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Art Pharma® A goiter, its causes and possible treatment.

 Art Pharma® Lugol’s Iodine Solution Product description

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"Approximately 40% of the world's population remains at risk for iodine deficiency."
American Thyroid Association (ATA)
“It is estimated that 1.88 billion people worldwide remain at risk of insufficient iodine intake...”
World Health Organization, “Salt reduction and iodine fortification strategies in public health,” March 2013

What is a goiter condition?

A goiter is an abnormal enlargement of the thyroid gland.  The presence of a goiter indicates that the thyroid gland is growing abnormally.  It does not necessarily indicate that the thyroid gland is malfunctioning.

A multinodular goiter is comprised of one or more nodules.  If the nodules are small enough, the overall size of the thyroid may not be enlarged.  This is usually the case in early stages of nodule formation.  The cause of multinodular goiter is not well understood.

What causes a goiter?

Iodine deficiency

Worldwide, goiter is commonly caused by iodine deficiency.  Before the 1920s, iodine deficiency was common in the Great Lakes region, Appalachia, northwestern regions of the U.S., and most of Canada.  This led to the region from the Rockies to the Great Lakes Basin to western New York being referred to as the "Goiter Belt."  The Goiter Belt has been virtually eliminated by the introduction of iodized salt as a treatment of iodine deficiency.  Many other parts of the world, however, do not have enough iodine available through their diet, and iodine deficiency continues to be an important public health problem globally. 

When iodine is deficient, the thyroid gland can't make enough thyroid hormone.  When this happens, the pituitary gland detects that there isn't enough thyroid hormone in the blood and sends a signal to the thyroid gland to make more thyroid hormone.  This signal is a hormone called "thyroid stimulating hormone" or "TSH."  In addition to stimulating thyroid hormone production, TSH also stimulates the thyroid gland to grow. 

Hashimoto's thyroiditis

A more common cause of goiter in the U.S. is Hashimoto's thyroiditis – an autoimmune disease.  It occurs when a person's immune system makes antibodies that attack the cells of the thyroid gland.  When the cells are under attack, the thyroid gland can't make enough thyroid hormone.  The pituitary gland detects that there isn't enough thyroid hormone in the blood and sends TSH to stimulate the thyroid gland to make more thyroid hormone and to grow.

Graves' disease

Goiter is also caused by another autoimmune disease – Graves' disease.  The immune system produces "thyroid stimulating immunoglobulin" or "TSI."  TSI acts like TSH and stimulates the thyroid gland to make more thyroid hormone and to grow.  The pituitary gland detects that there is too much thyroid hormone in the blood and stops sending TSH to the thyroid gland.  In spite of this, the thyroid gland continues to grow and make more thyroid gland because it is responding to TSI.  Not only does a goiter form but the person develops hyperthyroidism – a condition characterized by the overproduction of thyroid hormone.

About 30% of people with Graves' disease have a condition known as Graves' ophthalmology.  The condition results from inflammation and other immune system events that affect tissues, including muscles, around the eyes.  Eyes may bulge (exophthalmos), be sensitive to light, or feel gritty.  There may be pain or pressure in the eyes, which may be inflamed or reddened.  The eyelids may be puffy or retracted.  Double vision or loss of vision also may occur.

Although uncommon, Graves' dermopathy also can occur.  The skin, typically on the shins or tops of the feet, becomes red and thick.

Can a goiter be treated?

A goiter can be treated. The treatment depends on what is causing the goiter. 

If the goiter is due from an iodine deficiency, please visit your doctor and mention Art Pharma® LUGOL'S IODINE SOLUTION as a possible solution for the deficiency in iodine. We do mention for transparency reasons, that we cannot provide medical advice. It is important to have a conversation with your healthcare provider.

If the goiter is due to Hashimoto's thyroiditis and the person is hypothyroid, treatment involves administration of thyroid hormone. Thyroid hormone levels will return to normal, and the goiter will get smaller.  The thyroid gland may still appear somewhat enlarged.  In some instances, the goiter is treated surgically but, afterwards, thyroid hormone production can be so low that lifetime thyroid hormone replacement may be needed.

If the goiter is due to Graves' disease and the person is hyperthyroid, treatment involves administration of anti-thyroid medication or radioactive iodine.  The goiter will get smaller, and may even disappear.