Goitre

Original article by Tom Leach and Hazel Polge | Last updated on 19/5/2014
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Goitre - enlarged palpable thyroid gland, moves on swallowing
  • Best way to assess is via USS
  • Not necessarily indicative of disease
  • Simple Goitre - normal level of hormones, no treatment necessary
  • Multinodular Goitre - progresses with age, secrete autonomously, many nodules can cause hyperthyroidism
  • Most common causes;
 
Endemic – when over 5% of the children in a population have a goitre (can exceed 30%)
  • Affects over 200 million people worldwide, caused by iodine deficiency or ‘goitrogens’ (chemicals found in food that exaggerate the effects of iodine deficiency eg. Cassava, selenium, cabbage). 
  • Usually diffuse goitre, becoming nodular with age, rarely compressing.
  • Treated with iodine supplements, iodized salt/water
 
Sporadic – unknown cause
  • 5% population, M:F – 1:4. Incidence declines with age.
  • Usually changes from diffuse to multinodular. TSH levels are normal. Nodules from an entire follicle rather than a single cell. Mostly visible, with compression on the neck.
  • Should be left alone unless causing pain or significant compression