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;
- Problems with thyroid function (hypo or hyperthyroidism)
- Sporadic non-toxic
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