Thyromegaly: Symptoms, Causes, Types, Treatment, Medication, and Prevention
The thyroid is one of the glands of the endocrine system that secretes hormones in the body. It has the shape of a butterfly and is located on the neck, specifically along the front of the windpipe. The thyroid gland produces the hormones diiodothyronine (T2), triiodothyronine (T3), and thyroxine (T4). These hormones affect the body’s basal metabolic rate, protein synthesis, blood flow rate, body temperature, fetal and child development, sexual function, sleep pattern, and thought patterns. It also produces the hormone calcitonin that is responsible for the regulation of blood calcium levels.
And, like any organ in the body, the thyroid experiences disorders that can cause havoc in the body. One of such disorders is thyromegaly or goiter, which is the enlargement of the thyroid gland.
Due to various causes, the gland develops soft tissues that lead to its enlargement, which is often a sign of a dysfunctional or diseased thyroid gland. With its role in various processes in the body, abnormal thyroid function can lead to abnormalities and diseases. For this reason, it is important to be aware of the symptoms, causes, treatment, prevention, and management of this disorder.
A Normal Thyroid
A healthy thyroid gland is around 4 to 6 centimeters in length and 1.3 to 1.8 centimeters in thickness. It should also weigh between 20 to 60 grams. It tends to be on the lower end of weight, length, and thickness range when one consumes optimal levels of iodine.
Aside from its physical characteristics, a healthy thyroid would produce the normal amount of thyroid hormones that the body needs to function properly. To determine these amounts, an individual would have to undergo the following tests, and their results should be within the given range:
Thyroid Medical Test Information
Thyroid-Stimulating Hormone (TSH) Test
TSH is a pituitary hormone that stimulates the production of thyroid hormones. The ideal range of this hormone is between 1 to 1.5 milli-international units per liter (mIU/L).
Free T3 and Free T4 Test
The normal amount for an individual ranges from 240 to 450 picograms per deciliter (pg/dL) for T3 and 0.9 to 1.8 nanograms per deciliter (ng/dL) for T4.
Thyroid Antibody Testing
This test determines whether the body has autoimmune reactions towards its own thyroid.
Basal Body Temperature
This is done by measuring the body’s temperature immediately upon waking up and while still lying down. The ideal temperature is around 37 degrees Celsius.
Thyrotropin-Releasing Hormone (TRH) Stimulation Test
The TRH is the hormone released by the hypothalamus to stimulate the release of TSH in the anterior pituitary gland. This is done by administering TRH into an individual and measuring the change in their TSH level. Depending on the result, it identifies the cause of thyroid abnormalities. If there’s an increase in TSH levels, it means the hypothalamus is not producing enough TRH. If there is no increase, it means the anterior pituitary gland is not producing enough TSH to stimulate the release of thyroid hormones.
Whenever these levels are outside of what is normal, this would often mean a problem with one's thyroid gland or endocrine system. And, usually, abnormal results from these tests would indicate thyroid enlargement. However, more often than not, an enlarged thyroid won't be noticeable in its early stages. For this reason, a check-up from the doctor is recommended if one experiences some of the following symptoms: bad breath, dizziness, headache, nausea, voice quality changes, stiffness or tightness of the throat, breathing difficulties, difficulty swallowing, fever, or cough.
Causes of Thyromegaly
Insufficient Hormone Production
The enlargement of the thyroid is often due to the insufficient production of thyroid hormones. This could arise from a lack of iodine in one's diet, or a defect in an individual's genetics.
Iodine deficiency causes insufficient thyroid hormone production because the said nutrient is an essential component for its production. When there's not enough iodine, the body responds by having the pituitary gland release more thyroid-stimulating hormone (TSH) to increase thyroid hormone production. Unfortunately, increased levels of TSH also stimulate thyroid growth that results in its enlargement.
As for those caused by genetic defects, the insufficient production arises from a missing protein that permits the thyroid gland to produce hormones. This results to mutations in the gland that would eventually lead to the noticeable enlargement.
Thyromegaly induced by insufficient thyroid hormone production causes symptoms such as weakness, headache, decreased physical endurance, and heart discomfort. In more severe cases, an individual could feel a squeezing sensation in their neck, labored swallowing and breathing, asthma attacks, and dry cough. If left untreated, it could lead to heart enlargement and thyroiditis.
