Nodular goiter of the thyroid gland: Symptoms and Treatment

Nodular goiter - a heavy thyroid disease, which is characterized by the appearance of a gradual increase in a limited tissue area. Node are all the education thyroid, which are different in structure. At the same illness in the neck appears a significant cosmetic defect, and the patient appears to him that something is choking.

Establish an accurate diagnosis upon detection of such symptoms can be through palpation, ultrasound, biopsy, x-ray, MRI and CT. How to treat nodular goiter should decide endocrinologist. The most common methods of treatment: hormonal drugs, thyroidectomy, at least - a course of radioactive iodine.

What it is?

Nodular goiter - a collective clinical concept that brings together all the separate education in the thyroid gland, different morphological characteristics from the rest of the fabric. The term "node" in clinical practice to understand the tumor in the thyroid gland of any size, which may have a capsule and determined by palpation or by visual methods research.

Currently allocated: endemic nodular goitre (iodine deficiency); solitary nodular goiter (single node); multinode goiter (a large number of nodes); conglomerate nodular goiter (nodes are interconnected. Thyroid nodules are detected in 4% of the US population, and the identification of thyroid cancer is 40: 1 million a year and the death rate - 6: 1 million per year.

The causes of nodular goiter

The causative factors of various diseases, leading to the appearance of nodes in the thyroid, also different.

1. Node zhelezykisty thyroid thyroid formed as a result of small hemorrhages, degeneration or follicular hyperplasia nodes formed at a nodal colloid goitre.
2. Nodular colloid goiter almost 100% of cases develop on the background of the deficit in the human diet iodine.
3. Autoimmune thyroiditis is cause genetic predisposition to this disease, coupled with the impact on the body of environmental factors.
4. Thyroid cancer occurs for unknown reasons, to date; it is believed that the risk of developing cancer increases with mutations of specific genes, as well as by the impact of radiation on the body.
5. Follicular Adenoma occurs due to increased secretion of TSH, and at violation of functions of the autonomic nervous system.

If the thyroid lacks iodine, affects a number of incentives to it that are key synthesis required amount of this hormone on body against substances substrate deficiency (addition the iodine). These processes cause or diffuse enlargement of thyroid or growth of certain groups of its cells, of which, in fact, subsequently formed components.

Classification

Depending on its thyroid hormone activity loss may occur as follows:

1. Reduced hormone production of the body is called hypothyroidism. As a result of a lack of hormones is slowing down the metabolism in the human body. This results in obesity, inhibition of the nervous response, the tendency to water retention and development of edema.
2. When the production of hormones is maintained at the same level, such a state is called euthyroid. The symptoms of hormonal disorders at the same time are not available, and the disease manifests itself only in terms of how increased thyroid gland.
3. Elevated levels of hormones, or hyperthyroidismIt arises from the organ hyperfunction. It leads to the fact that metabolic processes are accelerated considerably. Man thus loses weight, becomes nervous and irritable.

Goiter may be formed as a single node, and from the group. Depending on the degree of proliferation and size formations, isolated following sub disease:

1. Solitary unit - a single, large-sized formation in the thyroid tissue, surrounded by a single capsule
2. Multinodular goiter - the presence of prostate tissues sets nodules separated capsules.
3. Conglomerate nodular goiter - a group of formations, the structure resembling a multi-crop, but they are all fused together into conglomerates
4. Mixed goiter (diffuse nodular goiter thyroid) - the presence in tissues of various types gland formations

The disease has three degrees of development, which are determined by clinicians, depending on the size of the thyroid gland:

1. The first - an increase is so small that is detected only by additional instrumental examinations.
2. The second degree characterized by an increase that can not be determined visually in a normal position of the neck. A small change is observed at the turn of the head and at the time of palpation examination.
3. When third-degree goiter completely changes the shape of the neck.

symptoms

The initial stage of development of the disease does not give any obvious symptoms, their manifestation occurs in the later stages, so it is often the treatment is not timely. Only a special survey is able to detect nodules.

