Enlarged Thyroid.

Non toxic goiter is  enlargement of the thyroid gland without any hyper functioning of the thyroid. In other words, there is no increase in the blood levels of the thyroid hormones, T3 and T4. There are therefore no symptoms of “hyperthyroidism”. Yet, on detection, prompt treatment should be sought, as this swelling in the neck can be quite an awful  sight.

Non Toxic Goiter.

In  this type of goiter, there may be diffuse  enlargement of the thyroid  or the thyroid may become  nodular. It is more common in women than in men.

Causes of Non Toxic Thyroid Goiter.

There are two causes of this type of goiter:

1. Deficiency of iodine in the diet: Due to awareness, nowadays, this cause is almost nonexistent, except in very backward areas.
2. Increased secretion of Thyroid stimulating hormone (TSH) due to defective synthesis of the thyroid hormones because of an intrinsic defect in the thyroid gland itself. Low levels of thyroid hormones in blood cause the Pituitary gland to secrete more TSH. Refer to “Thyroid diseases – an Overview” to know the relation between TSH and the thyroid gland.

Symptoms of Nontoxic Goiter.

Symptoms of non toxic goiter are mainly due to the enlarged thyroid    pressing on the neighboring  structures in the neck.

1. Pressure on the trachea (windpipe) by the enlarged thyroid results in difficulty in breathing (dyspnoea), cough and waking up at night due to sudden chocking. Change in the voice is also seen.
2. Pressure on the esophagus by the enlarged thyroid gives rise to difficulty in swallowing (dysphagia), and a feeling of something being stuck in the throat. Esophagus is situated behind the trachea and therefore these symptoms are felt  later when the enlargement has progressed.
3. Pressure on the neighboring blood vessels by the enlarged thyroid causes them to dilate and  are seen as engorged blood vessels in the neck .

Diagnosis of  Non Toxic Goiter.

Besides the appearance of an enlarged thyroid in the neck, blood test for non toxic goiter is done.

• Blood analysis will show normal levels of thyroid hormones (T3 and T4) and increased levels of TSH.

Treatment of Non Toxic Goiter.

1) Conservative Treatment for Non Toxic Goiter.

Oral thyroid hormones are given in the form of pills  to normalize the secretion of TSH by the pituitary gland. The progression of the thyroid enlargement is arrested. However, no regression in size is achieved.

2)Surgery for Non Toxic Goiter.

Surgery is indicated when:

• The patient asks for surgical removal of the enlarged thyroid for cosmetic reasons.
• Conservative treatment fails. Surgery involves excision of the thyroid gland. It may be partial or total, depending on the case. Malignancy of the thyroid spreads very slowly and is rare, the incidence being about 5% only of the Goiter cases.

Related posts:

1. Graves’ Thyroid Disease or Diffuse Toxic Goiter.
2. Thyroid.