GOITER AND YOU

A goiter is an enlarged thyroid gland that causes swelling on the neck. The thyroid gland is situated in front of the windpipe and is responsible for producing and secreting hormones that regulate growth and metabolism.

The extent or degree of swelling and the severity of symptoms produced by the goiter usually depends on the individual.

Key points about goiter includes:

·    Goiter describes a condition where the thyroid gland, located in the neck, becomes enlarged.

·    Iodine deficiency is the leading cause of goiter.

·    In developed countries, goiter is usually caused by an autoimmune disease.

·    Goiter is diagnosed by physical examination, but thyroid function blood tests and scans may be used.

·    Treatment is not necessary unless the goiter is large and causes symptoms (there are often no symptoms).

CAUSES

IODINE: Iodine deficiency is the major cause of goiter worldwide, but this is rarely a cause in more economically developed countries where iodine is routinely added to salt.

As iodine is less commonly found in plants, vegan diets may lack sufficient iodine; this is less of a problem for vegans who live in countries such as the United States that add iodine to salt.

Dietary iodine is found in:

·       seafood

·       plant food grown in iodine-rich soil

·       cow's milk

The thyroid gland needs iodine to manufacture thyroid hormones, which regulate the body's rate of metabolism.

HYPERTHYROIDISM

An overactive thyroid gland is termed Hyperthyroidism. This is another cause of goiter. This usually happens as a result of Graves' disease, an autoimmune disorder where the body's immunity turns on itself and attacks the thyroid gland, causing it to swell.

AUTOIMMUNE DISEASE

This is the main cause of goiter in developed countries. Women over age 40 are at greater risk of goiter, same as people with a family history of the condition.

OTHER CAUSES

·       nodules - benign lumps

·       smoking - thiocyanate in tobacco smoke interferes with iodine absorption

·       hormonal changes - pregnancy, puberty, and menopause can affect thyroid function

·       thyroiditis - inflammation caused by infection, for example

·       lithium - a psychiatric drug that can interfere with thyroid function

·       overconsumption of iodine - too much iodine can cause a goiter

·       radiation therapy - particularly to the neck

TREATMENT

Most simple goiters are preventable through adequate intake of iodine, which is added to table salt in many countries.

Active treatment of goiter is reserved for cases that cause symptoms - otherwise, no action is taken, and some simple goiters resolve on their own. If the goiter is small and thyroid function is normal, treatment is not usually offered.

SURGERY

Surgery to reduce the size of the swelling is reserved for cases where the goiter is causing troublesome symptoms such as difficulty breathing or swallowing.

SYMPTOMS

Most goiters don’t show symptoms. The following are the most common symptoms that are seen with goiter:

·       throat symptoms of tightness, cough, and hoarseness

·       trouble swallowing

·       in severe cases, difficulty breathing (possibly with a high-pitch sound)

WHAT YOU NEED TO KNOW ABOUT FIBROIDS

Fibroids are abnormal growths that develop in or on a woman’s uterus. Sometimes, these growths or tumors become quite large and cause severe abdominal pain and heavy periods. In some cases, they show no signs or symptoms at all. The growths are typically noncancerous. The cause of fibroids is unknown.
Some research shows there may be a relation between estrogen levels and fibroid. When estrogen levels are high, especially during pregnancy, fibroids tend to swell. Research has also shown it develops more with women who are taking birth control pills that contains estrogen. It has also been observed that when estrogen is low, like in menopause, fibroids tends to shrink
According to  research, 70 to 80 percent of women have them by the age of 50, most do not show symptoms.

TYPES OF FIBROIDS

Intramural Fibroids
Intramural fibroids are the most common type of fibroid. They appear within the muscular wall of the uterus. Intramural fibroids may grow larger and can stretch your womb.

Subserosal Fibroids
Subserosal fibroids form on the outside of your uterus. This part of the uterus is called the serosa. They may grow large enough to make your womb appear bigger on one side.

Pedunculated Fibroids
When subserosal tumors or fibroids develop a stem, they become pedunculated fibroids.

CAUSES

As stated earlier, it is unclear why fibroids develop, but several factors may influence their formation. These factors includes

Hormones
Estrogen and progesterone are the hormones produced by the ovaries. They cause the uterine lining to regenerate during each menstrual cycle and may stimulate the growth of fibroids.

Family History
Fibroids in most cases run in the family. If your mother, sister, or grandmother has a history of this condition, you may develop it as well.

Pregnancy
Pregnancy increases the production of estrogen and progesterone in your body, this inversely increases the chances of fibroid development.

SYMPTOMS

Symptoms depends on the location, size of the tumor(s) and number of the tumors. A small sized tumor and a woman at the menopause stage may not have any symptoms. Fibroids may shrink during and after menopause.
Symptoms of fibroids may include:

heavy bleeding between or during your periods

pain in the pelvis and or lower back

increased menstrual cramping

increased urination

pain during intercourse

menstruation that lasts longer than usual

pressure or fullness in your lower abdomen

swelling or enlargement of the abdomen

DIAGNOSIS

A gynecologist will do a pelvic examination. This is done to check the condition, size, and shape of your uterus.

Other tests may also be required:

Ultrasound
An ultrasound uses high frequency sound waves to produce images of your uterus on a screen. This enables a doctor to see its internal structures and any fibroids present.

Pelvic MRI
MRI produces pictures of uterus, ovaries, and other pelvic organs.

TREATMENT

A treatment plan is developed by the Doctor, based on the patients age, size of fibroid(s), and overall health.

Medications
Medications to regulate your hormone levels may be prescribed to shrink fibroids. Gonadotropin-releasing hormone (GnRH) agonists, such as leuprolide (Lupron), will cause your estrogen and progesterone levels to drop. This will eventually stop menstruation and shrink fibroids.

Surgery
Surgery to remove very large or multiple growths (myomectomy) may be performed.

PREVENTION

Regular uterus check up is advised for women of age 35 and above.

When you start observing irregular mensuration, please check with your doctor.

Reduce pill intakes that has high estrogen levels.