This is the inflammation of the thyroid gland. There are a variety of causes for an inflammation to occur. Each cause results in a different type of inflammation, which would also require a different approach for treatment. Here are the different types of thyroid inflammation:
- Autoimmune thyroiditis: This is a chronic disease wherein the body identifies the hormones T3, T4, and TSH as harmful chemical compounds. This prompts the body's immune system to produce, at least, one of the three different antibodies that attack thyroid proteins. There are two categories of this disease: Hashimoto's thyroiditis and Graves' disease.
- In Hashimoto's thyroiditis, the thyroid is slowly destroyed by auto-antibodies that mistake the thyroid hormones as threats. This causes the formation of a painless goiter and the development of hypothyroidism and thyroid lymphoma. Common symptoms of this disease include fatigue, joint and muscle pain, depression, slow heart rate, panic disorder, weight gain, and constipation.
- In Graves' disease, the body sees thyroid-stimulating hormones (TSH) as threats and produces antibodies for it. This causes the gland to abnormally increase the production of thyroid hormones as the antibodies chronically stimulate TSH. This disease can increase the risk of birth defects, miscarriage, stroke, vision loss and defects, and bone mineral loss. In extreme cases, it can even lead to death. Its symptoms include increased heart rate, abnormal heart rhythm, and bulging eyes.
- Postpartum thyroiditis: As the name implies, this is experienced by women following pregnancy. This is caused by the return of the immune system from its suppression during pregnancy. This rebound of the system causes a rapid increase in thyroid antibodies. Symptoms normally include heat intolerance, palpitations, nervousness, and irritability. This would initially lead to hyperthyroidism and, after three to twelve months of the postpartum period, would eventually lead to hypothyroidism. Treatment or intervention is usually not required as thyroid function would eventually normalize after one year of the postpartum phase. If it exceeds the one year mark, it is not considered as postpartum thyroiditis.
- Subacute thyroiditis: This type of thyroid inflammation is caused by a viral infection. Symptoms include fever and tenderness of the thyroid. During the initial stage of the infection, the gland produces above the normal levels of thyroid hormones. This would be sometimes followed by a phase of low thyroid hormone production. Treatment is usually with high doses of corticosteroids or NSAIDS and healing takes a few months.
- Acute Infectious thyroiditis: This disease is quite rare as the thyroid normally has a high resistance against infection. But, if certain bacteria, fungi, or parasite comes in contact with it, the left lobe of the gland can become infected and form abscesses. Most cases of this disease occur after an infection of the upper respiratory tract. Treatment is done through antibiotics and, in severe cases, surgical drainage.
- Drug-Induced thyroiditis: Certain drugs can cause the thyroid gland to swell. These drugs are often those that contain amiodarone, a-interferon, cytokines, lithium, and any other substances that interfere with thyroid hormone release or cause thyroid gland damage. And, when these substances come into effect, the thyroid compensates for insufficient hormone production and results to the swelling of the gland. There's an increased risk for this disease among women and those with already existing and previous history of thyroid abnormalities. Problems associated with drug-induced thyroiditis include heart disease, miscarriage, infertility, pituitary tumors, and, in severe instances, myxedema coma. Aside from discontinuing the medication, this type of thyroiditis is managed by taking a thyroid hormone replacement like Levothyroxine.
- Reidel's thyroiditis: This is a chronic inflammatory disease characterized by a replacement of functional thyroid tissues with a dense formation of excess fibrous connective tissue. This causes the thyroid, along with adjacent tissues around the neck, to have a woody and stone-hard texture. Treatment of Reidel's thyroiditis includes medication with prednisolone and Tamoxifen and surgical removal of the thyroid gland.
Tumor formation in the thyroid gland is another cause of goiter. The tumor is usually benign, but there are cases when it is malignant. Most tumors are thyroid nodules that result from the abnormal growth of thyroid cells. These nodules could contain fluids collected from the bleeding of the fragile blood vessels in the tumors. This bleeding is what causes the sudden onset of pain and swelling. This pain and swelling eventually subside as the bleeding recedes.
