SIMPLE NON TOXIC GOITER

Simple nontoxic goiter, which may be diffuse or nodular, a noncancerous hypertrophy of the thyroid without hyperthyroidism, hypothyroidism, or inflammation.

Except in severe iodine deficiency, thyroid function is normal and patients are asymptomatic except for an obviously enlarged, nontender thyroid.

Simple nontoxic goiter, the most common type of thyroid enlargement, is frequently noted at puberty, during pregnancy, and at menopause. The cause at these times is usually unclear. Known causes include

Intrinsic thyroid hormone production defects Ingestion of foods that contain substances that inhibit thyroid hormone synthesis (cassava, broccoli, cauliflower, cabbage), as may occur in countries in which iodine deficiency is common Drugs that can decrease the synthesis of thyroid hormone (e.g., amiodarone or other iodine-containing compounds, lithium)

In the early stages, the goiter is typically soft, symmetric, and smooth.

DIAGNOSIS OF SIMPLE NONTOXIC GOITER: 

• Thyroidal radioactive iodine uptake
• Thyroid scan, Thyroid ultrasonography, Thyroid function test in the early stages, thyroidal radioactive iodine uptake may be normal or high with normal thyroid scans. Thyroid antibodies are measured to rule out Hashimoto thyroiditis.
• In endemic goiter, serum TSH may be slightly elevated, and serum T4 may be low-normal or slightly low, but serum T3 is usually normal or slightly elevated.
• Thyroid ultrasonography is done to determine whether there are nodules that are suggestive of cancer.