That non-toxic goiter 1 degree. How to prevent the appearance of diffuse non-toxic goiter? cherry blossom tea

Increase in size thyroid gland. It is considered enlarged if the size of the particles is larger than the size of the terminal phalanx of the thumb.

Iodine deficiency and endemic goiter

A region is said to be endemic for goiter if more than 10% of the inhabitants of that area develop goiter. If more than 5% of children and adolescents determine the thyroid gland of degree Ia or in 30% of adults the size of the thyroid gland exceeds the degree of 16 - this is also an indicator of the endemic territory behind the goiter.

In the epidemiological indicators of the assessment of a territory endemic for goiter, the Lenz-Bauer coefficient also belongs - the ratio of the number of men with goiter to the number of women with goiter. Goiter is taken into account to determine the coefficient to a large extent in persons over 20 years of age.

Mild endemia is determined if the Lenz-Bauer ratio is 1:9-1:7, medium-1:6-1:4, large-1:3-1:1. An indicator of endemia is also the presence of goiter in herbivores (cows, horses, sheep).

Epidemiologically, in the regions of goiter endemia, goiter correlates with the prevalence of deaf-mutism.

The reasons

The main cause of endemia behind goiter is an increase in the environment depleted in iodine. According to WHO (1993), about 655 million people in the world suffer from endemic goiter, about 15 billion of the population are observed various complications caused by iodine deficiency. In Ukraine, endemic areas for goiter are traditionally Prykarpattya, Carpathians, Transcarpathia.

Iodine is vital necessary elements. It is found in all living organisms without exception. The vast majority of iodine enters the human body with drinking water.

Determining that iodine is the main factor in the occurrence and development of goiter endemia, the role of other factors in the development of goiter endemia should be recognized. Families with significant degrees of goiter and without it at all, families with obvious clinical hypothyroidism, deaf-mutism, cretinism and families without hypothyroidism and psychoneurotic disorders live in one territory. Given the above, the problem of endemic goiter cannot be reduced solely to iodine deficiency. Strengthen the occurrence of goiter endemia deficiency of zinc, manganese, selenium, molybdenum, copper, cobalt, excess calcium. The goiter effect of a lack of biogenic microelements is due to their participation in the active centers of iodine metabolism enzymes. In particular, the lack of copper leads to a decrease in the activity of iodinase involved in the addition of iodine to the tyrosyl radical. The activity of cytochrome oxidase and ceruloplasmin is associated with the copper content. Due to the lack of cobalt, the biosynthesis of thyroid hormones slows down due to the insufficient activity of iodoperoxidase, and the processes of goiter formation are intensified.

The compensatory ability of the body to maintain sufficient synthesis of thyroid hormones with a mild degree of iodine deficiency decreases in the case of infectious diseases, helminthic invasions, poor sanitary and hygienic living conditions of the population.

Hereditary factors of goiter endemia include congenital defects in the biosynthesis of thyroid hormones. In closed populations, the number of these defects increases due to marriages between people of the same family. If both parents are sick with goiter, then the likelihood of goiter in children increases by 4 times compared with the offspring of healthy parents. Genetic analysis reveals the dominant type of inheritance of a defect in the biosynthesis of thyroid hormones with a penetrance of 0.7-0.8. Incomplete penetrance of dominant genes indicates the possibility of influence external factors on the implementation of a hereditary predisposition to goiter.

Along with a clear lack of iodine, factors that contribute to the development of relative iodine deficiency predispose to the development of iodine deficiency conditions: natural strumogens food products; substances that block the transport of iodides to the thyrocyte (nitrites, periodates, perchlorates, thiocyanates); drugs, disturbing organization of iodine (thiourea derivatives, para-aminobenzoic acid, sulfonamides, acetylsalicylic acid, resorcinol). The development of relative iodine deficiency is promoted by genetic defects in the biosynthesis of thyroid hormones with increased urinary excretion of monoiodotyrosine and diiodotyrosine. Damage to the digestive organs and the presence of a significant amount of humic substances in the water lead to impaired absorption of iodine.

Symptoms

Lack of iodine in itself contributes to goitregenesis and a decrease in the secretory capacity of the thyroid gland. Due to a decrease in intrathyroid iodine in the gland, the synthesis of diiodotyrosine decreases and the amount of monoiodotyrosine increases, the ratio of hormones increases due to the growth of biologically active triiodothyronine. This compensates for the euthyroid state against the background of iodine deficiency.