Although a thyroid tumor is often benign, it is important to know the symptoms of a malignant tumor. These symptoms are:
- Rapid enlargement and swelling within only a few weeks
- Difficulty swallowing
- New thyroid-associated pain
- Shortness of breath
- Coughing up blood
If an individual has any one of these symptoms with their thyromegaly, they have a high likelihood of having a malignant tumor in their thyroid.
- Age: Old age can increase the risk of having thyromegaly. This is due to the aging thyroid gland having increased inter-follicular connective tissues. This decreases the amount of thyroid hormone the gland can store. Add the fact that TSH production also decreases in age; this results to the gland having hypothyroidism. This results in the swelling characterized in thyromegaly or goiter.
- Pregnancy: In rare cases, pregnancy can cause the thyroid to develop thyromegaly. This is due to the hormone human chorionic gonadotropin. This causes the thyroid gland to enlarge slightly and to cause hormone imbalances, including the T3 and T4 thyroid hormones.
- Diet: Cabbage, soybeans, peaches, peanuts, spinach, and rutabagas are abundant in goitrogen. This substance can interfere with the thyroid's ability to synthesize iodine into T3 and T4 hormones. A diet rich of these foods can lead to low thyroid hormone production, which could prompt thyromegaly due to increased TSH release. Take note that, for these food items to have this effect, one must frequently consume significant amounts of it. This type of swelling would eventually subside as the levels that obstruct hormone production decrease.
However, for individuals with thyroid problems, it is best to choose foods that contain smaller amounts of goitrogen. If you have to eat these vegetables, it is best to avoid eating it raw as cooking significantly reduces the goitrogen it contains. Consuming foods rich in iodine would help to counteract the negative effects of goitrogen-rich foods.
Types of Thyroid Enlargement
Thyroid enlargement can be medically classified in four ways: thyroid function, growth pattern, size, and cause. These classifications help in the identification of goiter by medical practitioners and researchers. This identification can help in diagnosing and treating one's condition.
According to Thyroid Function
In this classification, the thyromegaly will be assessed on how it affects the thyroid gland's functions. There are three states a thyroid gland can be in, and these are:
- Euthyroid: In this state, the swelling of the gland does not affect the functions of the thyroid. The thyroid with thyromegaly is producing the normal levels of thyroid hormones equivalent to that of a healthy gland.
- Hyperthyroidism: This is a state wherein the thyroid enlargement causes the thyroid to become overactive. This causes the thyroid to produce hormones more than the normal levels of a healthy gland. Symptoms of this condition include sudden weight-loss, rapid or irregular heartbeat, palpitations, increased appetite, anxiety, irritability, trembling extremities, sweating, change in menstrual patterns, more frequent bowel movements, muscle weakness, fatigue, difficulty sleeping, fine and brittle hair, and skin thinning. Long-term over-production of thyroid hormones can lead to congestive heart failure, atrial fibrillation, weak and brittle bones, eye problems, and vision loss. The worst that can happen when one has hyperthyroidism is thyrotoxic crisis, which is a life-threatening condition characterized by a high fever that can lead to heart failure.
- Hypothyroidism: In this state, the goiter is causing the thyroid gland to produce less than the normal amounts of thyroid hormones. This can cause an individual to experience increased sensitivity to cold temperatures, irregular bowel movement, depression, fatigue and shortness of breath, weight gain, hoarse voice, heavy menstruation, poor hearing, and numb or tickling sensation on the skin. In the long-term, this can cause delays in the intellectual and growth development of children, infertility, and miscarriage of pregnant women, increased LDL cholesterol, heart enlargement, and damage to peripheral nerves.
According to Growth Pattern
- Diffuse Goiter: The enlargement of the thyroid gland is due to hyperplasia. Hyperplasia is the increase of an organ's tissue caused by cell proliferation.
- Nodular Goiter: The swelling is caused by raised areas of tissues or fluid within the thyroid. These areas are known as thyroid nodules. A thyroid nodule can be a result of a concentration of cell proliferation in the gland, or a growth of a benign or malignant tumor.
In this classification, the nodules can be specified according to the number of nodules and the toxicity of the nodule. If a goiter only has one nodule, it is classed as uninodular and, if there are multiple nodules, it is classed as multinodular. These nodules would then be classed as either toxic or non-toxic depending on the result of various tests.
