Goitre is an abnormal enlargement of thyroid gland which can occur due to various reasons.

Goitre is a non-cancerous enlargement of the thyroid gland.

Thyroid gland is one of the largest endocrine glands located in front of the neck, below the larynx.

Several factors can cause goitre. These include iodine deficiency, Grave’s disease, Hashimoto’s disease, multi-nodular goitre or single non-cancerous nodules.

Human chorionic gonadotropin hormone secreted during pregnancy may cause the thyroid gland to enlarge slightly.

Inflammation of the thyroid gland can bring about swelling in the thyroid.

Goitres can be present at birth but they are more common after the age of 50.

Women are more prone to goitres. People who lack dietary iodine are at a risk of goitre.

A family history of autoimmune disease can increase your risk.

Other risks include pregnancy, menopause, certain medications such as immune-suppressants, certain heart and psychiatric drugs etc. Radiation exposure can also increase your risk.

Common symptoms of goitre

  •         Swelling of thyroid gland
  •         Depression
  •         Loss of concentration
  •         Emotional disturbances
  •         Anxiety
  •         stress
  •         Increased irritability
  •         Difficulty in swallowing
  •         Difficulty in breathing
  •         Constipation
  •         wheezing
  •         Headache
  •         Neck pain
  •         Tachycardia
  •         Weakness and fatigue
  •         dizziness
  •         Weakness of memory
  •         Increased sweating especially on palms
  •         Impaired growth
  •         Dryness and thickness of skin
  •         Tightness in throat
  •         Hoarseness of voice
  •         Coughing

 

 

Types-

 

SIMPLE GOITRE:-

 

This is the term used to describe diffuse or multi-nodular enlargement of the thyroid which occurs sporadically and is of unknown etiology. It is likely, however, that suboptimal dietary iodine intake, minor degrees of dyshoromonogenesis  are important in the development of simple goitre. Affected patients are euthyroid, usually female and often have a family history of goitre.

 

SIMPLE DIFFUSE GOITRE:-

This form of goitre usually present between the ages of 15 and 25 years, often during pregnancy, and tends to be noticed not by the patient but by friends and relatives.

Occasionally, there is a tight sensation in the neck, particularly when swallowing.

The goitre is soft and symmetrical and the thyroid is enlarged to 2-3 times normal size. There is no tenderness, lymphadenopathy or overlying bruit.

Concentrations of T3, T4 and TSH are normal and no thyroid autoantibodies are detected in the serum.

No treatment is necessary and in most cases the goitre regresses. In some, however, the unknown stimulus to thyroid enlargement persists and as a result of recurrent episodes of hyperplasia and involution during the following 10-20 years the gland becomes multinodular with areas of autonomous function .

 

SIMPLE MULTINODULAR GOITRE:-

Presentation is rare before middle age. The patient may have been aware of goitre for many years, perhaps slowly increasing in size.

Rarely painful swelling lasting a few days caused by haemorrhage into a nodule or cyst is told. The goitre is nodular or lobulated on palpation and may extend retrosternally.

Very large goiters may cause mediastinal compression with stridor, dysphagia and obstruction of the superior vena cava.

Hoarseness due to recurrent laryngeal never palsy can occur but is strongly suggestive of thyroid carcinoma.

Serum t3 and t4 are normal and in the majority are associated with normal TSH.

Radiograph of the thoracic inlet may show tracheal displacement or compression, intra thyroidal calcification and the extent of  retrosternal  extension.

 

INVESTIGATIONS:-

It is important to measure serum T3,T4 and TSH in all patients with a solitary thyroid nodule. The finding of undetectable TSH is very suggestive of an autonomously functioning thyroid adenoma which can only be confirmed by thyroid isotope scanning.

THYROID FUNCTION TESTS

1) SERUM T4- The normal range varies from 4-8 microgram/ dl. The level is usually raised in toxic goiters, low in hypothyroidism.

2) SERUM T3- The normal range varies from 150-250 ng/ dl. Toxic goiters show considerably raised levels.

3) SERUM TSH- The normal level is about 5 microunit/ ml. It is raised in hypothyroidism and almost undetectable in thyrotoxic goiters.

4) SERUM PROTEIN BOUND IODINE- The normal range varies from 3.5-8 microgram/dl.

5) T3 RESIN UPTAKE

6) IODINE 131 UPTAKE TEST- The rate at which the thyroid traps iodine reflects the rate of secretion of thyroid hormones. In hyperthyroidism the rate is increased.

7) THYROID SCAN- Scanning with a tracer dose will show which part of the gland is functioning or which is not (hot or cold). I131 and T99 are used.

8) RADIOGRAPHY- Helps to diagnose the position of trachea, retrosternal goiter etc. In case of carcinoma the bones should be X-rayed for evidence of metastasis. Barium swallow X- ray will indicate pressure effect on oesophagus.

9) FINE NEEDLE ASPIRATION CYTOLOGY-Thyroiditis, colloid nodule, benign and malignant tumours can be diagnosed.

10) MISCELLANEOUS TESTS- These include BMR, serum cholesterol, ECG, measurement of tendon reflexes etc.

 

Homeopathic  treatment

Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach.

Homoepathic medicines play an important role in immuno modulation at the cellular level

This is the only way through which a state of complete health can be regained by removing all the sign and symptoms from which the patient is suffering. The aim of homeopathy is not only to treat goitre but to address its underlying cause and individual susceptibility. As far as therapeutic medication is concerned, several remedies are available to treat goitre that can be selected on the basis of cause, sensations and modalities of the complaints.