Due to a decrease in the content of triiodothyronine in the blood plasma, the concentration of thyrotropin increases, which stimulates the growth of thyrocytes, activates blood flow in the gland and increases its size. An increase in the content of thyrotropin induces hyperplasia of parenchymal cells and increased absorption of iodine from the blood. As a result of this compensation mechanism, the absorption of iodine by the thyroid gland increases by 4-8 times.

Against the background of iodine deficiency, the conversion of thyroxin to sodium iodothyronine is accelerated, thereby achieving more economical use of iodine.

Reduced Mechanisms long time compensate for the lack of iodine intake from the environment and the euthyroid state of a person. An adaptive manifestation of iodine deficiency is goiter, which is considered the main symptom of iodine deficiency. It is diffuse at first, but with increasing iodine deficiency or thyroid hormone requirements (puberty, pregnancy, infectious or severe somatic diseases) the size of the goiter increases. After 10-15 years, hyperplasia is already local in nature, nodes and adenomas appear in the gland. Finally, diffuse endemic goiter becomes multinodular.

In case of exhaustion of the body's compensatory capabilities, hypothyroidism occurs.

However, the development of thyrotoxicosis is possible. Adenomas and nodes are capable of hyperfunction, and provided sufficient iodine supply, these autonomous nodes begin to secrete excess amount thyroid hormones, therefore, there is a clinic of iodine-induced thyrotoxicosis.

In 1980, individual immunoglobulins (class G) were isolated from the serum of patients with thyroid diseases, which specifically stimulate the growth of the thyroid gland and do not affect its function.

In the pathogenesis of clinical manifestations of endemic goiter, a significant place is occupied by inhibition natural immunity: decrease in phagocytic activity of neutrophils, complement and lysozyme titers; weakening of the ability to produce antibodies in response to vaccination in children.

Infectious diseases increase the functioning of the thyroid gland. Against the background of iodine deficiency, mild forms of hypothyroidism become clinically pronounced.

In the pathogenesis of disorders from nervous system underdevelopment of the curl lies in the case of deaf-mutism, neocortex - with mental retardation, striatum - in case of movement disorders.

A common manifestation of severe iodine deficiency is endemic cretinism. Its development is due to disturbances in the formation and activity of the nervous system due to a lack of iodine and maternal hypothyroidism. In the emergence and development of cretinism, the impact of iodine deficiency at all stages of development of the embryo, fetus and child is important.

Maternal hypothyroxinemia in the first trimester of pregnancy slows down the development of the brain and nervous system of the fetus. After the creation of the thyroid gland of the fetus (12th week), with a lack of iodine, the laying of synapses is disrupted.

The formation of the brain is completed within 3 years. If in given period life there is a lack of iodine and thyroid hormones, then irreversible disorders in the brain begin, which cannot be eliminated in the future.

Short stature in the regions of endemic goiter is explained by a decrease in the stimulating effect of thyroid hormones on the insulin-like cartilage growth factor and the release of somatotropin by the anterior pituitary gland.

A frequent manifestation of iodine deficiency is the gradual diffuse magnification in the size of the thyroid gland. The gland may be slightly enlarged or reach large sizes. Usually, the gland is enlarged evenly, although nodular and diffuse-nodular forms of goiter are possible. By easy and medium degree iodine deficiency growth of the size of the gland occurs gradually.

The clinical condition of people with goiter is euthyroid for a long time with the gradual development of hypothyroidism. A large goiter can cause symptoms of compression of the neck organs.

The nature and severity of clinical manifestations depend on the period of life during which iodine deficiency occurs (pregnancy, antenatal, postnatal periods, puberty). Of great importance are also hereditary factors, the body's ability to adapt to iodine deficiency, the influence of strumogens, somatic and infectious diseases.

The presence of a goiter is only cosmetic defect. Clinical manifestations disease leads to hypothyroidism, which is associated fatigue, slowing down mental reactions, dysmenorrhea, galactorrhea, impaired reproductive ability of women. In children, growth retardation is the leading sign. With an increase in the severity of hypothyroidism, its characteristic signs are found: constipation, physical and mental lethargy, drowsiness, chilliness, weight gain.

Children with endemic goiter and mild manifestations hypothyroidism students study worse at school, get sick more often, they are often diagnosed with anemia.

Classification

Allocate goiter diffuse,nodal and mixed. Histologically, goiter is divided into colloid and parenchymal.

Colloidal goiter consists of follicles of different sizes, filled with colloid. In some cases, the follicles are large, with a flattened epithelium, which is a sign of macrofollicular colloid goiter; in others, they are small, which indicates a microfollicular goiter. Perhaps a combination of these changes - micro-macrocoloid goiter. It is also possible for epithelial proliferation proliferative colloid goiter.