- Cystic Goiter: A goiter is classified as cystic goiter when the thyroid nodules are predominantly filled with fluid.
According to Size
- Class 1: The swelling of the thyroid gland cannot be seen when the head is normally positioned. The neck has to be examined by touch for the swelling to be noticed.
- Class 2: The swelling can be easily seen and be felt by touch.
- Class 3: The swelling is large and extends towards the region of the sternum. When pressure is applied to it, the skin reveals compression marks.
Diagnosis of Thyroid Enlargement
In case of minor thyroid gland enlargement, a medical practitioner would suggest to the patient to wait-and-see if it needs to be treated. This is due to some goiters being a side effect of pregnancy, diet, or medication. Further medication, supplementation, or surgical intervention can make what is a minor issue be a major one.
However, depending on the results of three clinical questions, the doctor might decide to treat it through more active methods. These clinical questions are the following:
- Is the thyroid, or a part of it, so large that it compresses, invades, or stretches to nearby structures of the body?
- Is the thyroid functioning normally or is it underactive or overactive?
- Is the goiter malignant?
To answer these questions, the following information will be collected from the patient:
- Gender and Age
- Local Neck Symptoms
- Evaluation of Symptoms Indicating Possible Cancer Spread
- Hyperthyroid Symptoms
- Hypothyroid Symptoms
- Individual health factors that increase the risk of thyroid cancer
In addition to using this information for deciding upon the treatment, a variety of diagnostic tests will be done as necessary. One of such tests is a thyroid sonogram. In this test, inaudible sound waves are beamed into the neck. The echo reflected will depict the size, firmness, mobility, and tenderness of the gland and, if any, its nodules. It also confirms if the lumps are actually in the thyroid and if it is cystic or solid.
Another test done is a measurement of TSH levels in the blood. If TSH is low, it indicates the possibility of existing thyroid nodules being benign. However, if it turns out to be high, this could signify the tumor as being malignant.
If there's a chance of tumor malignancy, more tests would be done on the thyroid. One test is radioactive iodine uptake wherein the individual is injected with a certain amount of radioactive iodine. This will identify which thyroid nodules take up more iodine and which one takes less iodine. The test will provide the information which nodules are malignant since cancerous nodules take lower amounts of iodine.
Another test is fine needle aspiration cytology (FNAC), wherein a tissue sample of the swelling is taken for a biopsy. This would determine if the growth is benign, malignant, suspicious for malignancy, or indeterminate.
Never take any medication, therapy, or other forms of treatment without consulting your doctor. Make sure to consider your medical history, existing medication, supplement use, and current health condition before deciding on a treatment. Any treatment has side effects, drug interactions, and risk for complications.
The answers to the three clinical questions and the result of the diagnostic tests would determine the treatment needed to be done on the individual. The treatment could be one or a few of the following:
Thyroid Hormone Replacement Therapy
If the thyroid gland is not making enough thyroid hormones, a thyroid hormone replacement therapy would be needed to manage the negative effects of insufficient thyroid hormone production on the body. It replicates normal thyroid functioning through a dosage of pure (natural or synthetic) T4 (thyroxine) hormone. Although both T3 and T4 hormones are not insufficiently produced in hypothyroidism, only T4 hormone replacement is taken in this treatment as it would be converted to T3 by the body as needed. However, there are cases wherein the body does not convert enough T3 hormones for the body. In such cases, an additional medication of said hormone is given to the individual.
The natural source for thyroid hormone replacements come from thyroid extract and desiccated thyroid derived from beef or pork. Synthetic thyroid hormone replacements come in the form of levothyroxine sodium for T4, liothyronine sodium for T3, and liotrix for both T3 and T4.
- Uses: Thyroid hormone replacement therapy is used to treat hypothyroidism and myxedema. It is also used to prevent the release of thyroid hormones from malignant thyroid nodules when treating thyroid cancers. Aside from these conditions, it is used to manage the latter stages of thyrotoxicosis when it has progressed to its phase of hypothyroidism.
- Possible Complications: The risks for complications only arise when there's excess amount of thyroid from replacement medication and internal sources. This is why it is important to constantly control and monitor the amount of replacement hormones being taken. Excess thyroid hormones from replacement therapy can increase the risk of accelerated bone loss and heart rhythm problems.
