Goiter is characterized by an increase in the volume of the thyroid, a gland whose role is to regulate the body. How to recognize the beginning of goiter? What are the causes of this swelling? What treatments to reduce it? Advice and pictures.
Definition: what is a goiter?
THE goitre corresponds to theenlarged thyroid. “It is an endocrine gland, shaped like a butterfly and located in the anterior part of the neck, whose role is toensure the secretion of thyroid hormones, explains Dr. Monique Quillard, general practitioner. The latter play a regulatory role within the body, particularly in terms of growth and activation of the metabolism.. We distinguish several types of goiter :
- endemic goiter (common in mountainous regions),
- multinodular goiter,
- epidemic goiter,
- compressive goiter (which compresses nearby organs)
- metastatic goiter (tumor)
- plunging goiter.
What is a sinking goiter?
A goiter is said to be “dipping” when it descends partly into the thorax. Plunging goiter is often associated with a change in thyroid hormonesespecially a elevation. This type of goiter is said to be compressive because it can give respiratory signs, in particular a discomfort due to compression exerted on the trachea. Plunging goiter can be caused by a lack of iodineby certain medications or by a thyroid inflammation. He requires surgery to usually remove the entire thyroid gland.
It is recognized by the fact that the neck begins to swell. But when it is really swollen, the goiter is already at an advanced stage. In addition, this swelling can cause, by compression of neighboring organs, difficulty breathing, difficulty swallowing (dysphagia) and voice disorders.
Photo of a goiter
What causes goiter to form?
Goiter can be caused by:
- an imbalance in the synthesis of thyroid hormones,
- a deficiency in iodine, a trace element necessary for the synthesis of thyroid hormones and found mainly in shellfish and sea salt,
- a condition of the gland (thyroiditis, Graves’ disease, etc.)
- a tumor.
What are the consequences of a goiter?
Some complications can be the consequences of its volume gain: voice modification with paralysis of a vocal cord, swallowing and breathing disorder, venous compression…”Added to this are the complications related to hormonal dysfunction of the thyroid: weight loss, tachycardia, tremor, anxiety, diarrhea in case of hyperthyroidism or weight gain, depression, fatigue and constipation in case of hypothyroidism“, says Dr. Quillard.
When and who to consult?
As soon as you notice a thickening of your neck, make an appointment with your doctor. If necessary, he will refer you to an endocrinologist.
Diagnosis of goiter
The diagnosis is made after observation and palpation of the neck. The doctor will then prescribe additional tests to confirm it and to find the cause. A thyroid scan and ultrasound will be carried out. Thyroid hormone blood test is carried out during this assessment. The blood assay for antibodies that may suggest an autoimmune disease is also performed, such as that for anti-TPO, the most significant markers of thyroid autoimmunity.
What treatments to reduce goiter?
The treatment will depend on the origin of the formation of the goiter. If iodine deficiency is involved, the administration of this trace element will reinitiate the synthesis of hormones ; treatment with synthetic antithyroid drugs in case of excess secretion will be prescribed; sometimes more radical treatment with use of radioactive iodine to destroy part of the hypersecreting gland will be proposed. In certain hyperthyroidisms, partial or total removal of the thyroid gland will be necessary. Finally, substitute treatments (synthetic hormones), in the event of a defect in the synthesis of thyroid hormones, may be offered.
What is a goiter operation?
In the event of treatment failure or if the volume is very large, surgery may be proposed. It consists of partial or total removal of the thyroid. This surgery is performed under general anesthesia and lasts about 1h30. The surgeon makes a small incision at the base of the neck and proceeds with the resection of the organ. “The postoperative course is not very painful and easily relieved by analgesic treatment, a temporary change in the voice (hoarseness) can be seensays Dr. Quillard. On the other hand, the neck may remain swollen for a few days, hampering the movements of the head“Food can be resumed the day after the operation.”Hormonal treatment will often be necessary in the weeks that follow, especially in the event of total removal of the thyroid.”adds our expert.
Thanks to Dr Monique Quillard, general practitioner.