Parenchymal goiter characteristic of the proliferation of the epithelium of the follicles in the form of structures with the formation of formations without colloid or with a small amount of it.

Diagnostics

The basis for the diagnosis is the presence of goiter in a person who has lived or has lived for a long time in areas endemic for goiter.

The content of thyroid hormones is directed towards an increase in triiodothyronine relative to thyroxine. According to the euthyroid status, the content of thyrotropin was within the normal range. As the functional capacity of the thyroid gland decreases, the content of thyrotropin increases. With the help of ultrasound, the volume of the gland and its structure are determined. On the scan, “cold” areas are often found, which are more often colloidal nodes with cystic degeneration. With the help of a cytological study, a variant of endemic goiter is established. Parenchymal nodes are characterized by the presence of thyroid epithelium and a small amount of colloid, blood cells due to good vascularization of parenchymal goiter. Nodular endemic goiter is mostly colloidal. In punctate - a significant amount of colloid, blood cells, siderophages, altered thyrocytes, connective tissue cells and lymphocytes.

According to fine-needle aspiration biopsy, differential diagnosis With autoimmune thyroiditis and thyroid tumors. These conditions are possible against the background of endemic goiter.

Diagnosis nodular goiter set in the presence of a node with a size of 5 mm. or more, confirmed echographically. After a fine-needle biopsy with the help of a cytological examination, the diagnosis is clarified (nodular goiter, adenoma, cyst).

A combination of ultrasound needle biopsy With cytological examination punctates allows to predict further tactics of treatment of the patient.

Laboratory diagnostics. The study of urinary iodine excretion (ioduria) allows you to identify an indicator of the assessment of iodine deficiency in the population, and not in a particular patient. Normally, in adolescents and adults, ioduria is more than 100 mcg / l.

The concentration of thyroglobulin in the blood plasma is inversely proportional to the iodine supply of the body, especially in babies. The median thyroglobulin concentration in adults should be less than 19 ng / ml, in infants - 24 ng / ml.

Prevention

Elimination of iodine deficiency is achieved through mass, group and individual prophylaxis. The main source of iodine in the human body is water, animal products (meat, milk), seafood.

For mass prevention of iodine deficiency, it is recommended to use iodine-enriched foods. A common measure of mass iodine prophylaxis is the use of iodized salt. To table salt add potassium iodide or potassium iodate. Salt must be packaged in waterproof bags. Under the influence of water, sunlight, iodide decomposes. The expiration dates of iodized salt must be observed. Over time, the iodine content in salt decreases. During cooking, iodine passes to the products.

Mass iodine prophylaxis can be carried out by iodizing butter, bread, adding iodides to pet food. For mass iodine prophylaxis, iodized oil is used - lipoidol. Ingestion of lipoidol provides prevention of iodine deficiency for 6-12 months. In regions where it is difficult to ensure a constant supply of iodized salt, this method is the main means of iodine prophylaxis, especially for pregnant women, mothers, and children.

Group prophylaxis is the use of dosed iodine preparations by certain categories of the population that have a significant risk of iodine deficiency: children, adolescents, pregnant women, mothers.

Inhabitants of endemic regions should always receive iodine, regardless of the size of the thyroid gland. best source iodine for babies is mother's milk. Therefore, breastfeeding will be an appropriate means of prevention, especially in the first 4-6 months of life.

When artificial feeding premature infants, the dose of iodide is 20 mcg. per 100 ml. milk, for full-term - 10 mcg. per 100 ml. milk.

Individual iodine prophylaxis is carried out in cases of an increasing need for iodine. It is recommended for women a year before a planned pregnancy, for convalescents after severe somatic or infectious diseases, after courses of antibiotic therapy (erythromycin, cyclosporine, penicillin, streptomycin) or treatment with sulfanilamide drugs, as well as in cases of diseases of the digestive system.

ENDOCRINOLOGY - EURODOCTOR.ru -2005

Simple non-toxic goiter is a disease characterized by diffuse or nodular enlargement of the thyroid gland in people who do not live in areas endemic for goiter.

Simple nontoxic or sporadic goiter occurs more often in women and in those working with goitrogenic substances. These are mercury, benzene, thiocyanates, nitrates.

There is a hereditary predisposition to the development of this type goiter. It can be familial and occur over several generations, especially in women. childbearing age. The frequency of non-toxic goiter increases with age, with malnutrition, especially with a lack of protein in the diet.