- Side Effects: Normally, thyroid replacement hormones are tolerated by the body well that it won't experience any side effects. However, there are cases when chest pain, excessive sweating, heat intolerance, anxiety, insomnia, vomiting, weight loss, fever, diarrhea, or increased heart rate may manifest. This is often due to increased levels of toxic thyroid hormones and the actual condition of hypothyroidism. It is recommended to immediately consult a medical practitioner when experiencing any of these effects.
- Drug Interactions: The replacement hormones used in this treatment can increase the effects of blood thinners such as warfarin. Therefore, added caution and monitoring with strict drug administration are required.
For diabetic individuals, insulin and oral antidiabetic medication dosage should be adjusted as starting and discontinuing thyroid replacement hormones can alter the body's ability to control blood sugar. When the individual returns to a normal state of thyroid activity, those taking beta blockers, digoxin, and theophylline would have to get their dosage of said medications adjusted.
Calcium carbonate, cholestyramine, colestipol, and ferrous sulfate bind to thyroid replacement hormones, which prevent its absorption and decrease its effectiveness. When taking any of these medicines, take it separately from the replacement hormones by separating its administration by four hours.
Standard Iodine Supplementation
Dietary iodine intake can be insufficient due to an individual's iodine. This could arise from the difficulty to get iodine-rich foods due to their geographical location or, simply, from an individual's food preferences. In such cases, iodine supplementation can aid in helping the body get the necessary iodine to support healthy thyroid function.
- Uses: A doctor would often recommend iodine supplementation to treat thyromegaly caused by iodine deficiency. It has been found to improve the condition of those with thyrotoxicosis and hyperthyroidism. It is also used by those who have undergone surgery for thyroid-related diseases. Dosage is on a case-by-case basis. Age, gender, existing health conditions, and medication can influence the dosage of iodine supplementation. It is best to consult a medical practitioner before taking iodine supplements.
- Possible Complications: Prolonged iodine supplementation at higher doses should only be done while under medical supervision. It can introduce additional thyroid problems and aggravate existing ones. Those with thyroid disease arising from causes of autoimmunity may be sensitive to iodine supplementation and could, therefore, experience side effects.
- Side Effects: Some people may experience stomach pain, headache, diarrhea, metallic taste, and runny nose. For those with sensitivity to iodine, they can experience angioedema (swelling of the face and lips), severe bruising and bleeding, joint pain, fever, lymph node enlargement, hives, and death.
- Drug Interactions: Iodine has a major interaction with mandelate, methimazole, potassium iodide, and other medications for an overactive thyroid. Never take iodine supplementation when taking any of the mentioned medications.
Caution should be exercised when taking amiodarone; high blood pressure medication such as lithium, captopril, enalapril, lisinopril, ramipril, losartan, valsartan, irbesartan, candesartan, telmisartan, and eprosartan; and water pills like spironolactone, triamterene, and amiloride.
Levothyroxine Suppressive Therapy (LST)
Levothyroxine is a thyroid hormone replacement used to prevent hypothyroidism and the growth or recurrence of existing or past cancer on the gland. This thyroid hormone replacement suppresses the effects of the thyroid-stimulating hormone (TSH) on the thyroid. By suppressing it, TSH cannot promote the growth of both thyroid and cancer cells. More importantly, TSH suppression causes the significant decrease of thyroid nodules in size and the prevention of new nodules.
- Uses: This is for the management and elimination of benign thyroid nodules.
- Possible Complications: Prolonged thyroid-hormone-suppressive therapy causes a state of hyperthyroidism. Since only long-term administration of the hormone has been seen to provide significant effects, it is important to take the therapy under strict medical guidance and monitoring. This can increase the risk of heart and bone ailments. If an individual has a history of heart ailments or osteoporosis, it is recommended to seek an alternative.
- Side Effects: While undergoing the suppression therapy, one may experience diarrhea, weight loss, arrhythmia, sleep difficulties, irritability, anxiety, and headache.
- Drug Interactions: Women who are pregnant or taking oral contraceptives or estrogen may need to increase their dose. A decreased dose might be required for those who had just given birth, recently stopped birth control pills, and had stopped taking certain medications.
