Nodular Goiter

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

A goiter is an enlargement of the thyroid gland. In the case when there are nodules in the thyroid gland, they speak of a nodular goiter. Nodular goiter is the most common pathology of the thyroid gland, it occurs in 5% of the population, and according to experts, if we take into account the latent forms of nodular goiter, which are sometimes revealed by accident during examination for another reason, this figure can be safely doubled. Women are prone to nodular goiter four times more than men.

Nodular goiter is a group of diseases, united by a common feature - the presence of nodes in the thyroid gland. The fact is that the tissue of the thyroid gland is formed by many follicles, each follicle is a microscopic cell ball containing a substance in a colloidal form inside. A thyroid nodule is an enlarged follicle - a single, multiple (multinodular goiter), several enlarged follicles welded together, a follicular cyst or a tumor arising from a follicle (adenoma, including malignant).

Causes of nodular goiter

The causes of nodular goiter are still unknown. It is generally believed that living in areas with a reduced iodine content in the water (endemic goiter) is important, but medical statistics indicate that thyroid nodules form in people living in areas with a normal iodine content only slightly less frequently. Therefore, if low iodine content is far from the only cause of nodular goiter.

An increase in follicles and the formation of cysts occurs in response to changes in the body, which increase the load on the thyroid gland. This happens with various diseases, hereditary predisposition, as well as the influence of certain environmental factors, especially stress. Some experts consider forms such as colloidal proliferating nodular goiter as an age-related change in the thyroid gland.

Types of nodular goiter

Depending on the origin, composition and cause of nodular goiter, the following types are distinguished:

Endemic nodular goiter;
Solitary node (single node of the thyroid gland);
Multinodular goiter (many thyroid nodules);
Conglomerate nodular goiter (conglomerate of nodes welded together);
Diffuse-nodular goiter (nodes formed in an enlarged thyroid gland);
True thyroid cyst;
Follicular thyroid adenoma (benign tumor);
Malignant tumor of the thyroid gland.

Grades of nodular goiter

Depending on how enlarged the thyroid gland, the degree of nodular goiter is determined. Earlier, the classification of the degrees of nodular goiter according to O. V. Nikolaev, in 1994, the World Health Organization proposed a new classification. However, in clinical practice, both the Nikolaev classification and the WHO classification are currently used, therefore we will give both.

The degree of nodular goiter (and goiter in general) according to Nikolaev:

0 degree - the thyroid gland is not visible and not palpable;
1 degree - the thyroid gland is not visible, but palpable;
Grade 2 - the thyroid gland is visible during swallowing;
Grade 3 - the thyroid gland enlarges the contour of the neck, making it thick;

Grade 4 - an obvious goiter that violates the configuration of the neck;
Grade 5 - the thyroid gland reaches enormous size and squeezes the adjacent organs.

The degree of nodular goiter (and goiter in general) as defined by WHO:

0 degree - no goiter
Grade 1 - the size of the lobes (or one lobe) is larger than the distal phalanx of the patient's thumb. The goiter is palpable, but not visible.
Grade 2 - the goiter is palpable, visible by the eye.

Symptoms of a nodular goiter

As a rule, there are no symptoms of nodular goiter. This is more true for the most common form, nodular colloid proliferative goiter, as well as for thyroid cysts. In this case, the only symptoms of a nodular goiter are the formations themselves, nodes and cysts, as a rule, the patient is not worried about anything. If the nodes reach significant sizes, complaints of a cosmetic defect or a feeling of compression of the neck may appear.

If we are talking about diffuse nodular goiter, then the symptoms of nodular goiter coincide with the symptoms of thyrotoxicosis: nervousness, weight loss with an increased amount of food intake, tachycardia, etc.

In general, it can be said that in all cases, except for colloid proliferative nodular goiter, and follicular cysts of the thyroid gland, the symptoms of nodular goiter correspond to the symptoms of the underlying disease that caused the formation of nodules.

Diagnostics of the nodular goiter

The diagnosis of nodular goiter is based on thyroid examination findings. For this, the following methods are used:

A blood test for the content of thyroid hormones;
Fine-needle puncture biopsy of the thyroid gland (TPB);
Radioisotope scanning of the thyroid gland;
Computed tomography (CT) or magnetic resonance imaging (MRI) of the thyroid gland are the most expensive, but also the most informative methods of examination.

Treatment of nodular goiter

Treatment of nodular goiter is carried out depending on the cause of the appearance of nodules in the thyroid gland. Most experts believe that the treatment of a nodular goiter in the form of a nodular colloid proliferative goiter is not required, in this case, dynamic monitoring of the state of the thyroid gland is prescribed, and treatment is prescribed only when the nodes show a tendency to grow for a short time.

Treatment of nodular goiter can be medication and surgical, the choice of the method is made by the attending physician. Drug therapy is carried out with drugs that suppress the excessive production of thyroid hormones. One of the effective methods of treating nodular goiter is the introduction of radioactive iodine preparations into the thyroid gland, which helps to reduce or even disappear the nodes and restore the normal size of the gland.

Surgical treatment of a nodular goiter consists in removing the nodes, and if there are special indications, for example, a malignant tumor, in removing one lobe or the entire thyroid gland.

Treatment of nodular goiter with folk remedies

Before starting the treatment of nodular goiter with folk remedies, you should definitely visit an endocrinologist, since in some forms the treatment can only be surgical, and by self-medication, precious time can be lost.

Treatment of nodular goiter with folk remedies is an excellent way to maintain health in the interval between taking drugs, or with a colloidal proliferative form of the disease, when drug treatment is not required.

In general, the treatment of nodular goiter with folk remedies is aimed at correcting the iodine content in food. A good way to do this is in the recipes below:

1. Take 1 kg of fresh black chokeberry berries, mix with 1 kg of sugar, grind thoroughly. Take the resulting mixture 3 times a day for 1-2 tsp.

2. Eat 50-100g of seaweed daily, or take a teaspoon of powder from it.

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The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!