The more they get, the more pronounced symptomatic pattern in both sexes, expressed as:

• hyperplasia (magnification) of the prostate;
• hoarseness and cough causeless;
• difficulty breathing;
• pain in the throat;
• discomfort when trying to swallow;
• feeling of tightness when trying to tilt your head;
• regular dizziness.

Symptomatology is diffuse-node pathology similar to clinical hyperthyroidism - state the body associated with an increased amount of thyroid hormones and is manifested in the following Symptom:

• poor appetite;
• insomnia;
• reduced blood pressure;
• heart pain and heart palpitations;
• dyspnea on exertion;
• deterioration of the skin (peeling and dryness);
• slight memory impairment;
• low body temperature;
• decrease in erectile function in men;
• painful nodular formation;
• nervous and irritable mood (women more frequently);
• violation monthly in women, as well as a possible miscarriage and infertility.

This disease affects not only adults but also children. The danger is that there is a direct impact on the mental and physical attributes of a child's development, the treatment process is difficult.

Graves' disease - gipertireoznaya pathology caused by an excess of thyroid hormones produced diffuse tissues "thyroid" poison and body - can provoke the following symptoms form:

• dry skin;
• nervousness or restlessness;
• shake of the upper and lower extremities;
• constant feeling of hunger;
• high temperature;
• significant bulging eyes.

Thyroid gland in nodular goiter appears superficial thickening of the neck, which can be seen with the naked eye. While noting its unevenness. After some time there is a manifestation of the symptoms of goiter mechanical plan, occurring due to the ever growing nodules. They are subjected to the action squeezes blood vessels, trachea, nerves, esophagus.

Diagnostics

To properly assess the state of the thyroid gland, several types of surveys should be made.

Diagnosis involves the use of simple and more complex estimation methods:

1. Analysis of patient complaints;
2. Needle biopsy for suspected cancer;
3. X-ray of the esophagus and chest;
4. Scintigraphy or imaging .;
5. Thyroid palpation (palpation method) and visual inspection;
6. Ultrasonic examination: establishing sizes shchitovidki circuits, structures and shapes of nodes, their number, the state of blood flow;
7. Laboratory analyzes of hormone panel: determination of TSH, calcitonin, free fractions T3 and T4.

The doctor prescribes a treatment only after diagnosis, because certain types of pathologies do not require medical treatment.

Treatment of nodular goiter

The choice of treatment of nodular goiter thyroid depends on the cause of its occurrence, the node type, size, age of the patient and concomitant illnesses.

There are three main methods of treatment: drugs, radioactive iodine and operation.

medication

Scheme of treatment of nodular goiter dependent on hormonal activity of the thyroid gland. In hyperthyroidism reduce the production of hormones, and hypothyroidism tireodnyh increase the concentration of hormones. Thus it is possible to achieve reduction of nodes.