There are two anti-thyroid drugs commonly used for thyroid issues: methimazole and propylthiouracil (PTU). These are anti-thyroid drugs used to treat hyperthyroidism and for preparation prior thyroid surgery. These two drugs are primarily used for the management and prevention of further swelling on the thyroid gland.
- Possible Complications: Pregnant and breastfeeding women should seek alternative options as these drugs could cause aplasia cutis congenital and thyroid gland enlargement on the fetus. Those who are planning to get pregnant are also recommended to exercise the same precautions. Individuals who had a history of blood disease and liver disease are advised to consult their doctor to seek alternatives for these two medicines.
- Side Effects: These drugs increase the risk of agranulocytosis due to a drop in white blood cells. If a complete blood count confirms this, drug use should be stopped and rhG-CSF, recombinant human granulocyte colony-stimulating factor, would be prescribed to accelerate recovery. Other side effects of methimazole and/or PTU use include itching, skin rash, abnormal hair loss, vomiting, loss of taste, upset stomach, tingling and prickling sensations, swelling, muscle and joint pain, drowsiness, decreased platelet count, and dizziness.
- Drug Interaction: Individuals taking anticoagulants or blood thinners, diabetes medications, digoxin, theophylline, and vitamins can experience adverse effects.
Radioactive Iodine Therapy (RAI)
- Uses: This is used in eliminating any remaining follicular or papillary thyroid cancer cells that surgery cannot remove. It also removes the thyroid cancer cells that may have metastasized from the gland. For it to be effective, patients must have high amounts of thyroid-stimulating hormone in their blood.
- Possible Complications: Like any radioactive treatment, an individual can become sterile. Although rare, there's an increased for an individual to develop leukemia.
- Side Effects: Administering RAI requires the body to be in a state of hypothyroidism. Because of this, symptoms of hypothyroidism are expected to manifest on the individual.
In the short term, those undergoing and those that have gone through RAI may experience neck swelling and tenderness, vomiting, nausea, tenderness and swelling of salivary glands, dry mouth, and taste changes. It can also reduce tear formation which could lead to dry eyes.
After treatment with radioactive iodine therapy, men might experience low sperm count for up to a year. For women, they might experience irregular menstruation for up to a year.
Percutaneous Ethanol Injection
When injected, ethanol causes irreversible damage on tissues by dehydrating cells, denaturing proteins, causing cell death, and clotting blood in small vessels. This effect led to ethanol being injected into tissues to treat benign and malignant lesions including those from parathyroid adenoma, papillary thyroid carcinoma, and thyroid hyperplasia.
- Uses: It is used for the removal of thyroid nodules or cysts in the gland. It is a low-cost and non-invasive alternative to surgical treatment as it only requires sonographic visualization and ethanol injection to eliminate nodules. There's still more research to be done, but early human clinical studies have shown it to be more effective than levothyroxine suppressive therapy in reducing the volume of thyroid nodules.
- Possible Complications: Currently, there is only one instance wherein ethanol injection caused necrosis on the larynx and Plummer adenoma.
- Side Effects: During the operation, temporary and localized pain will be experienced on the jaw. One might also experience transient dysphonia, flushing, fever, hematoma, and dizziness for a day.
A thyroidectomy is the surgical removal of a portion or the whole thyroid gland. This is performed by general, endocrine, and head and neck surgeons.
- Uses: If the result of the biopsy that the swelling is benign, there's no surgery needed and would only require an individual to have periodic check-ups for monitoring purposes. If it suggests malignancy, surgical removal would usually be done provided that it would not aggravate any existing medical or health conditions. If it is indeterminate, surgical removal of nodules of the gland is recommended as these cases have a 15% chance of the individual having thyroid cancer. It is also done for cases of extremely enlarged thyroid glands. The removal could be for purely cosmetic reasons or to alleviate breathing and swallowing difficulties arising from symptomatic obstruction.
- Possible Complications: Those who have undergone thyroidectomy have a 50 percent chance of hypothyroidism. The surgery can damage the laryngeal nerve, which results in a permanently hoarse voice and recurrent injury. In extreme cases, a surgical emergency might require an incision on the front of the neck to create a direct airway that will make breathing independent from the nose or mouth.
