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An overview of thyromegaly
The thyroid gland is the gland responsible for producing the hormones that regulate body temperature, metabolism, heart rate, digestion, mode, and respiration and enhance the growth and development of the body. Dysfunction of the thyroid gland leads to many clinical complications within the human body.
In recent epidemiological studies, American Thyroid Association said nearly 200 million people worldwide have some form of thyroid disease. One of the major diseases of the thyroid gland is Thyromegaly, which manifests as an enlargement of the thyroid gland. This thyroid enlargement can also be a serious indicator of malignancy.
What is thyromegaly?
Thyromegaly is a medical condition characterized by an abnormal enlargement of the thyroid gland. It manifests as an evident swelling below Adam’s apple in both men and women. The thyromegaly condition, also known as goiter, is largely credited to the dysfunctions of the thyroid gland.
The major cause attributed to this dysfunction is insufficient iodine. Globally, one-third of the population suffers from a low intake of iodine. So, when the thyroid gland cannot produce enough hormone, it enlarges to compensate. However, thyromegaly is usually painless, irrespective of how large it might be.
However, a large thyromegaly can cause a cough and difficulty in swallowing or breathing. If left untreated or unchecked, it can cause serious harm, as the thyroid gland can turn highly ineffective, stops making thyroid hormone, or produces too much.
This leads to hyperthyroidism and hypothyroidism. Most of the cases studied so far have indicated that women are more likely to develop thyromegaly than men, and heredity was a significant role in the diagnosed cases of the enlarged thyroid gland. The treatment of this condition depends on the size of the thyromegaly, the symptoms shown, and the cause.
- Iodine deficiency: The main cause of a thyromegaly condition is iodine deficiency. In the production of thyroid hormones, iodine plays a dynamic role. So, when the body does not produce enough iodine, or a person does not consume enough iodine or consumes a diet high in hormone-inhibiting foods, such as cabbage, broccoli, and cauliflower, the thyroid enlarges in a bid to obtain more iodine.
- Graves’ disease: This autoimmune disease occurs when the immune system wrongly attacks the thyroid gland. In response, the thyroid overstimulates and begins to release an excess of thyroxin hormones, which leads to hyperthyroidism, and in turn, a thyromegaly condition.
- Hashimoto’s disease: A thyromegaly condition can occur from an underactive thyroid (that is, hypothyroidism). Hashimoto’s disease is also an autoimmune disorder. That is, it occurs when the immune system, by mistake, attacks the thyroid gland. This damages the thyroid gland and makes it unable to produce sufficient hormones. The low hormone level motivates the pituitary gland to produce more TSH to stimulate the thyroid, which in the end, causes the thyroid gland to enlarge.
- Multi-nodular goiter: In some thyromegaly conditions, several solid or fluid-filled knobs known as nodules develop on both sides of the thyroid, thereby resulting in overall enlargement of the gland.
- Solitary thyroid nodules: in a few cases, a single nodule grows in one part of the thyroid gland. This is usually non-cancerous and never leads to cancer.
- Inflammation: An inflammation of the thyroid known as thyroiditis may occur and cause pain and swelling of the thyroid gland. Thyroiditis may also cause the body to produce too much or too little thyroxin. It can be caused by an infection, an autoimmune disease (such as Hashimoto’s or Graves’ disease), medications (such as interferon and amiodarone), and radiation therapy.
- During pregnancy: The body produces excess hormones during pregnancy. One such hormone is human chorionic gonadotropin (hCG) can cause enlargement of the thyroid gland.
- Medications: a few medications, such as lithium, amiodarone, interleukin-2, and interferon-alpha, can disturb the normal mechanism of thyroid hormone production .
- Pituitary gland dysfunction
Inflammation can also lead to leakage of the thyroid hormone into the bloodstream and cause the thyroid gland to swell.
The most common symptom of a thyromegaly condition is an enlarged thyroid gland.
Other common symptoms may include the following –
- Tightness in the neck and cough.
- Difficulty in swallowing food and breathing.
- Voice hoarseness.
- Fever (if the infection is present), headache, dizziness, and general malaise
- Nausea and vomiting
- Dry hair and skin and brittle nails (due to the degeneration of keratin cells)
- Depression, fatigue, constipation, weakness, and stiff joints.
- Abnormal weight loss or gain
- Muscle weakness
- Impaired growth in children
How is thyromegaly diagnosed?
A simple physical examination of the neck may be enough to diagnose a thyromegaly condition. During the examination, a doctor feels (palpates) the neck and asks the patient to swallow. If the thyroid gland is found to be enlarged, further analysis will be carried out to determine the underlying cause. The following may be requested to diagnose the underlying cause of a thyromegaly condition:
- Thyroid hormone function tests: carried out to measure the amount of T3, T4, and TSH in the blood.
- Ultrasound scan: to generate an image of the thyroid gland.
- Thyroid Radioiodine scan: to generate an image of the thyroid on a computer screen, using a radioactive isotope injected into the vein on the inside of the elbow.
- Thyroid fine needle biopsy (FNAC): A fine needle is used to take a sample of tissue in the thyroid gland for laboratory analysis.
- Thyroid antibody tests.
How is thyromegaly treated?
Thyromegaly treatment is based on the exact condition of the thyroid gland. That is, the underlying cause of thyromegaly. The doctor will choose the right thyromegaly treatment option for the patient after a thorough examination and the underlying cause. Some of the thyromegaly treatment options are – standard iodine supplementation, medications, thyroid hormone replacement therapy, levothyroxine suppressive therapy, radioactive iodine therapy, and thyroidectomy surgery .
Usually, nodules on the thyroid gland are non-cancerous, but in very rare cases, they can be cancerous. According to studies that have been carried out, thyroid cancer occurs in about 8% of thyroid nodules in men and 4% of thyroid nodules in women.
However, it is not quite understood why and how nodules increase the risk of cancer.
The outlook for thyromegaly conditions depends on the underlying cause and the size of the swelling.
a) Consumption of insufficient dietary iodine
b) Female sex hormone: Women are more prone to thyroid disorders.
c) Age: A thyroid gland disorder is more common among those above the age of 40.
d) Medical history: A personal or family history of the autoimmune disease increases the risk of developing this condition.
e) Radiation exposure: Exposure to radiation around the neck or chest area increases the risk of thyroid disorders.
A thyromegaly condition that doesn’t cause physical or cosmetic problems is not of concern. But large size thyromegaly condition can make it quite hard to breathe or swallow. Cough and hoarseness may also occur.
Other possible complications may be fatigue, weight gain, unintended weight loss, irritability, and trouble sleeping.
Yes. A family history of thyroid gland problems may put one at risk of having thyromegaly or other thyroid-related disorders.
1) Follow a strict thyroid-healthy diet.
2) Quit smoking and drinking.
3) Be wary of fluoride contamination in water.
4) Crash diets should be strictly no-no.
5) Beware of environmental toxins.
6) Reduce exposure to harmful radiations, such as X-rays
The human chorionic gonadotropin (HCG) hormone produced during pregnancy may cause the thyroid gland to enlarge slightly.
In most cases, the enlarged thyroid gland is painless. However, a larger goiter can cause difficulty in breathing or swallowing. It can also cause coughing and a tight feeling in the throat .