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Ions such as thiocyanate [7] (from cigarette smoking for example [8]) and perchlorate decrease iodide uptake by competitive inhibition and, as a consequence of reduced thyroxine and triiodothyronine secretion by the gland, cause, at low doses, an increased release of thyrotropin (by reduced negative feedback), which then stimulates the gland.
A goitre, or goiter, is a swelling in the neck resulting from an enlarged thyroid gland. [1] [2] A goitre can be associated with a thyroid that is not functioning properly. Worldwide, over 90% of goitre cases are caused by iodine deficiency. [3] The term is from the Latin gutturia, meaning throat.
It can alter cardiac function, with increased heart rate, increased left ventricular mass index, increased cardiac contractility, diastolic dysfunction, and induction of ectopic atrial beats. Long-term mild excess of thyroid hormone can thus cause impaired cardiac reserve and exercise capacity. [4]
Diffuse goiter may be seen with other causes of hyperthyroidism, although Graves' disease is the most common cause of diffuse goiter. A large goiter will be visible to the naked eye, but a small one (mild enlargement of the gland) may be detectable only by physical examination.
De Quervain's thyroiditis, also known as subacute granulomatous thyroiditis or giant cell thyroiditis, is a self-limiting inflammatory illness of the thyroid gland. [1] De Quervain thyroiditis is characterized by fever, flu-like symptoms, a painful goiter, and neck pain.
The most common type of hyperthyroidism, Graves' disease, may additionally cause eye problems (Graves' ophthalmopathy) and skin changes of the legs (pretibial myxedema). [6] Thyroid disease may also cause muscle weakness in the form of thyrotoxic myopathy, but this is constant rather than episodic. [5]
Before 1950 goiter was a widespread disease caused by iodine deficiency. [40] Up to 80 percent of the population were affected in inland areas. In the coastal communities, saltwater fish were an important part of the diet, and because of the presence of iodine in seawater, goiter was less common than in the inland districts.
Measurement of thyroid stimulating hormone and anti-thyroid antibodies will help decide if there is a functional thyroid disease such as Hashimoto's thyroiditis present, a known cause of a benign nodular goitre. [4] Fine needle biopsy for cytopathology is also used. [5] [6] [7] Thyroid nodules are extremely common in young adults and children.