General characteristics of the disease
Endemic goiter - is to increase the size of the thyroid gland caused by iodine deficiency in the body.
The cause of iodine deficiency can serve as an unbalanced diet - lack of eating fish, meat, seaweed, shrimp, dairy products, oats and buckwheat, etc. About 90% of the daily requirement of iodine person receives precisely because of nutrition.
Another possible cause of endemic goiter - gastrointestinal disease, leading to poor absorption of trace iodine. In the pathology of the intestine or stomach may develop goiter with full or partial iodine deficiency, even if the patient's diet is rich in foods containing iodine.
About 5% of the daily dose of iodine, obtained at the expense of the person water. As much as he gets because of air saturated with microelements of iodine.
There are regions with a low content of iodine in the environment and, therefore, at high risk of endemic goiter. To those, for example, refers inclusive central Russia with Moscow. Iodine deficiency is also observed in areas with increased radiation background.
Sometimes the occurrence of endemic goiter can cause a systematic reception of medicines that block the absorption of iodine. These include potassium perchlorate, lithium carbonate, nitrate, sulfonamides, and others.
It is also possible genetic predisposition to the development of endemic goiter in the genetic defects produce thyroid hormones.
Symptoms of endemic goiter
The increase (hyperplasia) of the thyroid gland in the endemic goitre - a reaction to the low concentration of iodine deficiency caused by her thyroid hormones. Often in parallel with endemic goiter develops accompanying disease - hypothyroidism.
Increasing the weight of the thyroid gland, the body tries to compensate for the lack of thyroid hormones, and this leads to the appearance of the following symptoms of endemic goiter:
- low physical endurance,
- discomfort in the heart,
These symptoms of endemic goiter may occur even at the subclinical stage of the disease with the size of the thyroid gland within the norm and virtually unaltered levels of thyroid hormones.
With further growth of the thyroid gland, new symptoms of endemic goiter:
- squeezing sensation in the neck,
- labored breathing and swallowing,
- dry cough,
- asthma attacks.
Symptoms of endemic goiter is the most severe stage of heart disease - so-called development of the thymus of the heart, expressed in the expansion and hyperfunction of the right atrium and ventricle.
Among the possible complications of endemic goiter of the thyroid gland called hemorrhage, acute and subacute thyroiditis, nodular malignant degeneration diseases.
Diagnosis of endemic goiter
In the diagnosis of endemic goiter used laboratory tests of blood and urine. The blood of patients with clinical symptoms of endemic goiter is tested for hormone levels of TSH, T3, T4 and thyroglobulin.
Patients with this type of disease is usually disrupted thyroid hormone balance, and there is an increased concentration of thyroglobulin. Iodine excretion rates in urine usually reduced.
Instrumental methods of diagnosis of endemic goiter is an ultrasound. Thanks to him, established form of the disease: diffuse or nodular goiter. By radioisotope scanning of the thyroid gland is estimated functional state authority.
When nodular goiter further biopsy is used to determine thyroid benign or malignant nature of the disease.
Treatment of endemic goitre
Tactics of treatment of endemic goiter depends on the degree of hyperplasia of the thyroid gland. With a slight increase in the size of the body is often quite a few courses of potassium iodide. Mandatory part of the treatment of endemic goiter I degree is also a dietetics foods rich in iodine.
Treatment of endemic goiter complicated by hypothyroidism involves the appointment of hormone replacement therapy. Artificial analogues of thyroid hormones considered Levothyroxine.
Treatment of nodular goiter with advanced disease primarily surgical. To prevent recurrence of thyroid hyperplasia postoperative patients underwent hormone replacement therapy.
Prevention of endemic goiter
Effective prevention of endemic goiter is the regular consumption of table iodized salt. It is important to add salt to food after its preparation, as trace elements iodine broken heating time.
To reduce the probability of occurrence of endemic goiter also allows regular consumption of seafood, walnuts, persimmons. The diet must be present fish dishes
and other foods rich in iodine.
Endemic goiter in children
Endemic goiter in children - the most common of iodine deficiency disorders. The most common form of diffuse disease. According to statistics from the past 10 years the incidence of endemic goiter in children increased by 6% and is now about 25% of all children endocrinological diseases.
Such high incidence explained the nature of the impaired nutrition and adverse environmental conditions. In a third of cases, endemic goiter in children diagnosed in adolescence (14 years and older).
Characteristic symptoms of endemic goiter in children have a more intense expression. In addition, it is in childhood disease often complicated by the development of endemic cretinism: a delay of intellectual and physical development, CNS disorders.
Due to the high prevalence and serious consequences of endemic goiter prophylaxis of iodine deficiency in children is recommended, since the mother's pregnancy and continue throughout the child's life.