For education thyroid hormones one of essential amino acids- tyrosine. And with a lack of it in food, the synthesis of thyroxine and triiodothyronine slows down. When exposed to pesticides, nitrogen oxides, lead salts, mercury, hydrogen sulfide compounds, cyanides, the formation of thyroid hormones is suppressed, which can also lead to the development of goiter. The action of all adverse factors in adolescence when the body grows and rebuilds and needs a lot of thyroid hormones. The same happens during pregnancy during menopause. Increase the need for thyroid hormones for a long time stressful situations and chronic diseases.

Possible occurrence simple non-toxic goiter at long-term use some medicines. These are drugs containing lithium, perchlorates, thiocyanates, thiouracil and thiourea derivatives. It also has an adverse effect on the functioning of the thyroid gland. a large number of fats in blood plasma. Under the influence of all these adverse factors, any of the stages in the formation of thyroid hormones is disrupted:

• uptake of iodine by gland tissue
• tyrosine biosynthesis
• synthesis of thyroxine and triiodothyronine
• the normal ratio of thyroxine and triiodothyronine shifts towards more active triiodothyronine
• transport of hormones to their site of action.

Failure thyroid hormones in the blood, in turn, causes the release of a large amount of the pituitary hormone in the brain - thyrotropin, which stimulates the thyroid gland. Under the influence of this hormone, the thyroid tissue grows, the thyroid gland increases in volume evenly ( diffuse goiter ) or local tissue growths are formed ( nodular goiter). Over time in thyroid gland cysts, hemorrhages in the nodes may occur, calcium salts are deposited in the thyroid tissue, calcifications are formed.

Diagnosis of simple non-toxic goiter.

Simple non-toxic goiter maybe for a long time proceed unnoticed by the patient, especially in the early stages. During examination and palpation, an increase in the size of the thyroid gland or an uneven structure of the gland - nodular formations can be detected. Palpation of the thyroid gland is painless.

Subsequently, there are discomfort in the thyroid gland, sensation of a lump in the throat, difficulty in swallowing, a feeling of pressure in the neck when tilting and turning the head. Sometimes when large sizes thyroid in the supine position, there may be difficulty in breathing. Thyroid function is usually preserved.

But sometimes they appear lung symptoms hypothyroidism (decreased thyroid function), which are aggravated by adverse conditions (chronic diseases, increased physical and mental stress, pregnancy).

The patient appears chilliness, slowness. Weight may increase. Patients have dry skin. Body temperature may be slightly reduced. The heart rate slows down. In women, it may be disturbed menstrual cycle. may also be the cause of infertility.

Diagnosis simple non-toxic goiter installed in patients who do not live in endemic goiter regions. Held digital examination thyroid gland, which suggests the presence of a goiter. At ultrasound examination gland, its size, the shape of the goiter (diffuse or nodular) are specified. To determine the function of the thyroid gland, a radioisotope study of the thyroid gland is performed, measuring the level of thyroid hormones in the blood. Sometimes, if the amount of blood hormones is sufficient, a test with rifatiroin is performed to study the reserves of the gland, which reveals latent hypothyroidism.

Treatment of simple non-toxic goiter.

In the treatment of simple non-toxic goiter great importance has a diet. Food must be complete. Food must be consumed enough squirrel. Goiter should be excluded from food products (contributing to the development of goiter). These are radish, radish, beans, swede, cauliflower, peanut.

Medical treatment simple non-toxic goiter carried out by synthetic thyroid hormones (thyroxine, thyrotomy). Thyroxine is prescribed on an empty stomach. The dose of the drug is selected individually under the control of the patient's condition and the amount of thyroid hormones in the blood. If the patient maintains a constant weight, the pulse and blood pressure normalize, the size of the thyroid gland decreases, in the blood normal amount hormones - the dose is considered sufficient.

Surgery simple non-toxic goiter carried out if the thyroid gland rapidly increases in volume despite treatment, if there are signs of compression of the neck organs and if a so-called cold knot is found in the thyroid gland. Cold nodule is called, which, when radioisotope study does not accumulate radioactive iodine and the results of his biopsy are doubtful, that is, it cannot be excluded cancerous degeneration thyroid cells. The prognosis for this disease is favorable. With timely treatment, recovery occurs.

Nodular non-toxic goiter of the thyroid gland is an increase in the size of the gland with the formation of seals or nodules in its tissue. It produces hormones that help regulate the metabolism of the human body. It is located on the neck in its front region directly under the Adam's apple. Nodules are rarely painful and tend to grow very slowly.

