ZOB is an increase in the thyroid gland. In itself, the name "goiter" is taken from the designation of the area of ??the enlarged esophagus in birds. It is also called goiter and is a kind of sump for food.
Such a disease is most often found in countries where there is an iodine deficiency (however, it can be caused by a high iodine content when iodine preparations are used). Women are susceptible to this disease 5 times more often than men. The formed nodes are nothing more than the set of fibrous scars that form in the tissues of the thyroid gland.
The thyroid gland (thyroid gland) is the center for controlling metabolism in the human body. She is often called a health guard, so she behaves accordingly if she has any problems with her: irritability, mood swings, fatigue and drowsiness.
Problems with shchitovidkoj happen at women at mature age more often, but also for men this problem is actual enough.
Thyroid gland is one of the most important organs of our body. Despite its meager size and weight (about 20 grams), it is truly a generator of vital energy. No wonder physicians call it "working bee". The thyroid gland produces thyroxine, triiodothyronine, and these are exactly the substances without which the body produces the necessary energy is practically impossible. And this energy is directed to the work of all human systems and organs.
The thyroid gland also regulates the activity of the heart, brain activity, muscle tone ("muscular armor"). This is the guardian of health. At women with the years there is a hormonal reorganization - before and after approach of a menopause. Therefore, the thyroid gland is very sensitive during this period, it reacts quickly to stresses, weakening of the immune system, infections, deficiency or excess of iodine. Because of the pathological activation of antibodies that counteract healthy cells, the body is more exposed to autoimmune diseases with age. These antibodies reduce the thyroid function. As a result, there is weakness, deterioration in memory quality, puffiness, weight gain, dry skin, brittle hair, muscle pains and spasms, constipation.
Throughout the world, the most common is endemic goiter. It is caused by iodine deficiency in food. In countries where iodized salt is used, Hashimoto's goiter, the alternative name of which is an autoimmune thyroiditis, is most often formed.
Other reasons can be divided into two conditional blocks:
- Genetic disorders of the treatment of endocrine gland hormones (eg, cretinism);
- The use of food products as a food, for example, cassava;
- Side effects after the use of medicines.
Symptoms of hypothyroidism - hair loss, dry and pale skin, brittle nails, thinning eyebrows, decreased appetite, weight gain. With thyroid disease, speech slows down, memory worsens, there is almost constant drowsiness, the menstrual cycle is lost. In this case, not necessarily the presence of all these symptoms, usually two or three, but they are more pronounced.
- Toxic goiter of diffuse type, known as Graves disease;
- Tireoids (active inflammatory processes);
- Oncology of the thyroid gland.
Hyperthyroidism is an increased production of hormones by the thyroid gland. Companions of this disease - insomnia, general weakness, irritability, heart palpitations, excessive sweating. The sufferer of this disease can have a good appetite, but lose weight. Plus to all this - high blood pressure, an increase in eyeballs, trembling in the hands (tremor).
Classification of diseases of the thyroid gland
Classify thyroid disease can be on a variety of grounds, the first of which is etatopogenetichesky. It determines the factors and mechanisms of formation. On this basis, the endemic (characteristic only for a certain type of terrain) and sporadic goiter are distinguished. The first is observed in geographic regions endemic to goiter, and the second, respectively, in all others.
According to morphology, diffuse, nodal and mixed (diffuse-nodal) goiter are distinguished. By location:
- Standard location;
- Partly behind the breastbone;
- Dystopic, consisting of embryonic-type bookmarks (eg, goiter of the root system of the tongue or an additional thyroid lobe).
Also, goiter is distinguished by the degree of increase. According to the WHO (World Health Organization) classification, it is possible to distinguish three types:
- Zero degree
- First degree
- The second degree.
In the first stage there is no increase, on the second stage - goitre is possible to palpate, but it is not visible at the usual position of the neck, and on the third - it not only gropes, but is visible to the naked eye.
A more detailed classification by degree of magnification was proposed by O.V. Nikolaev, according to her disease without the necessary treatment goes through the following stages:
- The first degree - the thyroid gland is palpable;
- The second - the thyroid gland is visible;
- The third is a significant thickening of the neck;
- The fourth is a change in the shape of the cervical region;
- The fifth is a huge goiter.
Symptoms of goitre of the thyroid gland
At primary stages, patients may not even notice the slightest manifestations of goiter. The formation of this disease over time provokes an obvious bulging or bulging of the neck in the front part (in the Adam's apple). Enlarged endocrine gland also begins to press on the trachea, nerve endings and blood vessels that are located near. Diffuse goiter, visually, is identified by a uniform increase in thyroid. If we talk about the nodal variety, it is, most often, much more increased from one side of the larynx. That is, not only the uneven, but also the non-uniform increase is expressed.
The impact on those organs that are located near, can manifest themselves following signs:
- Shortness of breath;
- Rapidly progressive change in voice, accompanied by hoarseness;
- Attacks of suffocation, manifested at night;
- Coughing cough;
- Difficulties in swallowing food;
- Dizziness, severe heaviness in the head.
