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Health Condition

Goiter

About This Condition

Goiter is an enlargement of the thyroid gland that often produces a noticeable swelling in the front of the neck.

This enlargement can be caused by iodine deficiency, inability of the body to use iodine correctly, or a variety of thyroid disorders, including infection, tumors, and autoimmune disease. Some environmental pollutants, heavy metal poisonings, and certain drugs can also contribute to goiter formation.1,2,3 Both iodine deficiency and inability to use iodine properly make the thyroid gland unable to produce thyroid hormone, a hormone that helps to regulate the body’s metabolic rate. This state is called hypothyroidism and the symptoms include fatigue, weight gain, heavy menstrual bleeding in women, dry skin and hair, as well as goiter.

Iodine-deficiency goiter can be common in regions where the soils and foods have insufficient iodine. Preschool children, adolescent girls, pregnant women, and the elderly are most vulnerable to goiter and other iodine-deficiency disorders.4 Areas where iodine supplies are inadequate see high rates not only of goiter but also of birth defects and retardation of both mental and physical development.5 While iodine deficiency is the leading cause of goiter worldwide, it is a rare cause of goiter in the developed world. For this reason, any goiter that occurs in the developed world must be evaluated by a healthcare provider and its cause determined before any treatment is given.

Symptoms

People with goiter may notice a soft swelling in the front of the neck.

Other Therapies

Other treatment includes the use of iodized table salt and the avoidance of goiter promoting (goitrogenic) foods, such as cabbage, Brussels sprouts, and soy. Surgical removal or radioactive iodine treatments may be necessary for cosmetic reasons or in individuals with large goiters that interfere with breathing or swallowing.

References

1. Prescott E, Netterstrom B, Faber J, et al. Effect of occupational exposure to cobalt blue dyes on the thyroid volume and function of female plate painters. Scand J Work Environ Health 1992;18:101-4.

2. Gaitan E. Goitrogens. Baillieres Clin Endocrinol Metab 1988;2:683-702 [review].

3. Gaitan E. Goitrogens in food and water. Annu Rev Nutr 1990;10:21-39 [review].

4. Ingenbleek Y, De Visscher M. Hormonal and nutritional status: critical conditions for endemic goiter epidemiology? Metabolism 1979;28:9-19 [review].

5. Lamberg BA. Endemic goitre--iodine deficiency disorders. Ann Med 1991;23:367-72 [review].

6. Koutras DA. Iodine metabolism in endemic goitre. Ann Clin Res 1972;4:55-63 [review].

7. Lee K, Bradley R, Dwyer J, Lee S. Too much versus too little: The implications of current iodine intake in the United States. Nutr Rev 1999;57:177-81 [review].

8. Cotran RS, Kumar V, Robbins SL. Robbins Pathologic Basis of Disease, 4th edition. Philadelphia: WB Saunders Co, 1989, 1227-8.

9. Gaitan E. Goitrogens in food and water. Annu Rev Nutr 1990;10:21-39 [review].

10. Wilson JD, Foster DW, Kronenberg HM, Larsen PR. Williams Textbook of Endocrinology, 9th edition. Philadelphia: WB Saunders Co, 1998, 469.

11. Ozata M, Salk M, Aydin A, et al. Iodine and zinc, but not selenium and copper, deficiency exists in a male Turkish population with endemic goiter. Biol Trace Elem Res 1999;69:211-6.

12. Kawada J, Nishida M, Yoshimura Y, Yamashita K. Manganese ion as a goitrogen in the female mouse. Endocrinol Jpn 1985;32:635-43.

13. Untoro J, Ruz M, Gross R. Low environmental selenium availability as an additional determinant for goiter in East Java, Indonesia? Biol Trace Elem Res 1999;70:127-36.

14. Corvilain B, Contempre B, Longombe AO, et al. Selenium and the thyroid: how the relationship was established. Am J Clin Nutr 1993;57:244S-248S [review].

15. Vanderpas JB, Contempre B, Duale NL, et al. Selenium deficiency mitigates hypothyroxinemia in iodine-deficient subjects. Am J Clin Nutr 1993 Feb;57(2 Suppl):271S-275S [review].

16. Roti E, Minelli R, Gardini E, et al. Selenium administration does not cause thyroid insufficiency in subjects with mild iodine deficiency and sufficient selenium intake. J Endocrinol Invest 1993;7:481-4.

17. Zimmermann MB, Adou P, Torresani T, et al. Effect of oral iodized oil on thyroid size and thyroid hormone metabolism in children with concurrent selenium and iodine deficiency. Eur J Clin Nutr 2000;3:209-13.

18. Keyvani F, Yassai M, Kimiagar M. Vitamin A status and endemic goiter. Int J Vitam Nutr Res 1988;58:155-60.

19. Mesaros-Kanjski E, Kontosic I, Kusic Z, et al. Endemic goitre and plasmatic levels of vitamins A and E in the school-children on the island of Krk, Croatia. Coll Antropol 1999;23:729-36.

20. Mutaku JF, Many MC, Colin I, et al. Antigoitrogenic effect of combined supplementation with dl-alpha-tocopherol, ascorbic acid and beta-carotene and of dl-alpha-tocopherol alone in the rat. J Endocrinol 1998;156:551-61.

21. Keyvani F, Yassai M, Kimiagar M. Vitamin A status and endemic goiter. Int J Vitam Nutr Res 1988;58:155-60.

22. Mesaros-Kanjski E, Kontosic I, Kusic Z, et al. Endemic goitre and plasmatic levels of vitamins A and E in the school-children on the island of Krk, Croatia. Coll Antropol 1999;23:729-36.

23. Mutaku JF, Many MC, Colin I, et al. Antigoitrogenic effect of combined supplementation with dl-alpha-tocopherol, ascorbic acid and beta-carotene and of dl-alpha-tocopherol alone in the rat. J Endocrinol 1998;156:551-61.

