Endemic Goiter

Endemic goiter is diffuse or nodular thyroid enlargement affecting more than 5% of a population living in iodine-defiguous inland/mountain regions. It is caused by chronic dietary iodine deficiency, leading to TSH-driven thyroid hyperplasia and hypertrophy. Most patients remain euthyroid; long-standing cases develop nodularity, hemorrhage, cysts, or hypothyroidism; in offspring, severe deficiency causes endemic cretinism.

Common Symptoms

Diffuse/nodular neck swelling; tightness; dysphagia; dyspnea; euthyroid or hypothyroid; rare hyperthyroidism (Jod-Basedow)

Causes and Pathogenesis

Dietary iodine deficiency reduces thyroid-hormone synthesis, causing compensatory TSH elevation, thyroid hyperplasia/hypertrophy and goiter formation; goitrogens (cassava) may contribute.

Treatment

Iodine supplementation; L-thyroxine suppression for diffuse goiter; surgery for compressive/nodular disease

Preventive Measures

Universal iodized salt; iodine prophylaxis in endemic regions; prenatal iodine.

Department to Visit

It is recommended to visit the Endocrinology department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.