Goiter
Nontoxic or simple goiter—thyroid gland enlargement not caused by inflammation or a neoplasm—is commonly classified as endemic or sporadic.
Endemic goiter usually results from inadequate dietary intake of iodine associated with such factors as iodine-depleted soil and malnutrition. Sporadic goiter follows ingestion of certain drugs or foods.
Endemic goiter affects females more than males, especially during adolescence and pregnancy, when the demand on the body for thyroid hormone increases. Sporadic goiter affects no particular population segment. With appropriate treatment, the prognosis is good for either type.
Causes
Simple goiter occurs when the thyroid gland can’t produce and secrete enough thyroid hormone to meet metabolic requirements. As a result, the thyroid gland enlarges to compensate for inadequate hormone synthesis. Such compensation usually overcomes mild to moderate hormonal impairment.
Because thyroid-stimulating hormone (TSH) levels are generally within normal limits in patients with simple goiter, the disease probably results from impaired intrathyroidal hormone synthesis or depletion of glandular iodine, which increases the thyroid gland’s sensitivity to TSH. Thyroid growth-stimulating immunoglobulins can also cause gland enlargement. However, increased levels of TSH may be transient and therefore missed.
Endemic goiter
Endemic goiter usually results from inadequate dietary intake of iodine, which leads to inadequate production and secretion of thyroid hormone. The use of iodized salt prevents this deficiency.
Sporadic goiter
Sporadic goiter commonly results from the ingestion of large amounts of goitrogenic foods or the use of goitrogenic drugs.
Goitrogenic foods contain agents that decrease thyroxine (T4) production. Such foods include rutabagas, cabbage, soybeans, peanuts, peaches, peas, strawberries, spinach, and radishes.
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