Thyromegaly

The thyroid gland is one of the most important parts of the body. It is the gland that secretes thyroid hormones, an essential hormone used for various bodily processes.

A thyroid gland has a shape similar to a butterfly. It is found below the Adam’s apple. A healthy thyroid gland regulates the right amount of thyroid hormone.

If the thyroid gland grows bigger than it is supposed to, it could result in a thyromegaly or commonly called goiter. ^{(1, 2)}

Thyromegaly ICD 9 : 240.9

Image 1: A comparison image between a healthy/normal thyroid and a swollen thyroid (thyromegaly).
Photo Source: healthosphere.com

Picture 2: A doctor performing physical exam in a patient suspected of an enlarged thyroid.
Image Source: 3.bp.blogspot.com

Photo 3: An image showing a normal thyroid, a thyroid that has undergone a partial thyroidectomy, and a subtotal thyroidectomy.
Picture Source: khalidalomari.weebly.com

Picture 4: An image showing the anatomy of the thyroid gland.
Photo Source: www.organsofthebody.com

Thyromegaly Symptoms

• Swelling of the neck
• Breathing difficulty
• Discomfort in the neck area when eating, drinking, or swallowing
• Stiffness in the throat area
• The voice becomes hoarse and accompanied by cough
• The neck is swollen
• Headache and dizziness ^{(1, 2, 3)}

Thyromegaly Causes

• Heredity – Thyromegaly runs in the family. If any of your family members have a thyromegaly, there is a tendency that it could happen to you too.
• Diet – If your diet lacks iodine, then you are prone to having thyromegaly.
• Side effects of medications – Some drugs such as cobalt and lithium can have drastic effect to the thyroid.
• Old age – The risk of thyroid problem increases as the person grows older.
• Medical conditions – Some medical conditions increase the chance of having thyromegaly such as Grave’s disease. It causes hyperthyroidism wherein the immune system of the body attacks the thyroid gland. Other health conditions that could lead to thyromegaly are thyroiditis (inflammation of thyroid gland) and thyroid cancer. ^{(3, 4, 5, 6)}

Varieties of thyromegaly

1. Hyperthyroid – The hormones produced by the thyroid gland are more than the usual causing the thyroid gland to enlarge.
2. Euthyroid – It does not affect the thyroid gland’s normal functions. The mass grows but is not cancerous.
3. Hypothyroid – The thyroid gland is not producing the right amount of thyroid hormone. It is categorized into three:

1. Diffuse goiter- the thyroid gland is entirely covered by big masses.
2. Non-toxic – It reduces the functions of the thyroid gland.
3. Toxic goiter – The mass is bigger than the usual. ^{(5, 6,, 7)}

Who are at risk?

• For unknown reasons, women are more prone to thyromegaly than men.
• Older people (more than 40 years old) are prone to thyromegaly, although young people can also have thyromegaly.
• People who take medications containing high doses of cobalt and lithium.
• People with family history of goiter.
• People who are exposed to radioactive materials for a long period of time.
• Some infections can cause goiter.
• Pregnancy can sometimes affect the functions of the thyroid gland. ^{(7, 8, 9)}

Diagnosis

• Physical examination – The doctor will thoroughly check the throat area for swelling and inflammation. A doctor who has a vast experience in handling thyromegaly cases can easily detect one by just merely doing a physical examination.
• Thyromegaly ultrasound – It is a non-invasive procedure that gives a clear view of the thyroid gland.
• TSH Test – It checks the level of thyroid stimulating hormone in the blood.
• T3 Test – It check the level of triiodothyronine in the blood.
• T4 test – It checks the level of thyroxine in the blood. ^{(2, 5, 10)}

Thyromegaly Treatment

If the thyromegaly is mild and caused by low iodine level in the body, the doctor will put the patient in an iodine supplement. If the thyromegaly is severe causing other discomforting symptoms, then the doctor will put the patient in a course of treatment which includes suppression therapy.

This is to reduce the secretion of levothyroxine. Ethanol infusion can also help in the treatment of non-cancerous lump in the thyroid. ^{(1, 3, 4)}

Diet plays a very important role in improving the function of the thyroid gland. There are foods you should eat and foods you should completely avoid. They include the following:

Foods to avoid

• Cruciferous vegetables like cabbage, broccoli, cauliflower, kale, and Brussels sprout, to name a few.
• Soy products like soy beans, soy milk, tofu, and anything that has a soy in its label.
• Peanuts, spinach, peaches, and strawberries. ^{(4, 5)}

Foods to eat

• Marine fish or fish that comes from the ocean.
• Shellfish such as shrimps, oysters, mussels, and clams.
• Milk and yogurt
• Eggs
• Use iodine treated salt (iodized salt) ^{(9, 10)}

Are surgical interventions necessary?

A surgery is needed if the patient develops malignancy or cancer in the thyroid gland. Surgery is the last resort. It should only be done if the radioactive iodine therapy didn’t work. The doctor will perform a surgery because of the following reasons:

• A nodule is present, which is an indicative of a thyroid cancer.
• Your diagnosis is confirmatory of a thyroid cancer.
• The nodule in the thyroid is causing discomfort such as difficulty swallowing and compression of the trachea. The mass in the throat can be unsightly, which makes people with thyromegaly want to remove it. ^{(3, 6, 7)}

Thyroidectomy is the surgical removal of the thyroid gland. It is categorized into two: partial and total thyroidectomy. A is a procedure in which the nodule is excised directly is called open thyroid biopsy. If only one love of the thyroid is removed, the procedure is called hemi-thyroidectomy.

There are instances when only a bridle of the thyroid tissue between the two loves is removed. This procedure is called isthmusectomy. If most or all of the thyroid tissue is removed, the procedure is called total or near total thyroidectomy.

A lot of people are not aware that they are suffering from thyromegaly. Hence, it is important to be very cautious on the signs and symptoms of goiter. Have yourself regularly checked to find out if you have been suffering from an underlying condition and that it should be treated at an early stage.

Thyromegaly is a serious condition which could lead to serious and fatal complications if left untreated. ^{(5, 9, 10)}

References:

1. http://diseasespictures.com/thyromegaly/
2. https://www.doctorshealthpress.com/general-health-articles/thyromegaly-goiter-causes-treatment/
3. https://healthosphere.com/thyromegaly/
4. https://medinfo.org/thyromegaly-101-what-you-should-know.html
5. https://medicalpoint.org/thyromegaly/
6. http://healthinstant.net/thyromegaly-symptoms-causes-treatment/
7. http://diseasedefinition.info/thyromegaly-definition-causes-signs-symptoms-treatment-and-prevention/
8. https://safesymptoms.com/what-is-thyromegaly/
9. http://healthncare.info/thyromegaly-enlarged-thyroid-symptoms-causes-treatment/
10. https://allhealthpost.com/thyromegaly/