The thyroid gland plays a very important role in the human body. Relating to the endocrine system, the body takes part in the regulation of energy metabolism. Its two lobes are connected by an isthmus, located on the sides of the trachea. The energy entering the body is distributed between the cells, but if it is not enough, thyroid hormones intervene. If the deficiency is constant, a certain tissue change occurs and goiter disease develops. There are several forms and degrees of the disease, which differ in causes and symptoms. Any kind of pathology requires diagnosis and treatment.
Thyroid goiter
The mechanisms of formation of neoplasms in the thyroid gland have not yet been sufficiently studied. The methods of treatment known in medicine today may not always be effective enough and cure the pathology completely.
Thyroid tissue is made up of follicles –spherical cells. Violations in the body associated with organ dysfunction lead to deformities. Multinodular goiter of the thyroid gland causes changes in certain areas, and diffuse - throughout the tissue. In addition to an increase in follicles, the disease can be characterized by the appearance of cystic formations (cystic-nodular goiter). The progression of the pathology can lead to the degeneration of nodes into malignant ones.
Reasons
Goiter is a disease that includes various damage to the thyroid gland. There are several types, forms and degrees of pathology, which differ in the nature of the course, causes and symptoms. The main reason for the development of toxic endemic goiter is a lack of iodine in the body, which reduces the secretory activity of the thyroid gland. Poor ecology also affects the functioning of the thyroid gland. Incoming toxic substances from outside can slow down the activity of the thyroid gland, suppressing the work of the endocrine system.
Insufficient intake of iodine-containing foods (milk, fruits, fish) can also cause goiter. The causes of the development of the nodal type of the disease are a cancerous process of the thyroid gland or adenoma. Differentiation and division of cells in this case occurs under the influence of toxic substances, radiation, and may be hereditary.
Basedow's pathology occurs as a result of the influence of special antibodies of the immune system on the organ. Treatment consists of taking drugs that inhibit the production of hormones, sometimes the problem is solved bysurgery.
Symptomatics
Goiter is a disease that does not manifest itself in the initial stages, and the patient may not even be aware of its presence. Only in connection with a significant increase in the thyroid gland, a certain clinical picture develops. Symptoms of thyroid disease are characterized by swelling in the front of the neck and compression of adjacent tissues. At the same time, patients complain of the appearance of a dry cough, hoarseness of voice, a sensation of a "coma in the throat", and shortness of breath. When the head moves, there is a feeling of tension and dizziness, which is associated with clamping of the vessels of the neck. Swallowing is impaired to some extent due to compression of the esophagus. Nodules of various sizes appear on the thyroid gland. What to do in such situations is to consult a doctor at the first suspicion.
With the development of pathology due to iodine deficiency, the clinical picture is supplemented by other symptoms associated with hypothyroidism: flatulence, frequent respiratory diseases, low blood pressure. With thyroid adenoma or Graves' disease, signs of hyperthyroidism appear: weight loss, irritability, hand tremors, hunger, fever.
Diffuse euthyroid goiter
Pathology develops as a result of iodine deficiency. The compensatory nature of hyperplastic and hypertrophic processes in the thyroid gland is aimed at providing the body with a sufficient level of thyroid hormones. Adaptive mechanisms to iodine deficiency are associated with the reutilization of endogenous iodine, a decrease in the secretion of iodide by the kidneys,synthesis of triiodothyrosine, enhanced uptake of iodine by the thyroid gland. In this way, the body compensates for iodine deficiency, but thyroid hypertrophy develops, which ensures the preservation of thyroid function. Euthyroid goiter can complicate its course as a result of exposure to factors such as excess calcium, lack of trace elements (molybdenum, copper, cob alt, selenium, zinc, manganese), certain medications, chronic infections, emotional stress, smoking.
In most cases, clinical manifestations do not develop, since this disease practically does not affect the function of the thyroid gland. Sometimes in the patient's condition one can observe general weakness, fatigue, increased fatigue. An increase in the thyroid gland is to a large extent accompanied by a visible cosmetic defect and a feeling of pressure in the neck. Other symptoms of thyroid disease are associated with hypertrophy of the organ, which can cause serious complications: inflammation of the gland, hemorrhages, compression of the esophagus, trachea. Against the background of this pathology, other, more complex types of goiter may develop.
Diffuse toxic goiter
In middle-aged women predominantly occurs diffuse toxic goiter. This disease is much less likely to affect children and the elderly. It is not yet completely established what factors affect the development of pathology, but most representatives of medicine consider genetic defects to be the main cause, as a result of which the system is disturbed in the immune system.regulation of antibody production. These disorders lead to the production of antibodies against the tissue of the patient's own thyroid gland. Genetic defects in this case are not an absolute predisposition, but a statistical pattern, that is, the child will not necessarily be sick if one of the parents has a goiter disease.
Rarely enough, with this pathology, the thyroid gland increases in volume. Eye enlargement occurs in 30% of patients (Graves' ophthalmopathy, endocrine ophthalmopathy, exophthalmos). The main symptomatology in diffuse toxic goiter is associated with an excess of hormones produced by the thyroid gland. Due to the excessive activity of hormonal effects in the patient, the functions of the heart are disturbed, up to the development of arrhythmia. Increased metabolic processes lead to weight loss. Patients may experience signs such as poor sleep, tearfulness and weakness, irritability, tremors.
