed at this stage.
- First degree - during the examination, the doctor can feel the thyroid gland, although there are still no noticeable physiological abnormalities.
- Second - the thyroid gland increases in size and is well palpable, patients complain of difficulty in swallowing, discomfort when tilting the head, swelling, irritability, loss of appetite.
- Third - the patient's neck increases in size, appetite decreases, and weight, on the contrary, increases, chest pains, shortness of breath appear.
- Fourth - the thyroid nodes are enlarged, a goiter appears on the neck.
- Fifth degree - an enlarged gland compresses neighboring organs.
Types and forms of goiter
Depending on the size, number of nodes, as well as the degree of change in the functional activity of the thyroid gland, several forms of the disease are distinguished:
- Colloid nodular goiter - accompanied by proliferation of the epithelium and an increase in the number of follicles in which hormones are synthesized.
- Solitary goiter - there is a single single formation in the tissues of the gland.
- Diffuse-nodular form - accompanied byuniform change in tissue structure.
- Multinodular goiter - a pathology that is accompanied by the formation of two or more catches.
- Nodular non-toxic goiter - characterized by the formation and gradual increase in nodes, but there are no changes due to the hormonal process.
- Toxic nodular goiter is accompanied by a sharp increase in the level of thyroid hormones, which is fraught with serious complications, including cancer.
What can the disease lead to?
Thyroid nodular goiter is a very dangerous and unpleasant disease that requires treatment. An increase in the size of the organ can lead to compression of the trachea and esophagus. In addition, rapidly growing nodes can compress the vessels, which disrupts the trophism of the gland tissues. There is a possibility of inflammation of the structures of the organ, which can lead to serious consequences (for example, to a violation of hormonal activity). The possibility of malignant degeneration of thyroid tissue should not be ruled out.
Diagnostic measures
Treatment of nodular goiter is directly related to the type of disease and its cause. That is why diagnosis is so important - the success of therapy depends on it.
First, you need to see an endocrinologist. If during palpation the doctor determined the presence of nodes, then an ultrasound examination is performed - during the procedure, the specialist can more accurately determine the number, size and location of neoplasms in the tissues of the thyroid gland. If the node diameter is greater than 1 cm, thena fine needle aspiration biopsy is performed (this procedure allows you to determine whether the structure is malignant).
Of course, they do a blood test for the level of thyroid hormones. Radioisotope scanning is performed to assess the functional activity of the organ. Sometimes an x-ray of the esophagus and chest using barium is additionally prescribed - this allows you to determine the degree of compression of the esophagus and / or trachea. To obtain more accurate information, the patient is sent for a tomography.
Basic treatments
Treatment of nodular goiter directly depends on the form and stage of development of the disease. If the patient has one small neoplasm, and there are no malfunctions in the endocrine system, then doctors, as a rule, decide on dynamic observation. The patient regularly undergoes examinations and tests - this enables the specialist to detect the further development of the disease in time.
Treatment of diffuse nodular goiter, which is associated with hormonal disorders, includes taking synthetic thyroid hormones - often this is what allows you to reduce the size of the thyroid gland. Radioactive iodine therapy is considered effective. According to statistics, through such treatment, it is sometimes possible to reduce the volume of the gland by 30-80%. Unfortunately, sometimes it is impossible to do without surgery.
Indications for surgery are as follows:
- nodules in the tissues of the thyroid gland grow rapidly;
- availablesuspicion of malignant tissue degeneration;
- there are serious disorders in the functioning of the gland (the level of hormones is sharply reduced or increased);
- the patient has a retrosternal location of the node;
- multiple cysts formed in the tissues of the thyroid gland, inside which a large amount of fluid accumulates;
- goiter grows rapidly, compresses the trachea and esophagus, significantly affects the patient's quality of life.
Sometimes during surgery, the doctor gently removes the nodule or cyst without affecting the thyroid tissue. Sometimes a partial resection of the organ is required, which may affect its endocrine activity. In the most severe cases (for example, if malignant degeneration of tissues occurs), complete removal of the thyroid gland is required. In this case, the patient requires lifelong hormone therapy in order to maintain the normal functioning of the body.
As you can see, the symptoms and treatment of nodular goiter are interrelated: the choice of therapeutic procedures depends on the presence of certain disorders.
Diet for illness
Treatment of nodular thyroid goiter must be supplemented with a proper diet. The diet directly depends on the level of thyroid hormones. So, if hypersecretion occurs, then daily food should be high-calorie, a sufficient amount of vitamins and mineral s alts should be supplied to the body. With hypothyroidism, foods high in iodine should be added to the menu. Useful in this case are fish, seaweed, millet, buckwheat.cereals, cheese, cottage cheese, milk, nuts and fruits. Avoid alcohol, smoked meats, coffee, chocolate, rich broths and spicy dishes.
Treatment of nodular goiter with folk remedies
Of course, drug therapy can be supplemented with some other measures. Traditional medicine offers a lot of recipes. These drugs have a positive effect on the functioning of the thyroid gland, help to normalize hormonal levels:
- Many healers say that walnuts are effective for goiter. 40 peeled nuts should be thoroughly washed, dried, and then poured with a liter of honey (it is important to choose a natural product). The mixture is infused for forty days in a dark place. You need to take a teaspoon of medicine with a glass of milk (once a day).
- Walnut partitions are also suitable for the treatment of nodular goiter. A glass of partitions is poured with 500 ml of vodka. The mixture is infused in a dark, cool place for a month. Herbalists recommend taking a tablespoon of tincture daily.
- Walnut is also suitable for compresses. You need to take the walnut shell and oak bark in equal amounts, pour water, bring to a boil and keep on low heat for thirty minutes. In the cooled broth, gauze is moistened, which is then applied to the skin of the neck (in the area of the goiter). The compress is left for 30 minutes.
- If hyperthyroidism occurs, then you can prepare a herbal tea. First you need to mix 100 g of nettle leaves, corn stigmas, burdock roots, licorice root, tricolor violet grass and 50 g of horsetail. All ingredients must be mixed thoroughly. Two tablespoons of the mixture pour three cups of boiling water. The container is covered and left for 30 minutes. The infusion should be filtered and taken 100-150 ml three times a day.
- It is also recommended to consume a small amount of seaweed every day (this will help saturate the human body with iodine).
- Some folk healers recommend doing an iodine mesh on the skin of the neck before going to bed.
- A plant such as horse sorrel is also useful: 50 g of crushed roots should be poured into 500 ml of vodka and left in a dark place for a week. Take the medicine three times a day for a tablespoon.
Of course, the above remedies can only be used as ancillary - they cannot replace full-fledged drug therapy. Under no circumstances should you take any medication without the knowledge of your doctor.
Patient prognosis and preventive measures
Nodular goiter is a serious disease that should not be ignored. Forecasts directly depend on the form of the disease and the stage of its development. For example, with euthyroid goiter, it is possible to normalize thyroid function. But the presence of malignant neoplasms can result in very dangerous complications. As for prevention, patients are advised to eat right, include foods containing iodine in the diet, and periodically take vitamin complexes (B vitamins are especially important). Physical activity, hardening and other will be usefulrestorative procedures.
