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| Enlargement of thyroid gland |
Goiter is an enlargement of the thyroid gland, which is one of the ductless glands and this gland lies in the neck in front of windpipe it looks like butterfly. In many countries it can be cured by food and drinking water but there are still it is a big problem in many countries like America, Asia and Africa. A temporary enlargement of the thyroid gland is usual in females during menstrual period and pregnancy. So this temporary enlargement does not indicate that it is goiter. But study proved that goiter is more common in women than men.
Goiter is more prevalent in Himalaya region. Himachal Pradesh, Punjab, Haryana, Uttar Pradesh, Bihar, West Bengal, Sikkim, Assam, Mizoram, Meghalaya, Tripura, Manipur, Nagaland and Arunachal Pradesh; these all area is included under Himalaya region. This broad area is known as goiter belt. Aravalli of Rajasthan, Himachal of Madhya Pradesh, Narmada valley of Gujarat, montane area of Odisha and Madhya Pradesh, Karnataka, Kerala, Pune and Delhi all are also known as goiter area.
Role of iodine in formation of thyroid hormone:
An amino acid named tyrosine is added to iodine and formed thyroid hormone. When it contains 3 molecules, it is called T3 or triiodothyronine and if it contains 4 molecules, it is called T4 or thyroxin.
Thyroid gland is controlled by the TSH (Thyroid Stimulating Hormone) of pituitary gland. When lack of iodine is occurred, thyroid gland is unable to secret adequate amount of hormone. In this condition to maintain a balance, TSH is secreted more than normal level so thyroid gland gradually enlarges. This condition is called goiter.
Symptoms:
At first the growth of the thyroid gland is gradual but later it enlarges (200 – 500 gm). When it enlarges, it creates pressure on windpipe. It may cause breathing problem. Other signs are –
- Nervousness
- Palpitation
- Loss of weight
- Exophthalmos
Exophthalmos
Causes:
We discussed early lack of iodine is the cause of goiter. Now we discussed lack of iodine in food. There are mainly two reasons of lack of iodine in food.
Environmental factors –
In all montane regions, salt of groundbreaker is rinsed out due to rainfall, snow-fall and flood. So it is common the lack of iodine in montane regions. On the contrary in sea water contains iodine. So there is no possibility of goiter in sea coast region.
Goitrogens –
Goitrogenic elements are another reason of goiter. Goitrogenic elements inhibit the work of iodine. Some goitrogens are thiocyanate, thiourea, thionamides which can bind to iodine and made it unable for the body. Goitrogenic chemicals are present in the foods such as cabbage, cauliflower, raddish, turnip etc. these foods are known as goitrogenic foods. Too much consumption of these foods hampers the absorption of iodine in body. Peanut and shell of soyabean contain some iodine anti substances. Note that goitrogenic foods are not the reason of goiter but if you have goiter, these foods should be consumed in small amount.
Drugs –
Drugs like methyl or propylthiouracil and carbimazole inhibit the formation of thyroxine.
Classification of goiter depends on severity of goiter.
- Grade 0 –
Goiter is not visible or palpable.
- Grade 1 –
Goiter is palpable but not visible.
- Grade 3 –
Swelling is common in the neck and it is visible.
Prevention:
The first step of prevention of goiter is to change of the residence. If it is not possible pure supply of drinking water should be started. Study proved that in developed countries, adding of iodine to salt, water, milk, sugar and roti is able to prevent goiter.
Where breathing problem is occurred, a surgical operation may have to be performed. This operation is required in the case of tumor or cyst in the gland.
To prevent goiter “The National Goiter Control Programme” or “National Iodine Deficiency Disorder Control Programme” was launched by the Government of India. The main objective of this programme is to provide iodized salt in goiter endemic areas and where iodized salt is not provided, there intra muscular injection of iodized oil and oral administration of iodized oil have been used.
Iodine content of food is diminished by the cooking process. Frying, grilling and boiling reduce the iodine content of food respectively 20 %, 23 % and 58 %. Intake of sea fish is important in this condition. Milk, meat and eggs are rich sources of iodine. Other sources are legumes and cereals grains.
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