Nodular goiter
Nodular goiter is a series of pathologies with one common feature - the formation of nodes in the thyroid gland. After suspecting the development of the disease, the patient needs to undergo a series of examinations to determine the degree and type. If more than one node is found in a patient, then a multinodular thyroid goiter is diagnosed. The most common manifestation of pathology is a colloid euthyroid goiter. Symptoms as such do not occur, but defects appear in the neck area, up to deformation. Along with pain, complications appear, which indicates the rapid growth of formations:hemorrhages in the node, the appearance of inflammation, while the thyroid gland increases even more. Large nodules can compress the trachea or esophagus, which is accompanied by impaired breathing and swallowing.
The development of nodular goiter is facilitated by factors such as genetic predisposition, chronic viral and bacterial infections, drugs, goitrogenic food factors, and environmental factors. The main reason is the lack of iodine in the body. It is not necessary to bring the disease to a neglected state. Contact your doctor immediately if you feel knots on the thyroid gland. What to do next, how to get rid of them and avoid complications - this can be found out at a specialized consultation after a full range of examinations. Only after that you can take some measures and prescribe treatment.
Degrees
The degree of nodular goiter is determined based on how enlarged the thyroid gland is. Nodes can be of different sizes and in different quantities. To date, there are two classifications of nodular goiter by degrees. The first - according to Nikolaev. There are 5 groups here. With a zero degree, the thyroid gland is not visible and it is not felt on palpation. At the first - it is not visible, but palpable. The second degree is characterized by a visible manifestation of the gland during swallowing. With the third, the contour of the neck increases and thickens. The fourth is manifested by an already obvious goiter, which violates the configuration of the neck. The fifth, last, degree of the disease is fraught with complications. The huge size of the thyroid gland leads to squeezing of neighboring organs, which disrupts the functionsrespiratory, cardiovascular and gastrointestinal systems.
According to the WHO classification, there are three (zero, first and second) degrees of the disease. At zero there is no goiter, the first one is not visible, but it is palpable and at the second degree the goiter is felt, and it is visible to the naked eye. If the initial stages of the development of pathology do not carry a visible danger to the body, then the progression of the disease can lead to serious consequences, because goiter is a fairly serious disease that, in addition to external changes, negatively affects the functioning of all systems and organs.
Diagnostic Methods
Primary examination of the patient is carried out with the help of palpation. If a neoplasm was detected, an ultrasound examination is prescribed to determine the volume of the thyroid gland and the exact size of the neoplasm. Fine-needle aspiration biopsy is performed when the size of the formation exceeds 1 cm, or there is a suspicion of a malignant tumor. Ultrasound combined with a biopsy increases the information content of studies.
Thyroid goiter, when located retrosternally and with large sizes, can shift towards the respiratory tract, which causes complications. To prevent this, an x-ray with a contrasted barium of the chest and esophagus is prescribed. Magnetic resonance imaging is used to study retrosternal goiter in detail. Normally, she is not assigned.
How to treat a goiter
Treatment of goiter can be conservative and operative. The first option is used if it has been diagnoseddiffuse, nodular, multinodular goiter of the thyroid gland. An absolute contraindication to surgery is also the reason for the use of conservative treatment. It consists of several steps. First, you need to review your diet and replace it with a balanced one. Sanitary and hygienic conditions also need to be improved. Here they can prescribe treatment at a specialized resort. Important components of conservative treatment are: normalization of the functions of the liver and intestines, sanitation of foci of chronic infections, normalization of iodine metabolism in the body. The latter is achieved by taking such drugs: Triiodothyronine, Thyroidin, Tireotom, Thyreocomb.
Surgical treatment is prescribed if there are indications for surgery: diffuse goiter IV and V degree, diffuse goiter III degree, which is not amenable to conservative therapy, mixed and nodular goiter, if the thyroid gland is enlarged. The goiter is removed in two ways: hemistrumectomy and lobe resection. Surgery is performed by a surgeon under the close supervision of an endocrinologist. It is also possible to treat goiter with folk remedies. The most tested and effective way is the use of elecampane grass. An infusion of vodka is prepared from it and used to gargle until completely cured.
Goitre prevention
In order not to encounter goiter disease, you need to provide yourself with conditions under which the disease cannot develop. We are talking about prevention, which in this case can be mass, group, individual. Bulk is to applyiodized s alt, which contains 25 grams of potassium per 1 ton. This technique is especially important in areas of increased risk of developing iodine deficiency. Group prophylaxis is carried out with the help of the drug "Antistrumin". It is used in military units, children's and school groups at a dose of 1 tablet per week. Patients who arrived in the area with iodine deficiency are also prescribed Antistrumine.
Specific prevention should be carried out in conjunction with the elimination of aggravating factors with the help of a number of sanitary and hygienic and social measures (the fight against intestinal infections, the sanitary culture of the population, the prevention of hypovitaminosis, a balanced diet, improving housing conditions).