- Side Effects: In the short-term after the surgery, pain could be experienced while breathing. This should alleviate after a few days. Pain and discomfort can be relieved through the use of non-steroidal pain relievers. There could also be neck and neck muscle tension and tenderness. This can be managed and prevented through daily gentle stretching of the neck muscles.
In the long-term, some individuals might be required to take thyroid hormone replacements. This is due to the thyroid being unable to produce adequate thyroid hormones. Even when one is not prescribed with replacement hormones, they should carefully watch for signs and symptoms of hypothyroidism. Regular testing for thyroid hormone levels is recommended for long-term management.
Management and Prevention
The simplest way to manage the symptoms of thyromegaly is through your diet. It is recommended to at least meet the daily requirement of iodine, which amounts to 150 micrograms. Foods abundant in iodine include beans, potatoes, kale, whole dairy milk, eggs, turkey, cranberries, and seafood. Aside from this, you can incorporate kelp into your daily diet as it has been found to stabilize the function of the thyroid gland. Due to their antioxidant content, garlic and green tea have also been found to be beneficial in managing the symptoms of thyromegaly.
Aside from supplementing your diet with these food items, you must also limit a few food items that can aggravate thyromegaly. It is recommended to limit your consumption of goitrogenic foods such as cabbage, spinach, and radish. Processed food, alcohol, and caffeine should also be avoided.
For thyromegaly caused by malignant thyroid nodules, it is always recommended to take an aggressive approach in its treatment. It is best to consult a medical practitioner and to strictly follow their recommendation. This can be life-threatening, and it can quickly escalate if not addressed correctly or immediately.
Lastly, you should also be aware of any drugs you're taking that can disrupt thyroid function. Some drugs that can lower thyroid hormone production include lenalidomide, tyrosine kinase inhibitors, oral cholecystographic agents, glucosteroids, and anticonvulsants. As for drugs that can increase thyroid hormone production, these include amiodarone, interferon, and eptoin. If you're taking or prescribed any of these, consult your doctor for alternatives with your thyromegaly in mind.
If your family has a history of thyromegaly or thyroid disease, it is best to take a proactive approach in its prevention. It is recommended to have a whole and balanced diet that can satisfy your body's nutritional requirements. Smoking and crash diets should be strictly avoided as these can increase the risk for thyroid disorders. You also have to start drinking purified drinking water as water from the tap contains trace amounts of fluoride that can disrupt thyroid function.
Moreover, it is recommended to have regular check-ups with your doctor to watch out for any hints of developing any cause for thyromegaly. By doing so, you can immediately address the cause before it can significantly affect your health. And, if you sense any symptom of thyroid disorder or any swelling on your neck, it is best to have it checked immediately to quickly address it.
Sources and More Information
- Ladenson, Paul. University of California San Francisco. Goiter & Thyroid Nodules. Retrieved on July 14, 2018 from https://endocrinesurgery.ucsf.edu/conditions--procedures/goiter.aspx
- Mercola, Joseph. Thyroid. Retrieved on July 14, 2018 from https://articles.mercola.com/thyroid.aspx
- Wikipedia. Thyroid-stimulating hormone. Retrieved on July 14, 2018 from https://en.wikipedia.org/wiki/Thyroid-stimulating_hormone
- Wikipedia. TRH stimulation test. Retrieved on July14, 2018 from https://en.wikipedia.org/wiki/TRH_stimulation_test
- Mayo Clinic Staff. Hypothyroidism. (May 22, 2018). Mayo Clinic. Retrieved on July 14, 2018 from https://www.mayoclinic.org/diseases-conditions/hypothyroidism/symptoms-causes/syc-20350284
- Mayo Clinic Staff. Hyperthyroidism (overactive thyroid). (Oct. 28, 2015). Mayo Clinic. Retrieved on July 14, 2018 from https://www.mayoclinic.org/diseases-conditions/hyperthyroidism/symptoms-causes/syc-20373659
- WebMD. Iodine. Retrieved on July 14, 2018 from https://www.webmd.com/vitamins/ai/ingredientmono-35/iodine
- Healthwise Staff. Thyroid-Stimulating Hormone (TSH) Suppression Therapy. (March 28, 2011). Cardiosmart. Retrieved on July 14, 2018 from https://www.cardiosmart.org/healthwise/hw16/8301/hw168301
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