Goiter is any enlargement of the thyroid gland. Endemic goiter is the enlargement of the thyroid gland in a large number of people living in the same area where the soil and water, little salt iodine. Accordingly, the iodine little vegetable food of the region and in the human body not getting enough iodine. Of endemic goitre say, if 5% of children and 30% of adults have thyroid enlargement of the first and higher degrees.
In such regions, the CIS is to Belarus, some areas of Ukraine, the republics of Central Asia and the Caucasus, regions of Siberia, the Urals, the Middle Volga. At night adult should receive food and water from 100 to 200 micrograms of iodine per day. If the iodine is reduced to 50 micrograms, there is a compensatory increase in thyroid size and develop endemic goiter. However, not all people suffer from this area.
For the development of crop needs and other factors. These include poor nutrition when food enters not enough protein and vitamins. Contributes to the development of the disease and the lack of other trace elements copper, zinc, selenium, molybdenum, and cobalt. Uptake of iodine by the body violates the excess in the diet of calcium, fluoride, manganese. Some products, called strumogennymi, prevent absorption of iodine by the thyroid gland, causing it to compensatory increase, and contribute to the development of goiter. These are products and chemicals that contain thiocyanate, thiouracil, thiourea, aniline derivatives, polyphenols, and perchlorate. Of the products can be called the cabbage, turnip, radish, carrot, soybean, mango, peaches, radishes, peanuts. Some substances are formed strumogennye in water and food in unsanitary conditions - thiourea, thiouracil.
Has a meaning and a genetic predisposition to the development of goiter. Occasionally found extreme manifestation of goiter with severe deficiency of the thyroid gland cretinism. It manifests intellectual impairment, delayed growth and sexual development. Insufficient iodine in the body is accompanied by insufficient intake of the thyroid gland and, consequently, reduced production of thyroid hormones thyroxine and triiodothyronine. By law, the feedback, the lack of these hormones in the blood causes an increase in production of the hormone in the pituitary tirotropnogo, which in turn stimulates the thyroid gland and causes it to compensatory increase.
The thyroid gland can grow uniformly (diffuse goiter), or only part of the growing cancer. In this case, is developing a form of nodular goiter.
In accordance with the classification of the World Health Organization, the size of goiter was graded as:
0 degree. No goiter.
I degree. Goiter can be felt but not visible to the eye.
Grade II. Goitre palpable and visible to the eye.
To clarify the size of the thyroid gland is carried ultrasound, which also identifies nodal forms of goiter. By keeping the thyroid gland produce goitre with normal function of the prostate - euthyroid goiter and with low thyroid function - hypothyroid. About half the patients usually have a goiter with normal thyroid function. Many of the remaining function may be reduced slightly, which is found only in determining the amount of hormones in the blood.
At an early stage, when thyroid function is adequate, the patient can be confusing for the discomfort in the neck: a feeling of pressure on the neck, intolerance of tight collars. If the size of the thyroid gland increases, there may be signs of compression of surrounding organs. A sense of constriction neck increases, especially in the supine position, there may be difficulty breathing, feel hampered in swallowing. For large size of goiter, compressing vessels of the neck, which can lead to circulatory problems and heart failure.
The diagnosis is established in endemic goiter endemic goiter area when an increase in thyroid palpation. Performed an ultrasound and scintigraphic studies of thyroid cancer, a study of thyroid hormones in the blood.
Treatment of endemic goiter.
Tactics lechenieya endemic goiter depends on the degree of thyroid enlargement and the state function of the gland. With a slight increase in the size gland (goiter first degree) is usually limited to the appointment of potassium iodide, necessarily intermittent, foods rich in iodine.
If you have to reduce thyroid function assigned to synthetic analogs of thyroid hormone or combination of drugs (tireotom, levothyroxine), under the control of thyroid hormone in the blood. If the form of nodular goitre, or fast-growing large sites, leading to compression of surrounding organs, surgical treatment of goiter. After surgery, appointed by the thyroid hormones for prevention of recurrence of goiter.
Prevention of endemic goiter.
Prevention of endemic goiter is the mass and individual. Mass prophylaxis of goiter in the addition of salt to potassium iodate - iodination. Per ton of salt added to 20-40 g of potassium iodate. This salt should not be stored longer period specified on the package, as the salt of iodine is destroyed, it also occurs during storage of salt in a humid atmosphere. Salt to food after preparation. When heated, iodine volatilizes.
Individual prophylaxis to patients who underwent surgery on the thyroid gland, temporarily residing in endemic goiter in the region, working with strumogennymi substances. Simultaneously, we recommend use of food rich in iodine: seaweed, sea fish and seafood, walnuts, persimmons.