There is different kinds goiter. Consider non-toxic goiter, or sporadic. This is a type of simple goiter, which can be:

• Diffuse - with the involvement of the entire tissue of the gland in the process.
• Nodal. In this case, the formation and growth of nodules on the gland occurs. Could be a multinodular goiter.

The development of seals is a marker of goiter progression. In this situation, it is necessary to consult an endocrinologist, who decides on further methods treatment of such a patient.

Reasons for the formation of nodes

The exact reasons why nodular non-toxic goiter develops are unknown. It can be caused by too much or, conversely, insufficient synthesis of hormones. There are cases when a goiter of the thyroid gland is formed during its normal function. The high frequency of such situations should be noted. Some possible reasons development of this disease is heredity. For example, among family members there are patients with thyroid goiter.

In addition, the problem can occur with the regular use of drugs such as lithium, propylthiouracil, phenylbutazone, or when many substances have been taken that have the ability to inhibit hormone synthesis. This list also includes foodstuffs such as cabbage, turnips, Brussels sprouts, algae and millet.

Iodine deficiency - quite a rare event in developed countries with organized medical care. Through the use of iodized table salt, this problem can be effectively controlled. In other parts of the world, especially in mountainous areas or areas that are subject to flooding, this becomes the main cause of the pathology.

The following factors increase the likelihood of thyroid goiter:

• Floor. Nontoxic goiter is more common in women than in men.
• Age over 40 years.
• food with low content iodine.

If there are any risk factors, this should be reported to the doctor. In addition, the presence of patients with goiter in the family, which was carried out in the past, is also reflected. radiation therapy on the head or neck area, especially in childhood.

Disease symptoms, diagnosis

Nodular goiter usually does not have obvious symptoms unless it gets too big. If any of the symptoms occur, you should not think that the presence of the node was the cause. They may be caused by less serious conditions. If these symptoms persist for a long time, you should consult a doctor:

• swelling in the neck;
• difficulty breathing, coughing, wheezing;
• difficulty swallowing;
• feeling of constriction of the neck;
• Hoarseness of voice or change in its tone.

The endocrinologist will definitely ask about the symptoms and medical history. An objective examination will also be carried out.

The following tests can be prescribed and carried out by an endocrinologist:

• examination of the neck to assess the degree of enlargement of the gland;
• ultrasound uses sound waves to identify nodules and their sizes, and also allows you to determine the degree of increase, there are three of them;
• a blood test to assess hormone levels, such as thyroid-stimulating, or autoantibodies to gland tissue;
• a radioactive scan of the thyroid gland, it is called a scintigraphy. This is a photograph of an organ after the introduction of radioactive isotopes into the body. This technique allows you to diagnose how it functions and exclude cancer;
• a biopsy may be performed - a tissue sample is taken with a small needle to determine whether the tumor is benign or malignant;
• barium test allows you to determine the clamping of the esophagus, if there are difficulties in swallowing;
• X-ray transillumination of the neck and chest to see the clamping of the trachea.

Thyroid goiter therapy

Nodular goiter, as a rule, grows very slowly. It cannot cause any symptoms. At this phase of the formation and growth of nodes, it is possible to identify them during ultrasound scanning. In this case, patients do not need specialized treatment. The main direction of therapy will be compensation for iodine deficiency. In fact, iodine prophylaxis will be a method of treatment, and at the same time very effective, allowing, if not achieving a reduction in the size of seals, then in most cases stopping their growth.

More aggressive therapy may become necessary when a thyroid goiter becomes significantly enlarged, compresses the neck, or interferes with breathing and swallowing.

If progression of thyroid goiter is observed and the nodule turns into cancerous tumor, then there is a need for specialized treatment. Treatment options.

• Hormone therapy to suppress the functioning of the thyroid gland. A synthetic analogue of triiodothyronine is prescribed in the form of a tablet preparation. It suppresses the secretion of thyroid-stimulating hormone, which has a stimulating effect on the gland. This therapy is most effective for early stage goiter of the thyroid gland, which was formed due to violations in the synthesis of hormones.
• Application of the radioactive isotope of iodine. This treatment is used in patients with thyroid goiter to reduce its size. It is used in the elderly when surgery cannot be used.
• Thyroidectomy. This is an operation to remove part or all of the gland. This treatment is chosen if there is a patient with a thyroid goiter so large that breathing or swallowing is difficult.

