Goiter (thyroid gland)

What is the thyroid gland?

Thyroid or thyroid gland is situated in neck under the so – called cartilage Adams apple. It secretes 2 hormones named triiodertyonine (T3) and tyroxine (T4) connected with the energy used by the body and with the energy storage.

What is the goiter?

Goiter is the growth of the thyroid gland. And the partial growth inside the thyroid gland is called the node. The growth of the thyroid gland sometimes does not cause functional disorder. At the same time, functional disorder of the thyroid gland cannot be seen with the goiter.

Hypothyroidism (A decrease in the function of thyroid gland):

This is the most seen thyroid disease. It happens more to women, when the age increases, possibility of coming across to this disease becomes more. It has genetic features.

Symptoms:

• Tiredness
• Inactivity
• Gaining weight
• Oppilation
• Dryness in skin and hair
• Disorder in menstrual cycle.
• Mental development delays

All of these traits may not exist in the person with hypothyroidism, and its severity is variable. It is possible to put early diagnosis of this disease with a simple blood test.

The cause of hypothyroidism:

İn adults its main reason is generally HASHIMO goiter. This disease damages the thyroid gland by forming antibodies against it with the help of immune system, violates hormone secretion. Hypothyroidism can also be formed as the result of radioactive iodine treatment or surgery in the healing of other thyroid diseases.
In addition to this, it may be due to congenital failure of the development of thyroid gland.

Why Hypothyroidism is important?

Sexual and physical weakness appears in adults due to the hypothyroidism. In addition to this, it may lead heart diseases as a result of high cholesterol. If not treated, mixedema coma may develop. It is possible to put diagnosis to the newborn child with the tests at birth. If not treated it causes mental and physical growth retardation.

How is the diagnosis put?

In the blood test TSH (Thyroid stimulating hormone) and the level of thyroid hormones are measured. When Hashimoto goiter is suspected, then auto-antibodies may be measured in blood against the thyroid gland.

Treatment:

It is treated by giving thyroid hormone. Mainly levothyroxine is used. This is the synthetic analogue of T4 as the synthesis of the thyroid gland.

If you have hypothyroidism, it should be treated. Otherwise it may cause serious problems. If you have one or more of the symptoms of hypothyroidism or if someone in your family suffers from thyroid it must be determined with blood tests whether there is a problem or not. During the pregnancy and in all women over the age of 60, the function of thyroid should be checked regardless of complaint.

Hyperthyroidism (Excess secretion of thyroid hormones):

The reason of the complaints is due to the impact of excess secreted hormone to the heart, muscles and nervous system. The symptoms vary according to the severity of the disease.

Symptoms:

• Hand tremors
• Heart beating
• Tiredness
• Nervousness
• Childlessness.
• Disorders in menstrual cycle
• Heat intolerance and sweating
• Eye problems (difficulties in seeing)
• Losing weight regardless of your normal or over eating
• Diarrhea (According to an increase in intestine movements)
• Muscle weakness (you would have difficulty in going upstairs, or in lifting a load)

Reasons:

1. Graves disease is a major cause of hyperthyroidism. The thyroid gland begins to grow and secretes more hormone. The disease occurs due to the immune system and genes. The antibodies created by the immune system against the thyroid gland irritate the gland and causes hormone synthesis be above the norm. In some patients with Graves disease, one of the noteworthy signs is the appearance of the eyes come out due to the swelling in the back of the eye.
2. Thyroid nodules
3. Acquisition of excess thyroid hormone medication due to other diseases. Inflammation of the thyroid gland (Subacute thyroiditis)
4. Lymphocytic thyroiditis or postpartum thyroiditis (postpartum thyroiditis) are also inflammatory diseases of the thyroid gland and they cause excess secretion of hormones.

Treatment methods:

Radioactive iodine treatment.

Radioactive signed iodine is caught by the thyroid gland and destroys the thyroid gland. It is used in the form of tablet or liquid. It should be insulated for 24 – 48 hours not to divulge radiation environment after the intervention.

Surgical intervention

Surgical removal of the thyroid gland (thyroidectomy) is a method that is used less. This surgery can be used if the thyroid gland is too big to breath, if the antitiroid drugs have no effect, radioactive iodine cannot be given for some reason. After the radioactive iodine and surgery, thyroid hormone levels should be regularly controlled in the body. In many cases hypothyroidism may arise after these interventions and in this case thyroid hormone pills should be taken once a day.

And the second group diseases of the thyroid gland nodule (nodular) diseases. Each nodule is not an indication for surgery. The basic surgery instructions: 1. If there are cytology, clinical or radiological signs of malignancy in the nodules 2.If the thyroid gland or node have pressures on the adjacent organs due to their size. If the clinical, radiological and cytological signs indicated benignancy of the node, there is no need in the surgery. These patients are regularly followed by radiological and clinical controls. If any growth is observed in the control ( more than 50% in an year) and if the node pressure on adjacent organs then surgical treatment is applied. In some cases if a definitive diagnosis cannot be confirmed with biopsy injections, and if other radiological methods of examination and clinical examination confirm that the nodule is malignant, then surgery can be chosen.