Goiter Diffuse (Basedow’s Disease): Causes, Symptoms, Diagnosis & Treatment

Goiter Diffuse(Basedow’s Disease) –Causes, Symptoms,
 and Treatment

What is Goiter Diffuse (Basedow’s Disease)?

Goiter diffuse, also known as Graves' disease or Basedow’s disease, is an autoimmune disorder that leads to hyperthyroidism (overactive thyroid). It occurs when the immune system mistakenly attacks the thyroid gland, causing it to enlarge and produce excessive thyroid hormones.

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Causes of Diffuse Goiter

The main cause of diffuse goiter is insufficient iodine intake, which is essential for the production of thyroid hormones triiodothyronine (T3) and thyroxine (T4). When the body receives low amounts of iodine, the thyroid gland enlarges to compensate.

Other Contributing Factors:

• Genetic predisposition (hereditary).
• Chronic respiratory diseases affecting oxygen supply.
• Deficiency of trace elements such as selenium, manganese, zinc, cobalt, molybdenum, and copper.
• Excess calcium intake, which interferes with thyroid function.
• Psychiatric disorders affecting hormone regulation.
• Infectious and inflammatory conditions (e.g., worm infestation, chronic infections).
• Poor sanitation, hygiene, and social conditions.

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Types of Goiter Based on Enlargement Degree

1. Degree I – Not visible when the head is in a normal posture but can be felt upon palpation.
2. Degree II – The goiter is palpable and visibly noticeable.
3. Degree III – The goiter is very large and may extend behind the sternum (retrosternal goiter).

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Symptoms of Goiter

The severity of symptoms depends on the size and function of the thyroid gland:

• Fatigue, headache, and general weakness.
• Neck discomfort – Pressure or tightness, especially when lying down.
• Difficulty breathing and swallowing – Due to compression of the trachea.
• Dry cough or hoarseness caused by pressure on the vocal cords.
• Unpleasant feelings in the heart – Possible palpitations or irregular heartbeat.

Severe Manifestation: Cretinism (In Childhood Cases)

• Severe mental and physical developmental delays.
• Speech difficulties and deaf-mutism.
• Short stature and delayed bone growth.

If you experience any symptoms, consult an endocrinologist for proper diagnosis and treatment.

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Diagnosis of Diffuse Goiter

1. Blood Tests – Measure TSH, T3, T4 levels.
2. Ultrasound of the Thyroid Gland – Determines size and structure.
3. Radioactive Iodine Uptake (RAIU) Test – Measures thyroid function.
4. Urinary Iodine Test – Evaluates iodine excretion levels.
5. Immunogram – Assesses immune system involvement.
6. Thyroid Biopsy (Fine-Needle Aspiration) – Checks for abnormalities.
7. Radioisotope Scanning – Maps thyroid activity.
8. X-ray of the Esophagus – Performed in cases of large goiter causing swallowing difficulties.

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Treatment and Prevention of Diffuse Goiter

1. Medication-Based Treatment

• For mild goiter (Degree I):
  • Potassium iodide supplements (intermittent use).
  • Iodine-rich diet (seafood, nuts, seaweed).
• For hypothyroidism cases:
  • Synthetic thyroid hormones (e.g., Levothyroxine Sodium).
  • Combination therapy under regular thyroid hormone monitoring.

2. Surgical Treatment (Thyroidectomy)

• Performed when:
  • Nodular goiter is present.
  • Large goiter compresses nearby organs.
  • Goiter grows rapidly despite treatment.
• Post-surgery prevention: Patients may need thyroid hormone replacement therapy to prevent recurrence.

3. Radioactive Iodine Therapy (RAI)

• Used to shrink the thyroid gland and reduce hormone production in hyperthyroid cases.

4. Lifestyle & Preventive Measures

✅ Iodine Fortification: Use iodized salt to prevent deficiency.
✅ Balanced Diet: Eat iodine-rich foods (persimmons, seafood, walnuts).
✅ Regular Checkups: Monitor thyroid function with routine tests.
✅ Stress Management: Avoid stress through meditation, yoga, and relaxation techniques.

Would you like more details on dietary recommendations or post-treatment care? 😊