1. Goiter Awareness: Recognizing Symptoms and Seeking Solutions By Dr. Valeria Simone MD (Southlake General Surgery, Texas, USA)

2. Overview • Goiter, a condition characterized by the enlargement of the thyroid gland, is a common thyroid disorder that affects millions of people worldwide. This condition can have a significant impact on an individual's overall health and well-being, causing a range of symptoms and complications. Understanding the causes, symptoms, and potential treatments for goiter is crucial to managing this condition effectively.

3. What is a goiter? • A goiter is a swelling or enlargement of the thyroid gland, which is located in the front of the neck. It can develop due to a variety of factors, including iodine deficiency, inflammation, hormonal imbalances, or certain medications. The size of a goiter can vary greatly, ranging from a small lump to a noticeable enlargement that can be felt or seen. In some cases, goiters may be painless and cause no symptoms, while in others, they can lead to a range of issues that affect the thyroid's function and overall health. • Goiters can cause difficulties with swallowing or breathing, as they can put pressure on the surrounding structures in the neck. • Additionally, they may lead to an overactive or underactive thyroid, resulting in symptoms such as: • weight changes • fatigue • mood swings • changes in heart rate. • Treatment for goiters depends on the underlying cause and severity, ranging from medication to surgery. Regular monitoring and management of goiters are essential to prevent complications and ensure optimal thyroid health.

4. How many types of Goiters are there? • In medical terms, goiter has several categories that can swell your thyroid, which include: • Simple Goiters– In this condition, your thyroid doesn’t produce sufficient hormones and consequently is enlarged in size to meet the requirement. • Multinodular Goiters – It occurs due to lumps known as nodules, which develop in the thyroid. • Nontoxic Goiters or Sporadic Goiters – This type of goiter generally has no known reason. Some medicines and medical treatments can cause them. • Endemic Goiters – It is also known as colloid goiters, and mainly happens in individuals who've got iodine deficiency. The thyroid uses iodine to produce hormones for our body. This condition is usually found in people where iodine is mixed in table salt and is found in countries like the United States. • When a goiter is specified as “harmful” it is associated with hyperthyroidism. This condition refers to the excess production of thyroid hormone. A “harmless” goiter doesn’t lead to any of these thyroid conditions, like hyperthyroidism or hypothyroidism (insufficient thyroid hormone).

5. What are the Symptoms of Goiter? • According to Dr. Valeria Simone MD experienced board-certified general surgeon and thyroid specialist at Southlake General Surgery, Texas., the symptoms of goiter may include swelling at the front of your neck. It can be a small bulge or several nodules to one large goiter either at one side of the neck or on both sides. • An individual may also experience: • A rough voice • Swollen veins of the neck • Feeling of dizziness on raising arms • Coughing • Difficulty in breathing • Problem in swallowing • Stiffness in the throat

6. In case of hypothyroidism, you may experience: Weight gain, depression, dry skin, or fatigue Latency in mental and physical functions Constipation Feeling of cold, or Numbness in hands Irregular menstrual cycle Low pulse rate • In case of a harmful goiter with hyperthyroidism, an individual may experience: • Nausea, nervousness, or Sweating • Diarrhea • High blood pressure • Weight loss • A high pulse rate or heartbeat • Trembling, weakness in muscles, or hand tremors

7. What are the causes of Goiter? • Goiters don’t constitute any one illness. They can develop rapidly or gradually over the years. • Iodine deficiency was the main reason for goiters in individuals in the U.S. before it was marketized with salt as iodized salt in 1920. In the United States, one of the main causes of goiters is an autoimmune disorder (that includes Hashimoto’s disease or Graves’ disease) and multinodular goiter. • A goiter can also be caused by thyroid inflammation, also known as thyroiditis. An individual may experience this condition after getting infected with any sort of virus or after pregnancy.

8. Risk Factors for Goiters • Individuals over 40 years old are at higher risk. • Women are more likely to have goiters and thyroid disorders. • Menopause and pregnancy are two factors that are associated with thyroid problems. • Family history of autoimmune disorders. • Drugs and medicines. • Medical treatments that expose patients to radiation, such as radiation therapy for cancer • Iodine deficiency in the body.

9. Diagnosis of Goiter • Diagnosis of goiter at Southlake General Surgery, Texas, will be easy and simple by examining the neck. Our doctor may prescribe that you go for a few tests to find out the exact reason and how it is affecting you. Tests may include: • Ultrasound to check the size of the thyroid and nodules. • CT scan and MRI, in case the size of the goiter is large and it has spread to the chest. • Blood tests to evaluate the thyroid hormone levels and check for antibodies that cause goiters. • Thyroid Scan – In this procedure, the doctor injects radioactive material to develop a picture of the thyroid on a computer screen. This helps to find out the size of the thyroid and its functionality. • Biopsy – In this procedure, the doctor collects a sample of tissue or fluid through a needle and sends it to a lab for testing to check for cancer.

10. Treatment of Goiter • An individual may not require any treatment for goiter if the thyroid hormone level is normal and the size of the goiter is small. However, goiter treatment is recommended if the thyroid hormone levels are too low or too high. • Your doctor will level up the thyroid hormones if they are not normal. Your doctor will also examine the causes of goiter and its seriousness to suggest treatment, which includes: • Medicines – Your doctor may prescribe a thyroid hormone replacement medication for an individual experiencing hypothyroidism. A successful medication course may settle the thyroid to its normal size. However, a large goiter with internal scar tissue might not settle with medicine. • Radioactive Iodine – This treatment destroys the cells to settle the thyroid. This is included in a pill for the treatment of an overactive thyroid. After this treatment, an individual will require hormone medicines throughout his or her life. • Surgery – Thyroid surgery, also known as thyroidectomy, is an alternative in cases where the goiter size is large or it’s not responding to medicines. • Let’s explore more: Goiter - Causes, Symptoms, Treatment, and Surgery - Southlake General Surgery

11. Appointment • For more information about Goiter Awareness: Recognizing Symptoms and Seeking Solutions or consultation with us. Please contact our healthcare expert today at +1 (817) 748-0200. You can also make an online appointment with us. • Follow us on Facebook. • Source: Goiter - Causes, Symptoms, Treatment, and Surgery - Southlake General Surgery

12. THANK YOU! SOUTHLAKE GENERAL SURGERY 1545 E. Southlake Blvd, Suite 270 Southlake, TX 76092 EMAIL: info@southlakegeneralsurgery.com VISIT US AT: www.southlakegeneralsurgery.com