Sporadic goiter is a common ailment that is associated with a violation of the structure of the thyroid gland, namely with its increase. Despite the fact that the disease is considered relatively safe, it should not be ignored - the patient needs qualified help.
Of course, faced with a similar problem, patients are interested in additional information. What is a disease? What are the first symptoms to look out for? What can modern medicine offer in terms of treatment? The answers to these questions will be useful to many readers.
What is an affliction?
Quite often in medical practice, terms such as endemic and sporadic goiter are used. Both of these diseases are accompanied by nodular or diffuse enlargement of the thyroid gland along with the preservation of its functional activity. Nevertheless, there is still a difference between them.
Endemic goiter is a disease that is associated with a lack of iodine in the body, which is so important for the normal functioning of the thyroid gland. This form of illnessregistered in residents of areas with iodine deficiency in food and water. According to statistics, the disease is common in Brazil, India, some regions of the United States and Russia, Egypt, Switzerland. The disease is much more common among residents of high mountain areas.
Sporadic thyroid goiter is accompanied by the same symptoms and structural changes. However, the disease has nothing to do with living in areas with low iodine content.
The main causes of the development of the disease
It is not always possible for specialists to find out why a sporadic goiter develops. However, there are several risk factors:
- For starters, it is worth mentioning genetics, as a hereditary predisposition to such a disease has been proven. In most cases, we are talking about a violation of the processes of iodine metabolism and the formation of hormones in the thyroid gland.
- The risk factors also include the negative impact of the environment.
- Nutrition is important, since substances that interfere with the normal synthesis of thyroid hormones (for example, flavonoids, thiocyanide) can enter the human body along with food.
- Often the cause of such a disease is the use of drugs that disrupt the absorption of thyroid hormones by body tissues.
- Sporadic goiter can develop during periods when the body's need for thyroid hormones is increased, such as during puberty or pregnancy.
- The cause of the development of the disease sometimesbecomes an adenoma or tumor growing in the tissues of the thyroid gland.
Insufficient synthesis of hormones, impaired iodine metabolism, decreased sensitivity of the body to thyroid hormones - all this triggers compensatory mechanisms. The pituitary gland begins to secrete more thyroid-stimulating hormone, which provokes hyperplasia of the thyroid tissue.
Sporadic goiter: classification
There are many classification systems for this disease. For example, depending on the functional activity of the thyroid gland, they distinguish:
- euthyroid form (hormonal levels are within normal limits, thyroid function is not disturbed);
- hyperthyroid goiter (characterized by increased activity of the gland and an increase in the level of thyroid hormones);
- hypothyroid form (thyroid function decreases, the amount of hormones decreases).
The location of the goiter is also taken into account - it can be cervical, partially retrosternal, retrosternal and retroesophageal. The goiter of the root of the tongue is also isolated.
Depending on the structure, the goiter can be diffuse (the thyroid gland is hypertrophied, the tissues are homogeneous), nodular (more dense nodules form in the thickness of the gland) and mixed.
Stages of development of the disease and a brief description
Sporadic goiter is accompanied by a gradual enlargement of the thyroid gland. Depending on the size of the organ, several degrees of development of the disease are distinguished:
- Zero degree - the gland is not palpable, its size is still within the normal range.
- First degree- at this stage, the gland is not visually distinguished, but its isthmus is visible during swallowing, it can be felt during palpation.
- Second degree - the thyroid gland is well palpable and visible during swallowing.
- Third degree - during this period, the thyroid gland is already clearly visible not only during swallowing, but also at rest. You can also notice a change in the contours of the neck (it looks thicker, a “second” chin appears).
- Fourth degree - the goiter is clearly visible, the shape of the neck changes.
- Fifth degree - an advanced form of the disease, in which the thyroid gland reaches a huge size. Often, an enlarged organ compresses the trachea and esophagus, preventing swallowing and breathing.
When drawing up a therapy regimen, the doctor must pay attention to the degree of gland enlargement.