The concept of non-toxic goiter means a persistent increase in size in the area of ​​​​the thyroid gland. This form pathology indicates the absence of changes in the level of hormones in the blood. In turn, the reasons for the increase in the thyroid gland lies in the hyperplasia of its tissues. The development of non-toxic goiter is not accompanied by a violation of the proper reproduction, growth and functioning of cells. An enlarged thyroid gland is not associated with inflammatory processes or the presence of malignant tumors. At the same time, the increase can occur both evenly and unevenly, accompanied by appropriate symptoms that cause discomfort to the patient.

The reasons

What a non-toxic goiter can cause in a minor patient depends, first of all, on the type of pathology. Today, based on how the violation manifests itself, three independent types of non-toxic goiter are distinguished, namely:

• diffuse. This state is not accompanied by a violation or complete dysfunction of the thyroid gland. The concept of endemic goiter means the very fact of an increase in the organ. At the same time, pathology is noted in every 10th person on earth. As a rule, the development of diffuse non-toxic goiter is caused by a negative environmental situation or genetic, hereditary factors.
• Colloidal nodal. The reason that entails the development of this type of goiter is the lack of iodine in the foods and drinks consumed by the child. This form of the disease is especially common among residents of regions where the level of iodine in the mail is minimal, and the area itself does not have close access to the sea. In addition, the development of colloid nodular goiter of a non-toxic type is determined by heredity and the presence of cases of goiter among the blood relatives of the child.
• Multisite. Experts are still not ready to answer the question of what can cause the development of this type of non-toxic goiter. The formation of nodules in connective tissues occurs as a result of differences in the growth rates of individual sections of the organ. Increase the risks can be violations at the genetic level, malnutrition.

Symptoms

As non-toxic goiter manifests itself, the patient does not feel signs of pain. The increase occurs gradually, and accelerates, in the case when any of the nodules show signs of hemorrhage. A striking manifestation of the pathology is the sensation of a compressed trachea. A minor patient often coughs, he begins to have breathing problems if it is a severe form.

The first signs of pathology are basic and look like this:

• the child can determine a slight increase in temperature;
• there are bouts of dry cough and frequent shortness of breath;
• the child's voice "sits down" becomes more hoarse;
• noted sharp rise sweating, especially at night;
• the child begins to have difficulty tolerating heat or low temperatures, sensitivity skin rises;
• the psycho-emotional state changes, there are signs of irritability, anxiety, sleep disturbances;
• the child complains of problems with stools that are not related to his diet.

Diagnosis of non-toxic goiter in a child

In order to accurately diagnose goiter of a non-toxic type, the doctor evaluates all parameters of the increase. Namely:

• the form,
• symmetry,
• structure,
• sizes, etc.

Before prescribing tests and hardware diagnostics for patients, the doctor conducts visual inspection with palpation of the neck zone in order to determine the location and weight of the pathology. In the case of a single nodule or several nodes at once, a biopsy is prescribed for a minor patient. Additionally, a method of assessment based on organ dysfunction is used to make a diagnosis. A biopsy is not required if it is a goiter of nodular or diffuse types.

Complications

Like any pathology of the thyroid gland, non-toxic goiter is more than dangerous. Problems with endocrine system cause severe and irreversible consequences in case of absence adequate treatment. Thus, the quality of the future adulthood child.

Treatment

Non-toxic goiter - the "slowest" it can develop asymptomatically for many years. If bright signs deterioration in the form of coughing, breathing problems, etc. are absent, there is no need to treat goiter. It is necessary to decide what to do only when the dynamics of the growth of an organ or a separate formed nodule is obvious. Similarly, first aid is provided to a child in cases where an enlarged thyroid gland is accompanied by real discomfort due to compression of the trachea or esophagus.

What can you do

Methods alternative medicine do not help cure non-toxic goiter in a child. In turn, self-administration of drugs (hormonal and iodine-containing) is not only undesirable, but also potentially dangerous. The task of parents is to provide the child with a comfortable psycho-emotional environment, to monitor compliance with the recommendations of doctors.

What does a doctor do

Surgical removal of an enlarged thyroid gland is extremely rare when the pathology has reached an impressive size. In other cases, the doctor prescribes thyroidectomy, therapy with drugs with iodine in the composition, corresponding to the age and condition of the child. Hormonal treatment starts when there are no other methods that can provide effective result in the form of recovery.

Prevention

In order to prevent the development of non-toxic goiter in a child, it is important to monitor his nutrition, strengthen immunity, protect against stress and negative factors environment. Regular visits to the doctor are mandatory, especially if the child lives in a region where the prevalence of non-toxic goiter is especially high.

