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What is goiter?

Goiter is the name given to the gland called thyroid, which secretes hormones , being larger than normal for various reasons. The thyroid is a butterfly -shaped gland with an average weight of 20 grams, located in the front of the neck, just in front of the trachea. However, its size may vary depending on the disease state and the person.

Goiter may be diffuse, single nodular , or have more than 1 nodule.

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What are the causes of goiter?


Endemic with iodine deficiency and goitrogenic foods;

With drugs such as iodide, amiodarone and lithium;

With subacute and chronic (Hashimoto) thyroiditis;

Familial with impaired hormone synthesis resulting from enzyme defects;

with benign tumors or cancers of the thyroid and

It may be due to resistance to thyroid hormone.

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What are the foods that cause goiter (goitrogen)?

Among the foods that are goitrogenous (causing goiter):



White cabbage,


Brussels sprouts,



lettuce and

Mustard seeds can be considered .

Excessive consumption of such foods may cause goiter.


What does endemic goiter mean?

The term endemic goiter refers to the occurrence of goiter in a significant number of individuals in a certain geographical region.

In the past, the most common cause of endemic goiter was dietary iodine deficiency.

This condition has largely disappeared in North America due to the routine use of iodized salt and the iodization of fertilizers, animal feeds, and preservatives.

However, in regions with iodine deficiency such as Central Asia, South America and Indonesia, goiter is seen in 90% of the population.


What are the symptoms of goiter?

Most patients with non-toxic goiter may not have any symptoms.

However, patients often complain of a feeling of pressure in the neck.

As the goiter grows too large, symptoms such as shortness of breath and difficulty swallowing occur due to pressure.

Patients also describe having to clear their throat frequently.

In the presence of a large goiter extending from the neck to the chest area (planjon goiter), symptoms such as facial flushing and swelling of the neck veins when the arms are raised above the head may occur.

Sudden growth of nodules or cysts due to bleeding may cause sudden pain.

During examination, a soft, widely enlarged gland in the front of the neck (simple goiter) or nodules of various sizes and consistencies can be detected in goiter with multiple nodules (multinodular).

What are the tests used in goiter?

The functions of goiter are investigated by measuring TSH and free T4 levels in the blood.

Thyroid scintigraphy usually has an irregular appearance.

To rule out the possibility of cancer, a fine needle biopsy is performed on the painful nodule, if any, and the continuously growing nodule.

In the presence of more than one nodule, a fine needle biopsy is performed from the largest nodule.

Computed tomography is performed to understand the condition of the planjon goiter or trachea extending to the chest.


How is goiter treated?

Endemic goiters are treated with iodine application.

Most patients with small, diffuse goiters but with intact thyroid function (euthyroid) do not require treatment.

In patients with small goiter, thyroid hormone can be given to stop the growth of the thyroid or reduce its size by suppressing TSH .

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In what cases is surgery performed on goiter?

Not every goiter requires surgery.

However, if;

If the increase in TSH cannot be stopped despite drug treatment,

If there are complaints related to pressure ,

If the goiter grows towards the chest,

If there is cancer or cancer suspicion as a result of fine needle biopsy and

If the swelling in the neck looks bad cosmetically , surgery is performed.

Near-total thyroidectomy (removal of nearly the entire thyroid gland) or total thyroidectomy (removal of the entire thyroid gland) is the preferred treatment.

Patients need lifelong thyroid hormone (T4) therapy.

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