A goiter is the non-neoplastic enlargement of the thyroid gland. It can be nodular or it can be diffuse and is non- inflammatory. There are various kinds of goiters that can be categorized as simple goiters or secondary goiters. Simple goiters can be colloid goiter, nodular, parenchymatous goiter and physiological or puberty goiter. The secondary goiters include primary thyrotoxicosis and secondary thyrotoxicosis which arises from colloid or nodular goiter.
During puberty changes in the thyroid function occur and this is an adjustment to body and sexual development. A study was conducted on 259 adolescents who were healthy, in the age bracket of 11 to 17 years in Switzerland where there was adequate amount of iodine. The studies indicated that physiological or puberty thyroid growth was predominantly influenced by growth factors that were required for somatic development. The growth spurt in thyroid which coincided in girls with menarche may have contributed to an increase in goiter during the puberty years. Some of the causes of goiters include Grave’s disease, Thyroiditis, Goitrogens, Idiopathic, iodine deficiency and physiological like puberty and pregnancy. Some of the other causes include tumours or syphilis and sarcoidosis. Occurrence of a goiter results in a swelling of the neck or a lump like mass. Treatment may not be required if the goiter is a smaller one. Goiter can be related to either hyper or hypothyroidism in this case especially Grave’s disease and may possibly be reversed by treatment. Grave’s disease for one can be cured with drugs that are antithyroid. The risk of goiter may be increased by hypothyroidism as it normally raises the production of TSH and TRH.
Diagnosing the simple goiter is done very simply by excluding all other possible causes like sub-acute thyroiditis, Hashimoto’s thyroiditis, carcinoma of the thyroid gland or dyshormonogenesis. Investigation of the goiter is firstly done by conducting a thyroid function test. In this case the level of thyroid activity is ascertained by the use of a test. Checking the serum cholesterol helps as it is elevated in primary thyroid failure. Tendon reflexes tend to get prolonged so this serves as another indication. Some thyroid antibodies like thyroglobulin or peroxidase are normally very strongly positive especially in the case of Hashimoto’s thyroiditis. Normally a thyroid scan is also done which helps to differentiate between a nodular goiter and a diffused one. Treatment includes adequate consumption of iodine especially in early years. Other treatments include replacement therapy.
answered by G M