Pathological enlargement of the thyroid gland also occurs outside the areas of goiter endemia. This phenomenon is called non-toxic goiter. The development of the disease is associated with a violation of the biosynthesis of thyroid hormones and iodine metabolism in the body, the influence of a small but prolonged increase in the level of TSH and TSH-like factors, immunoglobulins that stimulate the growth of the thyroid gland, but do not affect it. functional state, and etc.

Symptoms of the development of non-toxic goiter

Clinical signs of the disease are similar to those of endemic goiter. Ultrasound with a fine needle is important for diagnosis. aspiration biopsy. Determination of the level of TSH, T 3 and T 4 is indicated for patients toxic goiter with symptoms of increased or reduced function thyroid gland.

Symptoms different types non-toxic goiter

According to the nature of the damage to the thyroid gland, there are:

diffuse,

nodal

and multinodular nontoxic goiter.

Morphologically distinguished:

colloidal,

parenchymal and

most common in clinical practice mixed non-toxic goiter (proliferating colloid goiter).

Features of the treatment of non-toxic goiter

If the colloid goiter is diffuse or is represented by one small node (up to 3 cm in diameter), the patient should be treated conservatively with thyroid hormone preparations (L-thyroxine is preferred). The dose of the drug in the treatment of non-toxic goiter is selected so that the TSH level does not exceed 0.1 mU / l in premenopausal women and men under 60 years of age.

In postmenopausal women, men over 60 years of age and in patients with heart disease in the treatment of non-toxic goiter, lower doses of thyroxin are used, lowering the level of TSH to 0.5-1.0 mU / l (TSH-suppressive therapy). Such patients are subject to dynamic observation with repeated use of ultrasound with fine-needle aspiration biopsy, hormonal blood tests every 3-4 months.

Surgical removal of non-toxic goiter

The volume of surgical treatment of non-toxic goiter depends on the size of nodular formations and their localization. With nodular goiter, resection of the affected lobe is usually performed. With multinodular goiter with localization in one lobe, subtotal resection of the lobe or hemithyroidectomy is performed, with localization in two lobes - subtotal thyroidectomy with urgent histological examination.

Indications for surgical removal goiter

Indications for surgical treatment serve:

suspicion of malignancy of the node,

symptoms of goiter compression of surrounding organs and tissues,

no effect from conservative treatment non-toxic goiter for 6 months (progressive nodule growth).

Also, surgical treatment is subject to patients belonging to the risk group for possible development thyroid cancer (see section "Malignant tumors").

AT postoperative period to prevent recurrence of the disease, long-term therapy with thyroid hormone preparations under the control of the level of TSH and thyroid hormones is indicated. Preventive therapy Thyroxine is indicated for all patients after subtotal resection of the thyroid gland, as well as for patients with a smaller volume of surgery, but the level of TSH, which is at the upper limit of normal (5 mU/l).

Treatment with folk remedies for non-toxic goiter

Treatment folk remedies this disease helps patients well. Today there are a large number good recipes which help in the treatment of diseases of various forms.

Treatment of non-toxic diffuse goiter with folk remedies

From the formation of knots willow will help you. In the spring, young leaves of the tree are collected, stuffed into a saucepan (4 liters), filled with water and put on a small fire. You need to cook until all the water is gone, and at the bottom of the pan there is a little dark brown liquid, the consistency of which resembles sour cream. It is this liquid that must be applied to the neck in the thyroid gland every day. It is best to carry out the treatment at bedtime, and in the morning do not even rinse. The procedure should be done all summer, and by the autumn the nodes will disappear, and the diffuse goiter will become half as large.

Take 200 grams of honey, kernels walnuts and raw buckwheat. Nuts and buckwheat need to be ground in a coffee grinder. Stir the resulting mixture well into a homogeneous mass and eat within a day after preparation. Treatment of non-toxic goiter with this folk remedy must be repeated after three days, but it must be eaten for nine days. Do not consume for three days, then prepare another serving to be eaten within nine days. After about three to six months, repeat the course of treatment for diffuse goiter. This recipe helps to treat diffuse goiter very well.

Even for the treatment of diffuse non-toxic goiter, it is recommended to take a tincture of white cinquefoil. It is suitable as a remedy for grades 1-4. It also acts as a thyroid hormone regulator. To prepare such a folk remedy, you need to pour 1-2 tablespoons of grass with two cups of boiling water and leave it in a thermos overnight to infuse. In the morning, the tincture from diffuse goiter is filtered and taken 3-4 times a day, half a glass 20 minutes before meals.