Sporadic goiter: clinic and main symptoms
At the initial stages, the disease often does not manifest itself in any way - the person feels quite normal. But as the disease progresses, the thyroid gland begins to increase in size. At first, it can only be seen during swallowing, but the organ is constantly growing, which is accompanied by a change in the contours of the neck.
The increase in the volume of the thyroid gland affects the work of nearby organs. There is compression of the trachea, which is accompanied by the appearance of a dry cough, difficulty breathing. Patients complain of problems with swallowing. In some cases, hoarseness appears, which is associated with compression of nerve endings.
In elementarystages, the level of thyroid hormones is normal. But as the disease progresses, the amount of biologically active substances released may decrease or, conversely, increase. Hormonal disorders are fraught with the appearance of other disorders. For example, some patients develop tachycardia, hypertension, arrhythmia. Many patients complain of constant fatigue and drowsiness, irritability, muscle pain, swelling around the eyes. Symptoms include night sweats, intolerance to heat or cold, increased skin sensitivity, and constipation that persists even after a change in diet.
Diagnostic procedures
In most cases, patients go to the doctor already in the later stages of the disease. On palpation, the specialist may feel an increase in the thyroid gland. It is extremely important to collect a complete history (does the patient live in an iodine-deficient region, are there other cases of goiter in the family) and determine the cause of the development of the disease, because the success of therapy largely depends on this.
Mandatory ultrasound of the thyroid gland. This simple study makes it possible to determine the presence of nodes and cysts, find out the exact size of the organ, etc. An x-ray of the neck and chest is also performed, and sometimes computed tomography (makes it possible to see the degree of squeezing of the organs). The patient donates blood to determine the level of thyroid hormones. A biopsy is performed when a malignant neoplasm is suspected (most oftennodular goiter).
What does the treatment of the disease look like?
What should a patient who has been diagnosed with sporadic goiter do? Treatment depends on many factors. As a rule, suppressive thyroid therapy is carried out. Patients are prescribed Levothyroxine or another drug containing L-thyroxine. The dose and duration of therapy are determined individually.
In case of iodine deficiency or violation of its metabolism, the doctor additionally prescribes iodide (Antistrumin). An important part of therapy is the right diet. It is necessary to include foods rich in iodine and proteins in the diet, while limiting the number of foods that contribute to the development of goiter (in particular, radishes, swedes, peanuts, radishes, beans, cauliflower).
When is surgery indicated?
Medication helps to normalize the functioning of the thyroid gland, prevent its further growth and eliminate other disorders that accompany sporadic goiter. Surgery, however, is the only way to correct existing deformities. The decision to perform the operation is made by the attending physician if the overgrown organ compresses the trachea, blood vessels and nearby tissues. During the procedure, the surgeon removes excess tissue, restores the normal shape of the gland and neck.
Complications and possible consequences
In most cases, the disease responds well to treatment. Nevertheless, the danger exists. For example,sporadic goiter in children is fraught with impaired physical development and cretinism. If we are talking about the nodular form of hypertrophy, then there is always the possibility of malignant degeneration of cells.
The enlarged thyroid gland compresses the blood vessels, nerve endings, airways, significantly impairing the patient's quality of life. For example, people with grade VI and V hypertrophy are considered partially incapacitated - they are contraindicated in activities that require physical exertion.
Prevention measures
Sporadic goiter is a fairly common problem. And in this case, it is much easier to prevent the development of the disease than to worry about treatment later. Since the disease is sometimes associated with iodine deficiency, you need to monitor your diet, include iodized s alt, seaweed and other foods rich in this useful trace element in your diet.
Other risk factors should also be avoided, in particular the use of potentially dangerous drugs. Periodically, doctors recommend taking iodine-containing medications for prevention (in the event that the disease can be triggered by a deficiency of this substance in water and food). 1-2 times a year it is necessary to undergo examinations at the endocrinologist. If you have the slightest symptoms, you should immediately contact a specialist.