24. Ozata M, Salk M, Aydin A, et al. Iodine and zinc, but not selenium and copper, deficiency exists in a male Turkish population with endemic goiter. Biol Trace Elem Res 1999;69:211-6.

25. Kawada J, Nishida M, Yoshimura Y, Yamashita K. Manganese ion as a goitrogen in the female mouse. Endocrinol Jpn 1985;32:635-43.

26. Untoro J, Ruz M, Gross R. Low environmental selenium availability as an additional determinant for goiter in East Java, Indonesia? Biol Trace Elem Res 1999;70:127-36.

27. Corvilain B, Contempre B, Longombe AO, et al. Selenium and the thyroid: how the relationship was established. Am J Clin Nutr 1993;57:244S-248S [review].

28. Vanderpas JB, Contempre B, Duale NL, et al. Selenium deficiency mitigates hypothyroxinemia in iodine-deficient subjects. Am J Clin Nutr 1993 Feb;57(2 Suppl):271S-275S [review].

29. Roti E, Minelli R, Gardini E, et al. Selenium administration does not cause thyroid insufficiency in subjects with mild iodine deficiency and sufficient selenium intake. J Endocrinol Invest 1993;7:481-4.

30. Zimmermann MB, Adou P, Torresani T, et al. Effect of oral iodized oil on thyroid size and thyroid hormone metabolism in children with concurrent selenium and iodine deficiency. Eur J Clin Nutr 2000;3:209-13.

31. Lamberg BA. Iodine deficiency disorders and endemic goitre. Eur J Clin Nutr 1993;47:1-8 [review].

32. Koutras DA. Iodine metabolism in endemic goitre. Ann Clin Res 1972;4:55-63 [review].

33. Lee K, Bradley R, Dwyer J, Lee S. Too much versus too little: The implications of current iodine intake in the United States. Nutr Rev 1999;57:177-81 [review].

34. Lamberg BA. Endemic goitre--iodine deficiency disorders. Ann Med 1991;23:367-72 [review].

35. Dunn JT. Seven deadly sins in confronting endemic iodine deficiency, and how to avoid them. J Clin Endocrinol Metab 1996;81:1332-5 [review].

36. Ingenbleek Y, Jung L, Ferard G. Brassiodol, a new iodised oil for goitrous patients. Coll Antropol 1998;22:51-62.

37. Untoro J, Schultink W, Gross R, et al. Efficacy of different types of iodised oil. Lancet 1998;351:752-3.

38. Franceschi S, Talamini R, Fassina A, Bidoli E. Diet and epithelial cancer of the thyroid gland. Tumori 1990;76:331-8 [review].

39. Wilson JD, Foster DW, Kronenberg HM, Larsen PR. Williams Textbook of Endocrinology, 9th edition. Philadelphia: WB Saunders Co, 1998, 469.

40. Stoewsand GS. Bioactive organosulfur phytochemicals in Brassica oleracea vegetables—a review. Food Chem Toxicol 1995;33:537-43 [review].

41. Sartelet H, Serghat S, Lobstein A, et al. Flavonoids extracted from fonio millet (Digitaria exilis) reveal potent antithyroid properties. Nutrition 1996;12:100-6.

42. Divi RL, Chang HC, Doerge DR. Anti-thyroid isoflavones from soybean: isolation, characterization and mechanisms of action. Biochem Pharmacol 1997;54:1087-96.

43. Gaitan E. Goitrogens in food and water. Annu Rev Nutr 1990;10:21-39 [review].

44. Mawson R, Heaney RK, Zdunczyk Z, Kozlowska H. Rapeseed meal-glucosinolates and their antinutritional effects. Part 4. Goitrogenicity and internal organs abnormalities in animals. Nahrung 1994;38:178-91.

45. Bell JM. Nutrients and toxicants in rapeseed meal: a review. J Anim Sci 1984;58:996-1010 [review].

46. Gaitan E. Goitrogens. Baillieres Clin Endocrinol Metab 1988;2:683-702 [review].

47. Ozata M, Salk M, Aydin A, et al. Iodine and zinc, but not selenium and copper, deficiency exists in a male Turkish population with endemic goiter. Biol Trace Elem Res 1999;69:211-6.

48. Kawada J, Nishida M, Yoshimura Y, Yamashita K. Manganese ion as a goitrogen in the female mouse. Endocrinol Jpn 1985;32:635-43.

49. Ingenbleek Y, Luypaert B, De Nayer P. Nutritional status and endemic goitre. Lancet 1980;1:388-91.

50. Osman AK, Fatah AA. Factors other than iodine deficiency contributing to the endemicity of goitre in Darfur Province (Sudan). J Hum Nutr 1981;35:302-9.

51. Gaur DR, Sood AK, Gupta VP. Goitre in school girls of the Mewat area of Haryana. Indian Pediatr 1989;26:223-7.

52. Gaitan E. Goitrogens. Baillieres Clin Endocrinol Metab 1988;2:683-702 [review].

53. Lamberg BA. Endemic goitre--iodine deficiency disorders. Ann Med 1991;23:367-72 [review].

54. Centanni M, Maiani G, Vermiglio F, et al. Combined impairment of nutritional parameters and thyroid homeostasis in mildly iodine-deficient children. Thyroid 1998;8:155-9.

55. Filteau SM, Sullivan KR, Anwar US, et al. Iodine deficiency alone cannot account for goitre prevalence among pregnant women in Modhupur, Bangladesh. Eur J Clin Nutr 1994;48:293-302.

56. Gaitan E. Goitrogens in food and water. Annu Rev Nutr 1990;10:21-39 [review].

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The information presented by Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2018.

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