Overview of Goiter

What is Goiter?

Goiter, also known as thyroid nodule, is a common disease of the thyroid gland that typically manifests as a bulge in the neck due to an increase in the size of the thyroid gland.

Goiter is divided into three groups: benign goiter, cancer, and thyroid endocrine dysfunction. Of which, benign goiter is the most common, accounting for 80% of cases.

Benign goiter is a case in which the thyroid gland increases in size without affecting the function of the thyroid gland. Therefore, benign goiter cases almost never require surgical intervention. However, when the goiter is too large, causing difficulty swallowing, difficulty breathing, and protruding forward, causing loss of aesthetics, it is possible to surgically remove the goiter.

Causes of Goiter

The causes of goiter are divided into three main groups, which are:

• The body lacks iodine, which can be due to insufficient supply or increased iodine demand of the body.
• Due to the use of drugs and foods: drugs containing lithium salts are used in psychiatric specialties, asthma treatment drugs, rheumatism drugs, etc. Some foods such as bamboo shoots, vegetables, and water sources with high hardness all affect the synthesis of thyroid hormones and cause goiter.
• Some congenital thyroid dysfunctions are familial.

Symptoms of Goiter

Depending on the type of goiter, goiter symptoms may only have local signs or local manifestations accompanied by other systemic signs.

Systemic signs that may be present in goiter:

• Fatigue, stress, memory loss, dry skin, frequent cold
• Feeling of palpitations, sweating, weight loss
• Protruding eyes
• Changes in voice, often hoarseness.

There is a mass in the neck, local signs depend on the size of the goiter. When the goiter is small, the patient feels almost nothing, when the goiter is large and compresses components near the thyroid gland such as the trachea, esophagus, and nerves, the following symptoms may occur:

• Feeling of a lump in the throat or a sore throat.
• Difficulty swallowing, painful swallowing.
• Difficulty breathing, often in the lying position.
• Coughing and choking.
• Shortness of breath.

Subjects at risk of Goiter

• People who do not regularly consume foods containing a lot of iodine are especially common in mountainous areas.
• Subjects with high demand for thyroid hormones such as: children in puberty, pregnant or breastfeeding women…
• Suffer from chronic diseases such as colitis, prolonged diarrhea, chronic kidney failure… affecting the absorption and excretion of iodine.
• Have a history of thyroid diseases such as: infections, thyroid tumors, autoimmune thyroid disorders.
• Family members with goiter or thyroid diseases.
• After treatment of mental illness

Prevention of Goiter

Prevention measures are taken to limit cases of benign goiter and early detection of other types of goiter to improve treatment results. Including the following methods

• Ensure adequate iodine supply for the body by eating foods rich in iodine such as: sea fish, shrimp paste, fish sauce. Using iodized salt is a simple and easy way to reduce the risk of iodine deficiency.
• For subjects with thyroid diseases, after treatment of mental illnesses, with digestive diseases and chronic kidney disease at high risk of goiter, regular check-ups are needed to detect the disease early.
• When there are signs of the disease, go to the nearest medical facility for treatment.

Measures to diagnose goiter

Goiter is clinically determined through examination to see a bulge in the neck corresponding to the thyroid gland.

Tests to diagnose goiter can be performed as follows:

• Blood test: detects changes in thyroid hormones.
• Thyroid ultrasound: determines changes in the shape and structure of the thyroid gland.
• Pathological examination: taking samples from the thyroid gland through fine needle aspiration or thyroid biopsy to determine whether the goiter is benign or cancerous.
• Thyroid scintigraphy: is a new, modern test with quality images that allows a comprehensive assessment of the functional image of the goiter and helps detect thyroid cancer at an early stage. This is a completely painless, non-invasive test that does not affect the patient’s thyroid gland. Thyroid scintigraphy has been and is being performed at a number of major hospitals in Vietnam, especially at Vinmec Hospital, and has been applied with high efficiency.

Goiter treatment methods

How to treat goiter? In cases requiring treatment, depending on the classification and severity of the disease, goiter will be treated in one of the following three ways: medical treatment with oral medication, radiotherapy and surgery, specifically:

• Medical treatment uses drugs that are hormones to bring thyroid hormone levels back to normal or treat infections in the thyroid gland. Medical treatment can be applied alone to treat goiter with thyroid dysfunction or applied after thyroid surgery and radiotherapy. Drug treatment must be followed, prescribed regularly every day and hormone levels must be checked through periodic check-ups.
• Radiotherapy is a method of using radioactive iodine to reduce the size of the thyroid gland.
• Surgery, depending on each case, will remove part or all of the thyroid gland.