Thyromegaly

Thyromegaly Definition

The thyroid gland plays a very important role in the body. It secretes thyroid hormone, which is essential for various bodily functions. Anatomically and physiologically speaking, the thyroid gland is a butterfly-shaped structure found underneath Adam’s apple (male) and lower part of the neck (female).

The thyroid gland should always be in its perfect state so that it can produce a healthy number of thyroid hormones. A condition called thyromegaly happens if the thyroid gland becomes hyperactive and grows out of control. ^{(1, 2, 3)}

Thyromegaly ICD 10 : E01.0

Photo 1: The thyroid gland is situated below the voice box and just above the windpipe.
Picture Source: safesymptoms.com

The size of the thyroid gland

A healthy thyroid weighs about 15-25 grams. Each lobe is about 4-6 cm in length and 1.3 to 1.8 cm thick. There are various factors affecting the size of the thyroid. Those who live in places where iodine is prevalent have a smaller thyroid gland than those living in countries where the thyroid is scarce.

Pregnancy can significantly affect the size of the thyroid. Pregnant women have a large thyroid, but it is only temporary. After pregnancy, the thyroid gland goes back to its normal size. Smoker’s thyroid gland is larger than the usual. ^{(2, 3)}

Thyromegaly Causes

• Heredity – Thyromegaly has something to do with the genetic structure. If someone in your family has a goiter, then it put you at risk to goiter.
• Inadequate intake of iodine – An adequate amount of iodine is needed by the thyroid gland for it to function the way it supposed too. Insufficient iodine in the body increases the possibility of thyromegaly.
• Medications – Some types of drugs can increase the possibility of thyromegaly such as lithium and cobalt.
• Pregnancy – Pregnancy causes hormonal imbalance, which increases the possibility of thyromegaly.
• Health conditions – Some health conditions put you at risk for thyromegaly. Examples are Hashimoto’s disease, Graves’ disease, multinodular goiter, and thyroid cancer.
• Gender – Women are prone to thyromegaly than men.
• Age – People who are 40 years old and above are prone to thyromegaly.
• Toxic substance – Prolonged exposure to radioactive material increases the risk for thyromegaly. ^{(4, 5, 6, 7)}

Thyromegaly classifications

1. Hyperthyroid – The growth of the gland is caused by a high level of hormones.
2. Euthyroid – It is the non-cancerous type of goiter. The mass grows bigger as time passes by but fortunately, it does not affect the normal function of the thyroid gland.
3. Hypothyroid – The thyroid gland does not produce the expected number of thyroid hormones. Hypothyroid falls into three categories:

1. Diffuse goiter – The mass has entirely covered the thyroid gland.
2. Non-toxic goiter – It decreases the ability of the thyroid to function normally.
3. Toxic goiter – An extremely big mass in the thyroid. ^{(6, 7, 8)}

 

Thyromegaly misconceptions

• Goiter is a result of a severe illness.
• Goiter is a result of wrong breathing techniques during childbirth.
• Thyromegaly is caused by lifting too heavy objects. ^{(7, 8)}

Clinical manifestations/signs and symptoms

Image 2: The patient’s neck is swollen, which is one of the signs and symptoms of thyromegaly.
Picture Source: medicalpoint.org

• Swelling on the lower part of the neck
• Stiffness around the throat
• Hoarseness of voice
• Coughing
• Discomfort when drinking or swallowing ⁽⁹⁾
• Prone to choking
• Breathing problems (severe case)
• A headache and mild fever
• Nausea with or without vomiting
• Dizziness
• Bad breath
• Gastrointestinal-related problems ⁽⁸⁾

Diagnostic Procedures

Image 3: The doctor is performing a physical examination on the patient’s neck area.
Picture Source: 3.bp.blogspot.com

• Physical examination of the neck, especially the thyroid gland.
• Blood work to check for T3 and T4 level.
• CT scan to detect the exact location of swelling. ^{(4, 5)}

Recommended treatments for thyromegaly

The treatment approach depends on the type and severity of thyromegaly and the overall condition of the patient. Ideally, if the mass is small and non-cancerous, treatment might not be necessary at all.

After all, the mass won’t cause any problem and will not affect the normal function of the thyroid. On the other hand, if the mass is cancerous and growing, you need to seek treatment the soonest time possible. If left untreated could potentially damage your health. In fact, it could lead to fatal complications.

There is no single treatment approach for thyromegaly. It always is a combination of various treatment modalities. Recommended treatment modalities for thyromegaly include the following:

Thyroid replacement therapy

It can be done in the form of radiation treatment or through surgery. The patient should religiously take the standard dose of iodine. The patient needs to be immediately started on levothyroxine suppressive therapy. However, it only works in patients with non-toxic thyromegaly.

Drug therapy

The drugs of choice for thyromegaly are methimazole and PTU. They are effective in reducing the size of the thyroid gland.

Home remedies

There are things you can do at home that can be extremely beneficial for your thyroid. They are the following:

1. Increase the intake of fluids and natural fruit and vegetable juices/extracts. It cleanses
2. The blood and brings your hormone to a desirable level. Over time, you will notice a significant improvement in your thyroid problem. The swelling will gradually subside and you will feel more comfortable than before.
3. Increase your intake of iodine-rich foods such as kale, seafood, iodized salt, beans, shrimp, and turkey.
4. Increase your intake of kelp, a type of seaweed that contains a high level of iodine.
5. Dandelion plays an important role in reducing the swelling of the neck and alleviating discomfort brought by an enlarged thyroid gland.
6. Consume garlic on a day to day basis. Studies showed that garlic boosts the production of glutathione, which is one of the needed components for a healthy thyroid gland.

Photo 4: An image showing examples of foods rich in iodine.
Picture Source: healthosphere.com

Thyroidectomy

It is the surgical removal of the thyroid gland. A portion or all of the thyroid gland is removed depending on the severity of the patient’s condition. If a portion of the thyroid is removed, the remaining thyroid gland could still function normally.

However, if the entire gland is removed, you will need to undergo a thyroid hormone replacement therapy. ^{(6, 7, 9, 10)}

References:

1. http://diseasespictures.com/thyromegaly/
2. https://healthosphere.com/thyromegaly/
3. https://www.doctorshealthpress.com/general-health-articles/thyromegaly-goiter-causes-treatment/
4. http://symptomscausestreatment.com/thyromegaly-symptoms-causes-treatment.html
5. http://healthinstant.net/thyromegaly-symptoms-causes-treatment/
6. https://medicalpoint.org/thyromegaly/
7. https://safesymptoms.com/what-is-thyromegaly/
8. http://healthncare.info/thyromegaly-enlarged-thyroid-symptoms-causes-treatment/
9. https://en.wikipedia.org/wiki/Goitre
10. https://allhealthpost.com/thyromegaly/