During the treatment of non-toxic goiter, it is recommended to take a tincture of green walnuts. To prepare the tincture, you need to grind 50 grams of nuts and pour them with a glass of medical alcohol without impurities. It is necessary to insist on a folk remedy for diffuse goiter for two months in a dark place with room temperature. Periodically, the container with the tincture needs to be shaken, this will only improve your tincture. When the tincture is ready, you can start taking it. If you have diffuse goiter, then three times a day, one teaspoon half an hour before meals is exactly your portion. Such a tincture is very useful, because in addition to iodine it contains a lot of astringent and tannins, which are so necessary for the thyroid gland. But the microelement composition contributes to the proper production of hormones.

Treatment of non-toxic nodular goiter with folk remedies

A disease that is characterized by an increase or appearance of nodes and neoplasms in the thyroid gland is called nodular goiter. traditional medicine in such cases applies surgical intervention, but traditional medicine is not so radical and has many prescriptions for the treatment of non-toxic nodular goiter.

We take 100 gr. small twigs of cherry must be poured with buds with boiling water in the amount of half a liter, boil for 30 minutes. The method of taking a folk remedy for the treatment of non-toxic goiter: 1 tablespoon 3 times a day.

30-40 pieces of green walnuts should be washed, dried and poured with honey. For forty days you need to insist in a dark, cold place. A teaspoon 3 times a day, half an hour before meals, drink milk.

From ten lemons you need to squeeze the juice with pulp. Using a blender, grind 10 heads of garlic and mix everything together with one liter of honey. We insist a folk remedy in a dark, cold place for one week. Treatment for non-toxic goiter: 2 dessert spoons swallowed very slowly.

good effect in the treatment of nodular non-toxic goiter can be achieved by using powder from the leaves of seaweed, you need to drink large quantity water. The course of treatment of non-toxic goiter is not less than 30 days. Ready-made is sold in pharmacies.

We take 3 tablespoons of motherwort, dyeing gorse - one tablespoon. flowers chokeberry 3 tablespoons, 2 tablespoons of May lily of the valley. All ingredients must be mixed from the resulting mixture one tablespoon and pour 1.5 liters hot water, let stand for a few minutes, drain. Method of application in the treatment of non-toxic goiter: a teaspoon in the morning, afternoon and evening.

Take sand sugar, mix feijoa one to one - a very useful nodular goiter treatment with folk remedies. How to use: 2 tablespoons on an empty stomach (in the morning, 1 time).

Excellent tool in the treatment of nodular goiter there will be a tea made from silver cinquefoil herb. Drink the more the better.

Rubbing the neck with fresh oak bark has a beneficial effect in preventing non-toxic goiter.

Drink potato juice half a glass two to three times a day thirty minutes before meals, the course of such treatment of non-toxic goiter should be two to three weeks.

For effective treatment goiter nodal shape daily take half a liter of a mixture of different juices: potato, celery, carrot, cucumber and beetroot. This kind of juice therapy always gives the most positive result for the shortest lines, but only on condition that the patient's diet will exclude meat and fish products.

Eat seaweed, it is widely used in traditional medicine. You can take it in the form of powders, half a teaspoon or one teaspoonful, drink it with water, take it two to three times a day, always before meals. The course of treatment with seaweed is thirty days.

For the treatment of non-toxic nodular goiter, medicinal lemon balm and valerian are also useful. Pour two tablespoons of half a liter of boiling water, pour together with the grass in a thermos and insist overnight. Take one third or fourth cup five to four times a day. In order for the taste to be at the highest level, it is also allowed to add honey, sugar, and so on to the broth. The course of treatment is folk way ranges from one and a half to two months, after this time a break is made for ten to fourteen days, the composition of the collection changes slightly and the treatment is continued further.

Another way to treat this: you will need one teaspoon of internal partitions walnut, fill it with glasses of boiling water, insist until it cools down. It is worth taking twice a day for half a glass thirty minutes before meals. As general tonic It is recommended to eat walnut kernels. Nuts, by the way, excellent remedy in the treatment of atherosclerosis.

Pass the feijoa fruits in a blender or through a meat grinder, sprinkle them with sugar in a ratio of one to one, store the remedy in the refrigerator, take it one tablespoon two to three times a day half an hour before meals.

If you have a non-toxic goiter, you can choose the one that works best for you or combine several at once. It is also important to pay attention to vitamins in the treatment of goiter: it is advisable to drink the course in parallel with herbs.