Endemic goiter can develop due to insufficient intake of iodine in the body. The development of pathological deviation is facilitated by genetic and autoimmune factors. Also, the emergence of endemic goiter can occur due to long-term use of drugs that interfere or restrict the transport of the necessary amount of iodine into the cells.
Symptoms and Diagnosis of Endemic goiter
This disease, caused by a lack of iodine in food, is characterized by the growth of the thyroid gland to considerable size and the formation of nodes in it.
The mechanism of development of endemic goiter is very simple. Due to the lack of iodine in food and water, the production of thyroid hormones gradually decreases. The level of hormones in the blood drops, the feedback mechanism works, and the pituitary gland starts to hyperstimulate the gland, producing large doses of TSH.Under its long-term action, the tissue of the gland expands, trying to "take not by quality, but by quantity."Since this growth occurs unevenly, nodes form in the gland.
Symptoms. Patients complain of a sensation of interference on the neck, difficulty swallowing. Later, the gland expands to such a size that it becomes visible to the naked eye. She puts so much pressure on the trachea, especially during sleep, that the sick begin to worry about suffocation. Simultaneously, since the gland can not perform its function, the symptoms of hypothyroidism develop. Another symptom of endemic goiter is autoimmune ophthalmopathy.
Diagnostics. In the blood, as with any hypothyroidism, a low content of thyroxine and triiodothyronine is found, a high level of thyroid-stimulating hormone and cholesterol. It is very important to distinguish endemic goiter from autoimmune thyroiditis when diagnosing, as with autoimmune thyroiditis, medications containing iodine can be harmful. In order to conduct differential diagnosis of endemic goiter and autoimmune thyroiditis, the radioiodine absorption curve and the urinary iodine content assay are assigned. The capture curve is high and does not decrease during the entire analysis. The low content of iodine in the urine indicates its lack of food.
Treatment and prevention of endemic goiter
Treatment. To treat endemic goiter, thyroid hormones are prescribed in combination with microdoses of iodine. With nodular goiter and severe compression of the trachea, surgical treatment-removal of part of the thyroid gland is indicated. After the operation, hormonal treatment is still prescribed.
Prevention. If you live in an area where people are massively ill endemic goiter, which indicates a lack of iodine in food and water, you need to eat foods that contain a large amount of iodine or fortified with iodine specifically.
But do not start this prophylaxis of endemic goiter before visiting a doctor, since with autoimmune thyroiditis, the symptoms of which may be similar to the symptoms of endemic goiter, such prevention will do more harm than good.
The daily requirement for iodine for an adult is about 150 micrograms per day.
In some periods of life, this need may increase;Thus, the daily requirement for iodine during pregnancy and lactation is 180-250 micrograms per day.
The need for iodine is satisfied mainly by products of plant origin. On average, a person receives 70-75 micrograms with plant food, 35-40 micrograms from animal food, and 5 micrograms with water.