At the presented neoplasm which is accompanied by a hypothyrosis, the atypical form of a pneumonia, a bronchitis or ORVI can be formed. In addition, most often in women, there is hypotension, painful and just unpleasant sensations, similar to compression, in the heart. All this, as the disease progresses, is aggravated by shortness of breath, a decrease in the habitual desire for any food, bloating, nausea and drowsiness. At the final stages, memory deteriorates and weight increases, despite all the problems with the gastrointestinal tract.
In the male on the basis of a low ratio of iodine in the blood there is a decrease in sexual desire, destabilization of sexual function. Women are characterized by such changes as menstrual cycle disorders, which, in turn, are the catalyst for infertility and miscarriages.
With such varieties of goiter as Basedova disease or hyperplasia of the thyroid gland of a benign type, such signs as:
- Prolonged maintenance of fever;
- Reduction of total body weight;
- Protrusion of eyeballs;
- Permanent hunger;
- Exhausting insomnia;
- Sporadic irritability;
- Progressive trembling in the upper limbs.
Causes of goiter
Factors directly affecting the formation of goiter, should be considered in more detail. This is because the lesions of the endocrine gland, like their causes, can be very different.
As already noted earlier, the main cause provoking the appearance of endemic toxic goiter is iodine deficiency in the body. Its insufficient quantity is explained by the absence of the present compound in specific territories. This is what causes the decrease in the secretory degree of activity.
In addition, some negative impact on her work is due to poor environmental ecology. Thus, substances of toxic origin that appear in the human body from the outside, are able to suppress the functioning of the endocrine system and slow down the activity of the thyroid.
Endemic goiter can also be formed with a relatively small use of products, the list of components of which includes iodine. It's about fish, fruits and milk.
In the case of the occurrence of Based's disease, or toxic goiter of diffuse origin, the endocrine gland is exposed to specific antibodies. They are produced by the human body and are an integral part of immune protection for their own tissues. In this case, we are talking about the structure of the thyroid gland.
If to note the most important factors of the development of goiter of the nodal type, then it is necessary to distinguish:
- Adenoma of the endocrine gland;
- New the formation of cancer.
With such lesions, there are progressive disorders in the process of cell division, as well as their differentiation. This can be triggered by a radiological background, toxic substances dangerous from a toxic point of view, and also have a genetic character.
Goiter in children
Separately, it is necessary to talk about goiter in children, because this is the most common iodine deficiency ailment. In the overwhelming majority of cases, a diffuse form of the disease is formed.
According to WHO studies over the past 10 years, the incidence of goiter in childhood has increased by 6% and is equal to no less than a quarter of children's endocrinological diseases combined. Such high rates are associated with the wrong nature of food, as well as adverse environmental conditions. In 30% of cases, goiter in childhood was diagnosed after 14 years and beyond.
Characteristic signs of goiter are associated with a more intense degree of severity. In addition, exclusively in children, the ailment is most often complicated by the formation of specific endemic cretinism. This form is characterized by a delay not only intellectual, but also physical development, as well as a disorder of the central nervous system.
Diagnosis of goitre of thyroid gland
In the diagnosis of goiter, blood and urine tests of laboratory type are used. The blood of a person with any clinical signs of neoplasm is checked for the ratio of such hormones as TSH, T3, T4 and thyroglobulin. The diagnosis is determined on the basis that those who encountered the type of ailment presented usually have a disorder of the balance of thyroid hormones and an increased ratio of thyroglobulin. At the same time, data on the release of iodine in the urine remain reduced.
The instrumental way to diagnose the formed goiter is ultrasound. Thanks to him, it is possible to accurately determine the form of the development of the disease, for example, diffuse it or nodal goiter. With the help of radioisotope scanning, an assessment is made of the functional state of the endocrine gland.
At the nodal type of endemic goiter as an additional measure of examination, specialists resort to biopsy of the gland. This makes it possible to determine the nature of the disease. So, it can be benign or malignant.
If as a result of palpation there are suspicions of goiter in the thyroid, for the establishment of a certain diagnosis, identification of the etiology and stage of the development of the disease, it is necessary to consistently conduct such mandatory examinations as:
- Provide a blood test for the ratio and level of hormones (it is recommended to take the test several times within two to three months from the start of treatment);
- Survey of reflexes of tendon type on time;
- Ultrasound of the thyroid gland.
The test for determining the level of iodine in the body
We can distinguish three most accurate and easily feasible tests for determining the ratio of iodine in the body:
- Test 1. The first of these is as follows: you need to take a standard (3 or 5% -cent iodine). With his help, you need to draw a grid on your own body - preferably in the evening, when physical activity is finished. Particular attention should be paid to the lower abdomen, as well as the hips. After the absolute drying of iodine, you must go to bed. So, if in the morning it turned out that the grid "left" at least half, then obviously insufficient iodine content in the body. If the shade of the net lasted more than 12 hours and even more 24 hours, then this indicates that there is some excess of iodine, which should also be combated.
