Goiter diffuse non-toxic: diagnosis and treatment
Diffuse non-toxic goiter - a fairly common disease, which is accompanied by an increase in the size of the thyroid gland. It affects women and men of any age( it is often diagnosed in children).Of course, patients should get acquainted with the information about this disease, because not completely understandable diagnosis often causes a person only panic. So, how dangerous can the disease be and how to avoid its development? What symptoms should I pay attention to?
Diffuse nontoxic goiter: the ICD code and the main characteristics of the disease
This disease is characterized by hyperplasia and hypertrophy of thyroid tissues. Simply put, the thyroid gland begins to increase in size. This pathology is numbered E04.0 and is described in ICD-10.
Diffuse nontoxic goiter is not accompanied by functional disorders. Against the background of the disease, there is no hyper- or hyposelection of the thyroid, so the hormonal background remains normal. The prevalence of the disease is 4-5%.By the way, women are more susceptible to it than representatives of the stronger sex. Often there is a diffuse non-toxic goiter in children, but more often it is diagnosed in people of mature age, after 30 years.
Classification: varieties and forms of the disease
In most cases, nontoxic goiter develops against a background of iodine deficiency in the body. If we are talking about the lack of this element on the territory of residence, then the illness is called endemic - it affects the majority of the population.
But there are also cases in which goiter develops in the absence of iodine deficiency in the area of residence. This sporadic form of the disease, which is associated with an insufficient level of secretion of thyroid hormones.
Non-toxic goiter can be diffuse, nodular( in the tissues of the thyroid gland dense benign nodules are formed) and mixed. In addition, hypertrophied iron can have a different consistency - the tissues can be soft, elastic, dense, and sometimes they develop small hollow cysts.
Stages of development of the disease
Goiter diffuse non-toxic in most cases develops slowly. In modern medicine, it is common to distinguish three stages, guided by external signs:
- At the so-called zero stage, there are no visual changes - the contours of the neck remain the same, and even if it is palpated, it is difficult to determine the presence of the disease.
- Diffuse nontoxic goiter of 1 degree can not be determined on examination, but during palpation an experienced physician can mark the enlargement of the gland.
- In the second stage of goiter development, you can not only feel with your fingers, but also see - the enlarged thyroid gland is visualized as a large hill under the skin.
This classification scheme is of great diagnostic value.
What are the causes of the disease?
An increase in thyroid gland in a similar disease is compensatory. Tissue proliferation is associated with iodine deficiency. Against the backdrop of a lack of this element, thyroid cells, thyrocytes, begin to actively capture iodine. The number of cells increases in order to accumulate as much as possible of this element, respectively, the mass of tissues increases.
A similar phenomenon is associated with either iodine deficiency( it does not enter the body in sufficient quantities) or with an insufficient amount of thyroid hormone secreted by the gland.
Causes of goiter can not be determined. It is known that there is a certain hereditary predisposition. For example, in some patients genetic diseases associated with the disruption of enzyme systems are detected.
On the other hand, there are some risk factors. For example, the sex and age of the patient is important( more likely in a woman's disease of adulthood).Goiter diffuse non-toxic often develops against a background of nervous overstresses and prolonged stresses. Risk factors are also attributed to vitamin deficiencies and a deficiency of certain trace elements in the body, in particular, zinc, manganese, molybdenum, selenium, cobalt and copper. Excess of calcium can also lead to goitre. To the same list it is possible to carry smoking, chronic infectious diseases, and also reception of some preparations.
Clinical picture and main symptoms
Goiter diffuse non-toxic develops slowly, and in the initial stages, which can last for months or years, the disease is not manifested at all. Occasionally patients complain of weakness and dizziness, attacks of headaches. But the symptoms occur sporadically, so people simply do not pay attention to them.
As the disease progresses, the size of the thyroid gland increases - you can notice the appearance of a tubercle, a change in the contours of the neck. Hypertrophy of the gland is often caused by compression of nearby organs, for example, vessels, trachea, esophagus, etc. Sometimes patients complain of a constant sensation of a coma in the throat. Patients may experience breathing problems( especially when lying down), as well as with swallowing. Constant dyspnea in the most severe conditions leads to a gasp of suffocation. Syndrome of the superior vena cava in patients is the result of compression( compression) of blood vessels.
To what complications can the disease cause?
As already mentioned, diffuse nontoxic goiter is an unhealthy disease, especially if it was diagnosed on time, and the patient received the necessary help. Nevertheless, the disease is associated with some possible complications.
Sometimes the thyroid gland grows so much that it squeezes nearby structures, in particular, nerve endings and vessels that carry blood to the brain. In addition, an increase in the volume of the endocrine gland can lead to compression of the respiratory tract. Occasionally, the ailment is complicated by the inflammatory process and the appearance of small hemorrhages in the gland tissue.
Unfortunately, there are cases when patients develop diffuse / nodal toxic goiter, which is already accompanied by severe hormonal disorders.
What does modern diagnostics look like?
Diagnosis in this case is very important, because thyroid hypertrophy can indicate many violations. To begin with, of course, the doctor collects an anamnesis and palpates the thyroid gland - at later stages of development, its increase can be seen during a visual examination.
Further it is necessary to donate blood in order to determine the level of thyroid hormones( with nontoxic goiter, the hormonal background corresponds to the norm).An obligatory part of the diagnosis is ultrasound examination of the thyroid gland, during which the doctor can accurately determine the size of the gland, determine the presence or absence of nodules, cysts and other neoplasms.
Sometimes radiography is additionally performed - this allows to determine the degree of compression of the esophagus and respiratory tract. In the presence of nodules, patients are advised to undergo a biopsy.
Non-toxic diffuse goiter: treatment of
Therapy for this disease largely depends on the patient's condition and the degree of enlargement of the gland. For example, at the zero stage, specific treatment may not be required - the patient is recommended to adjust the diet, avoid stress and regularly undergo checks.
In the second and third stages, patients are prescribed iodine preparations( the daily dose of potassium iodide is about 200 μg).To gradually reduce the gland, patients sometimes need substitution therapy, namely, taking drugs containing levothyroxine. Quite often, doctors recommend such medications as "Eutirox", "Levothyroxine" and "Iodothyrox".
Surgical excision of parts of the gland is carried out only in the most serious cases, if the patient has seen a serious compression. In such situations, the risk of suffocation and vascular problems is high, so the operation is simply necessary.
Are there any preventive measures?
Of course, it is much easier to prevent the development of ailment, than to then seek ways to effectively eliminate it. Specific prevention does not exist, but patients should follow some simple rules. As is known, in regions with a fixed iodine deficiency, the population is advised to periodically replenish the reserves of this element in the body, taking iodine-containing medications. As prevention, the same drugs prescribed for children during periods of intense growth and pregnant women.
For normal functioning of the thyroid gland, it is important that the body receives vitamins, in particular, retinol, tocopherol, vitamin B12 and D. Therefore, 1-2 times a year, people are useful to take vitamin complexes.
Of course, an important preventive tool is a diet. In the menu it is necessary to introduce products containing iodine, including seafood, fish and caviar. Butter, liver, carrots and cod liver oil will saturate the body with the necessary vitamins. But such products as broccoli, radish, turnips, horseradish, colored and white cabbage slow down the process of iodine digestion in the body. Of course, you should not completely abandon them, because they contain a lot of other useful substances, but you need to limit their number. Of course, it is necessary to avoid stress, adhere to the correct mode of sleep and rest, spend more time in the fresh air and give up harmful habits. All this will help prevent the development of a disease such as diffuse / nodal non-toxic goiter.