Simple Goiter A simple goiter is an abnormal, noncancerous enlargement of the thyroid gland. Simple goiters can be classified as either endemic, which are most commonly associated with iodine deficiency, or sporadic, which can be caused by certain medications. Simple goiters may also develop due to hereditary factors and are considered risk factors for women over the age of 40. Although the majority of simple goiters are benign, they can also progress into thyroid tumors which, in some cases, can be cancerous. Simple goiters can also develop small, hardened nodules over time that begin creating their own thyroid hormone. These are known as toxic nodular goiters. The primary function of the thyroid is to concentrate iodine which assists in the production of thyroid hormone. When the body is experiencing an iodine deficiency, the thyroid gland cannot make enough thyroid hormone. Additionally, the follicular cells of the thyroid, which produce colloid, do not have the ability to iodinate the colloid or transform it into functioning thyroid hormones on their own. Sensing this decrease in thyroid hormone, a condition called hypothyroidism, the pituitary gland in the brain sends signals (thyroid stimulating hormone) to the thyroid hormone, instructing it to make more thyroid hormone. Unfortunately, the pituitary gland’s persistent signals fall on deaf follicles, thereby causing the follicles to swell and enlarge with accumulated colloid. This process is referred to as a negative feedback loop and is the reflection of the body attempting to return to and maintain homeostasis. The result of this negative feedback loop is a visible bulge at the base of the neck right above the collarbones. Proper diagnosis of a simple goiter includes a physical exam by a doctor and a blood test to measure thyroid stimulating hormone (TSH) and T4 levels. Needle aspirations, and thyroid ultrasound may also be used to properly diagnose and treat goiters. Treatments for these goiters vary from person to person depending on the cause and severity of the goiter, and the dietary restrictions or impediments that may be faced by those living in low-resource countries. Iodine supplements are a common treatment for simple goiters that help the thyroid gland decrease in size. Despite this treatment however, the thyroid gland will not usually return to its normal size. Depending on the size of the goiter, swallowing and coughing may become impeded, in which case portions of the goiter may need to be surgically removed (thyroidectomy). Radioactive iodine can also be used to shrink the enlarged thyroid. Although simple goiters are not as common of a health concern in the United States as they once were, it’s still important to include sources of iodine in your diet to ensure healthy thyroid function. Natural sources of iodine include dairy products, shellfish, fish, and seaweed. In response to nationwide iodine deficiencies in the 1920s, American salt companies began iodizing their products by adding potassium iodate during the processing and drying stages of salt production. This solution has lowered incidence of iodine deficiency-related goiterism within the United States. References Goiter. American Thyroid Association, https://www.thyroid.org/goiter/. Accessed November 29, 2021 Goiter and Thyroid Nodules. UCSF Endocrine Surgery, https://endocrinesurgery.ucsf.edu/conditions--procedures/goiter.aspx. Accessed December 1, 2021 Thyroid Goiter. UCLA Endocrine Center, https://www.uclahealth.org/endocrine-center/thyroidgoiter. Accessed December 2, 2021