- Test 2. The second test consists in the following - it is necessary to dip a cotton swab in a solution of iodine of alcohol type. After this, apply iodine containing the mesh on any area of ??the body, in addition to the endocrine gland itself. The next day, you need to carefully consider this place. If there are no traces of iodine, then it is necessary for the body, if, on the contrary, the figure remains, then there is no shortage.
- Test 3. And finally, a third, much more accurate testing. For its implementation, before going to bed, apply on the skin in the region of the forearm three strips of iodine solution. Do this consistently: first a thin line, then a little thicker and then the thickest. If in the morning it was discovered that the first line had disappeared, this means that with the iodine ratio everything is normal.
If you can not see the first two, then you should pay close attention to your health. In the same case, if there is not a single strip left, it is possible to talk about the obvious shortage of iodine. What are the methods for treating goiter in the endocrine gland?
Methods of treatment
Timely recognition of symptoms will be the key to successful treatment, which will help to cope as quickly as possible with the disease. So, when there are signs of an increase in goiter, it is necessary to consult a specialist endocrinologist. The appeal to him is very important, because any other specialists can simply refer to overwork.
The main method of treating goiter should be considered hormone replacement therapy. For this, a variety of active derivatives of tyrosine are used. This is because they are characterized by the physiological parameters of those hormones that are produced by the endocrine gland. It is extremely important to choose not just a sufficient dosage of the drug, but one that does not lead to negative results. Treatment, periodic use of drugs, very often should continue until the end of life. It is recommended that you do not forget about controlling the ratio of hormones.
Thyroid hypothyroidism is also amenable to adjustment due to hormone therapy. It is much more complicated with hyperfunction. So, if there is a real danger of formation of a tumor of any genesis or complications of the cardiovascular type, then it makes sense to resort to surgical intervention (it will be discussed below). This will change the situation on thyroid hypofunction. In turn, this will allow for easier and more accessible adjustment due to hormone therapy.
With a more severe form of endocrine gland hypofunction, a person can fall into a coma. Hyperfunctions are inherent in the fact that a toxic crisis can lead to a fatal outcome. In this regard, it is necessary to comply with a strict diet and the receipt of the necessary ratio of iodine to the body. At the same time, it is unconditional to consult a specialist and submit tests for the amount of iodine in the body. After all, as is known, more iodine also negatively affects thyroid.
Operation and radioactive iodine
Surgical intervention on this organ is extremely difficult, because the endocrine gland contains a significant number of blood vessels. This makes the operation much more problematic. However, in some cases, one can not do without it, therefore, surgical intervention in goiter is one of the most frequently used methods of treatment.
Thus, local anesthesia is injected and large nodal or potentially dangerous areas are removed. In the most complicated and neglected cases, it is permissible to remove one of the thyroid glands. It can also, in turn, provoke hypo- or hyperthyroidism. However, even with the resection of one or more nodes, there is a need for drug rehabilitation.
An alternative way to treat the thyroid gland is to use radioactive iodine. This solution is used to destroy the tissues of the endocrine gland. It is extremely difficult to choose the optimal dosage. For this, additional groups of analyzes are also conducted. In this case, in the first year, 25% of people start to form hypothyroidism. However, radioactive iodine is a unique tool, which does not currently exist. What are the preventive methods for detecting goiter?
Prophylaxis of goiter
Prevention of goiter can be carried out in three versions and be mass, group and individual. The most effective is the first method, for its implementation in those products that one way or another consumes each person, add a small amount of iodine. It's about common, but iodized salt.
The advantages of this method are that this product is very inexpensive, but the effect of this effect is obvious. According to the WHO, as a result of such prevention, the formation of goiter is reduced by 20% every year. For prophylactic mass iodization, other products, for example bread or water, are also used.
Prevention of goiter in a group type implies the use of drugs in which iodine is located by persons who are in the category of risk for a similar diagnosis. This is, first of all, children and adolescents who are in institutions such as kindergartens and schools.
The closest in terms of physiological means is potassium iodide, which is available in a variety of dosages and is used according to a certain algorithm. For such prevention, it is also possible to use food products that contain iodine.
A separate category of the risk group for the formation of goiter is women who are at any gestational age. They have the highest need for this component - 200 mcg per day. In this regard, it is necessary to carry out individual prophylaxis. In addition, even at the planning stage of pregnancy, the woman is recommended to identify the thyroid status.
Prevention of goiter by individual type also implies the use of drugs with iodine. The desired dose is determined individually, and also depending on the age category. Without a prior visit to an endocrinologist, such prevention is not desirable for people who have a history of problems with the endocrine gland.
Many people are sure that the need for iodine per day will be compensated for by a special diet that contains some products. However, this is not 100% true, because to compensate for the already established deficit, essential changes in the diet are needed. Secondly, such changes are quite expensive. In addition, the use of iodine simply must be strictly dosed. After all, any fluctuation: from an overabundance to a deficit is fraught with significant problems with the endocrine gland and health in general.
Thus, goitre of the endocrine gland is one of the most common health problems. This condition practically does not lend itself to absolute cure, because constant prevention and application of iodine is necessary. This will help to maintain optimal life activity and health.