What's Best For Goiter

Goiter is the swelling of the thyroid gland which commonly occurs in women. It may follow the development of benign nodules or in rare cases may be triggered by benign or malignant tumors or an iodine deficiency. Some people develop goiter as a result of taking certain drugs, especially those that are used to treat manic-depressive states and diabetes.

Simple goiter is caused by an iodine deficiency which is common in those who live far from the sea. Iodine is required for the normal functioning of the thyroid gland. This can easily be obtained from io¬dized salt, seafood, milk and kelp. When a person lacks iodine, the thyroid gland has to work harder to continu¬ously produce a hormone that the body needs to func¬tion properly. In the process, the gland gets bigger and that's how goiter begins.

If the enlarged thyroid gland produces an extra hormone to make up for the shortage of iodine, the goiter is called "toxic." A "nontoxic" goiter means no extra hormone is being made. Aside from the enlarged gland, other symptoms of simple goiter are dry thick skin, retarded growth, deafness and lethargy.

Obviously, the best way to prevent this problem is by taking iodine-rich foods. But sometimes, even if a person gets enough iodine from his diet, he or she may still develop goiter. This is because certain foods may actu¬ally prevent the thyroid gland from using the iodine. Foods which interfere with the body's ability to manufacture the thyroid hormone contain substances called "goitrogens."

"These include Brussels sprouts, cabbage, carrots, cauliflower, peaches, peas, soy beans, spinach and turnips. If eaten in large quantities regularly, these can cause iodine deficiency. This is characterized by an enlarged thyroid gland (goiter) and sluggish metabo¬lism - tending to cause weight gain. A deficiency dur¬ing pregnancy can cause fetal growth retardation and mental retardation and deficiency during childhood can cause growth stunting. Cooking goitrogenic-containing foods inactivate these toxic substances to a great degree," according to Dr. Myron Winick, director of the Institute of Human Nutrition Columbia Univer¬sity College of Physicians and Surgeons, in “The Colum¬bia Encyclopedia of Nutrition.”

If you feel hot in spite of the cold weather, you could be suffering from hyperthyroidism or the over activity of the thyroid gland that may also be ac¬companied by goiter. This condition is also known as exophthalmic goiter because it is characterized by pro¬truding or bulging eyes.

“The affected person tires easily, complains of the heat, is physically and mentally overactive, and shows a fine tremor of outstretched fingers. The symptoms are due to an oversecretion of the thyroid hormone and are similar to those of thyroid overdosage. Other symp¬toms include excessive sweating, weakness, muscular wasting, morbid apprehensiveness, frequent bowel movements, and rapid and irregular heartbeats," ex¬plained the late Dr. Morris Rshbein, the former editor of the Journal of the American Medical Association, in his “Popular Illustrated Medical Encylopedia.”

Depending on your condition, age, and the size of the thyroid itself, goiter may be treated either with drugs to shrink the thyroid gland, radioactive iodine or surgery. Discuss these options with the doctor for each has its own advantages and disad¬vantages. Surgery is usually offered as a last resort when other measures have failed or if the patient is unable to benefit from the above options.

"Patients sometimes want the excess goiter tissue removed for cosmetic reasons. Also, the goiter may have to be excised if it becomes so large as to compress nearby structures, causing coughing, hoarseness and difficulty in swallowing. But remember a goiter is rarely malignant. You should have it operated on only if its appearance disturbs you, if you suffer pressure symptoms from it or possibly because it's toxic. If surgery is recommended, ask for a second opinion from an endocrinologist," said Dr. Isadore Rosenfeld of the .New York Hospital - Cornell Medical Center in “Second Opinion.”

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