Endemic goiter - Causes, symptoms and treatment. MF.

Endemic goiter is an enlargement of the thyroid gland that changes the shape of the neck, which develops due to a lack of iodine in people living in areas with iodine deficiency in the environment.

Iodine - a microelement necessary for the formation of thyroid hormones - thyroxine and triiodothyronine. Iodine enters the body with food, water, air.90% of the daily requirement for iodine is provided by food, 4-5% - water, and about 4-5% - with air. Iodine is found in fish, meat, sea kale, shrimp and other seafood, milk and dairy products, mineral water, iodized salt, buckwheat and oatmeal, beans, lettuce, beets, grapes, milk chocolate, eggs, potatoes.

Endemic goiter is an enlargement of the thyroid gland, altering the shape of the neck, which develops due to a lack of iodine in people living in areas with iodine deficiency in the environment.

The disease affects large populations in geographic areas in which iodine deficiency in the environment is observed.

The degree of enlargement of the thyroid gland.

Degrees of development are determined by the size of the thyroid gland, which is the main clinical sign.

• 0 degree - the thyroid gland is not visible and is not detected during palpation;
• 1 degree - the thyroid gland is not visible on examination, the legs pri probe during swallowing is determined;
• 2nd degree - the thyroid gland is visible on examination during swallowing, well defined by palpation, but does not change the shape of the neck;
• 3 degree - enlarged thyroid gland changes the shape of the neck in the form of a "thick neck";
• 4 degree - the thyroid gland is visible on examination and changes the shape of the neck in the form of a prominent goiter;
• 5 degree - an increase in the thyroid gland leads to compression of the trachea, nerves, vessels, esophagus, etc.

Symptoms of endemic goiter

Diffuse( uniformly enlarged thyroid gland), nodular( presence of a mass of gland nodes) and mixed goiter( when along with diffusean increase in the thyroid gland is felt for individual nodes).By location, goiter can be unilateral( defeat in the region of one lobe) and bilateral( the defeat of both lobes).

Over the years, as the growth grows, goiter begins to exert pressure on neighboring organs - the trachea and esophagus, resulting in difficulty in breathing and swallowing.

The compression of the veins of the neck leads to a violation of blood circulation: an expansion of the veins of the neck and vessels of the chest, a sense of tension in the head with tilts, a puffiness of the face.

Infringement of breath and stagnation in a small circle of blood circulation( passage of blood through the lungs), caused by the compression of the vessels, leads to the development of the "goitrous heart" - the expansion and expansion of its right divisions.

The pressure of goiter on the nerves can cause hoarseness, enlargement of the pupil, a change in the eye gap, a violation of sweating.

Depending on the state of thyroid function, euthyroid, hyperthyroid and hypothyroid goiter are distinguished.

The most common is euthyroid.

Causes of endemic goiter

The most likely factor contributing to the development of goiter is the lack of iodine in water, soil, and therefore in plants and animal organisms in those areas that are the focus of endemic goiter. In such areas, an increase in the thyroid gland is usually seen from early childhood and sometimes does not give any clinical symptoms. A confirmation of the theory of iodine deficiency is the fact that when iodine enters the body its symptoms disappear.

There is an absolute iodine deficiency( deficiency of iodine intake with food and water) and relative, i.e.iodine deficiency is associated with diseases of the gastrointestinal tract, in which there is a violation of iodine absorption in the intestine, congenital disorders of hormone production by the thyroid gland.

With chronic iodine deficiency, the pituitary gland is activated, which stimulates the thyroid gland function, which leads to the overdevelopment of individual areas( the formation of cysts( a pathological cavity in the body filled with liquid contents) and nodes).

1. As with many endocrine diseases, a hereditary predisposition to goiter is one of the most dangerous factors.
2. A possible cause may be genetic defects in the formation of thyroid hormones, i.e.hormones are formed, unable to perform their functions.
3. Pollution of water by chemicals that hinder iodine absorption.
4. Use of drugs that block the movement of iodine into the thyroid gland.
5. Presence of food products in the diet.
6. Influence of infectious and inflammatory processes, especially chronic, helminthic invasions, unsatisfactory sanitary and hygienic norms and social conditions.

Complications of endemic goiter

Complications develop mainly with a significant increase in the thyroid gland in volume and are manifested in the following:

• compression of the esophagus, trachea, adjacent nerves and vessels;
• because of the compression of the vessels that depart from the heart, there can be an increase in the function of the heart and expansion of its right divisions - a so-called "goat heart" is formed.
• Hemorrhage in the thickness of the thyroid gland;
• Strumit - an inflammation of the enlarged thyroid gland, clinically similar to subacute thyroiditis;
• Malignant degeneration of the thyroid gland.

Treatment and prevention of endemic goiter

Treatment at the initial stages of the disease is the introduction of iodine in the form of drugs. In the presence of development of hypothyroidism, the hormones of the thyroid gland are forced, and these drugs not only stop the symptoms of thyroid insufficiency, but also reduce the increased activity.

For prophylactic purposes, the widespread use of iodized salt, bread, the appointment of potassium iodide in the form of tablets, etc. is shown. To prevent disease, you must eat foods that contain iodine.