Enlargement of Thyroid
Thyroid hormone affects all cells in the body and controls most of the body functions. The pituitary gland and hypothalamus in the brain regulate amount of thyroid hormone which is produced by the thyroid.
The pituitary gland releases thyroid stimulating hormone (TSH) which directs the thyroid to produce more thyroid hormone. By detecting the correct amount of thyroid hormone in the body, pituitary gland decreases the production of hormone.
The thyroid may be enlarged if the production of thyroid hormones is altered which is what happens in most cases. If the enlarged thyroid produces more hormones, it is called hyperthyroid (hyperthyroidism). Hyperthyroidism is hyperfunction of the thyroid gland. If the thyroid produces too few hormones, it is called hypothyroid struma (hypothyroidism: hypofunction of the thyroid gland).
The enlargement of the thyroid gland may be diffuse or nodular, so it is referred to diffuse goiter and nodular goiter. if there are many nodules, it is called multinodular goiter.
Depending on the thyroid gland is swollen, the following degrees of goiter are distinguished:
Grade 0: Enlargement of the thyroid can only be checked by ultrasound. Enlargement of the thyroid is not visible or palpable.
- Grade I: Enlargement of the thyroid is palpable, but not visible.
- Grade II: Enlargement of the thyroid is visible and palpable.
Enlargement of Thyroid Causes
Enlargement of the thyroid causes may be several. The most common cause of enlargement of the thyroid is lack of iodine: the thyroid gland needs iodine to produce thyroid hormones T3 (triiodothyronine) and T4 (thyroxine). This is called iodine deficiency goiter which occurs mainly when iodine is not taken enough through the diet.
Other causes of the goiter are inflammations of the thyroid. These are often accompanied by hypothyroidism (hypofunction of the thyroid gland). Thyroid cancer is another possible cause of goitre. However, thyroid tumors are uncommon and depend on the type and stage of the tumor. In most cases, they have have a good prognosis.
Enlargement of Thyroid Diagnosis
If the thyroid gland is enlarged in the case of goiter, it is important to get an accurate diagnosis. To find out why the thyroid gland is enlarged, the doctor first asks some questions. The doctor also asks if there are any other discomforts (such as discomfort during swallowing, breathing problems, exhaustion) and if you have previous illnesses.
Physical examination is also very important to diagnose goiter. During the procedure, doctor looks closely to neck and inspects the swelling. By palpation, doctor estimates the size, consistency, and mobility of the thyroid. In addition, check for nodules and touch of the skin over the thyroid. The doctor then measures the perimeter of the neck. Ultrasound is also often helpful in assessing the size, possible nodules, and other changes in the thyroid gland. If there are nodules, it is appropriate to perform a thyroid scintigraphy which allows the doctor to determine if the nodules are “hot” with hormonal activity, or “cold” (no hormone production).
doctor analyzes the blood in order to check above all the amount of thyroid hormones T3 and T4, as well as the hormone that stimulates the production of thyroid hormones (TSH) to diagnose the goiter. If necessary, other blood tests should be performed. Depending on the outcome of the previous diagnosis, additional examinations, such as x-rays and a CT scan will be necessary.
Enlargement of Thyroid Treatment
The treatment of enlargement of the thyroid gland depends on the underlying causes of the condition. If iodine deficiency causes enlargement of the thyroid and the amount of thyroid hormones in normal blood (euthyroid iodine deficiency), doctor prescribes iodine tablets (iodide treatment). In addition, an iodine diet (fish, iodized cooking salt) is recommended. However, if iodine intake is not sufficient to treat goiter, additional thyroid hormones (iodine-thyroxine tablets) may be taken. Periodic check-ups of thyroid values (blood tests) and their size (ultrasound) are important in the treatment of the goiter or enlargement of the thyroid.
If goiters are very large and have many nodules or are suspected of having thyroid cancer, surgery may be necessary. Depending on what the surgeon finds, it removes parts of the thyroid gland or the entire organ. If the thyroid is complete, those affected should take thyroid hormones in the form of pills for life.
As an alternative to the operation, in some cases (eg, hypothyroidism, thyroid cancer) the possibility of radiation (radioactive iodine treatment) is considered.