drugs group	produced the effect	A course of treatment
antithyroid	Reduce the synthesis of thyroid hormones, blocking the enzymes that ensure the iodization of thyronine. Accelerating the elimination of iodine from the thyroid gland. The results depend on the concentration of hormones, but usually after 3-7 weeks of treatment, hyperthyroidism passes.	Mercazolilum taken orally after meals 1 tablet (5 mg) 3-4 times a day. The course of treatment for 3-6 weeks. Then reduce the dose and take 1 tablet 1 time a day or two in the morning after breakfast. Propylthiouracil dose set individually, 2-6 tablets 3-5 times a day. The duration of treatment 1-1,5 years. During treatment, periodically do control the level of thyroid hormones.
Tireodnye	Synthetic thyroid hormones T3 makes up for the deficit and T4 hypothyroidism. They affect the pituitary gland, reduce production of thyroid stimulating hormone, which stimulates growth of the thyroid gland. This scheme is more efficient in diffuse goiter, but can be used for treatment of nodular goitre caused by autoimmune processes.	Levothyroxine take one time a day, in the morning 30 min before breakfast reception, squeezed tablet with a little water and not liquid. Receiving the first week of 25-100 micrograms per day. Every 2-3 weeks, increase the dose of 25-50 mg before the appointed physician of 100-200 mcg. Tireotom begin with receiving ¼ tablet, gradually increasing the dose. Appoint 1-3 tablets a day for 30 minutes before eating. A tablet is drunk 100 ml of water, swallowed without chewing. The course of treatment from 6 months to 2 years.
combined	Help to increase the concentration of iodine required for iodination of tyrosine in the thyroid. Slow down the production of TSH and thus stop the growth of the crop. Used in the primary forms of the disease and during preparation for surgery.	Potassium iodide 200. Treatment is carried out courses for 20 days with a break of 10 days. Take 200-500mkg / day after meals with water. The course of treatment from a few weeks to several years. Yodtiroks. It comprises levothyroxine and an inorganic iodine. Take a half hour before breakfast on poltabletki. After 2-4 weeks your doctor may increase the dose dose. Duration of treatment 1-3 months, the number of courses a doctor sets individually, in some cases, a life-long drug.

Radioiodine therapy of thyroid

An effective method of treatment is considered toxic nodular goiter with radioactive iodine 131. It causes cell death at a distance of 2 mm from the places where iodine isotope, which allows point-to work on site. The introduction of an adequate dose helps reduce the size of the node by 30-80%.

Treatment of nodular goiter is conducted by external radiotherapy. Single doses up 15-30 mCi. This is almost 10 times less than the level of radiation in cancer. Therefore, there is no side effects.

Folk remedies

Along with the medication, or if there is no need to conservative therapy can successfully treat nodular goiter folk remedies. There are many recipes of traditional medicine to relieve the symptoms of this disease.

1. Tincture of cherry branches. It takes approximately 100 g of young branches with swollen buds cherries and coarsely crush. Poured half a liter of hot water and boiled for about 40 minutes. Allow to cool and use 2 tablespoons three times a day before a meal. The course of treatment lasts from 3 to 5 weeks. The effect will be noticeable at the end of treatment.
2. Juice and pulp are mixed with five lemons crushed garlic (five teeth) and one of honey. The mixture should be insisted in a dark place for seven days. Take one teaspoon in the morning and evening was slowly swallowing.
3. The infusion of walnut. Fifty young green walnuts are crushed and placed in a glass jar. After the addition of 100 g of alcohol and poured honey. Infused for about a month in a dark cool, dry place. Tincture, take 1 teaspoon 4 times a day, drinking a glass of milk. Due to the high concentration of natural iodine in walnuts, nodular goiter significantly inhibited development and may cease altogether. Milk promotes the speedy assimilation of iodine. The course of treatment lasts from 6 weeks to 2 months.
4. Well helps an alcohol tincture of bee Podmore. It normalizes the immune system, so that the body restores itself. Podmore on the glass (dead bees) take 4 cups of vodka. The mixture should insist 2 weeks, after which it will be ready for use. Strain and take her teaspoon twice a day. You can drink water infusion.
5. Dry seeds of quince and grind them to a fine powder. Mix 1 part of the seeds with 2 parts of honey and 1 part of lemon juice, mix and store in the refrigerator. Take in the morning on an empty stomach on a table spoon of the drug. Very soon you will feel relief.

Before using the popular methods of treatment, you should consult with your doctor. And, in any case, can not replace traditional medication therapy traditional methods.

disease prevention

In order not to run the disease, to avoid dangerous complications and possible recurrence should not neglect preventive measures, which include:

• proper nutrition.
• enough exercise.
• the absence of stress.
• receiving iodine preparations or products increase iodine in the diet.
• restriction staying in areas with increased radioactivity or high concentration of chemicals in the air.

It should be remembered that the key to successful treatment in the event of symptoms of nodular goiter of the thyroid gland is dependent on timely diagnosis, because you need to be attentive to their health and undergo annual comprehensive examination.