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A goiter is an abnormal enlargement of the thyroid gland, often caused by iodine deficiency, autoimmune diseases (Hashimoto’s or Graves'), or nodules, resulting in a visible swelling at the base of the neck. Symptoms range from none to difficulty breathing/swallowing, coughing, and hoarseness. Treatment depends on the cause and size, ranging from observation and medication to surgery. 

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Causes of Goiter

  • Iodine Deficiency: The most common cause worldwide, necessary for producing thyroid hormones.
  • Autoimmune Diseases: Graves' disease (overactive) or Hashimoto's disease (underactive)

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Symptoms of Goiter

  • Visible Swelling: A swelling at the base of the neck, ranging from a small nodule to a large lump.
  • Tightness: A feeling of tightness in the throat area.
  • Respiratory/Digestive Issues: Difficulty breathing or swallowing, a dry cough, or wheezing due to pressure on the windpipe or esophagus.
  • Voice Changes: Hoarseness. 

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Risk Factors

  • Iodine Deficiency: People living in regions with low dietary iodine.
  • Gender: Women are more likely to develop goiters.
  • Age: People over 40 are at higher risk.
  • Medical History: Family history of autoimmune diseases or personal history of radiation treatment. 

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Diagnosis and Treatment

  • Diagnosis: Determined by physical exam (palpation), blood tests (TSH, T3, T4), ultrasound, or scans.
  • Treatment: Small, asymptomatic goiters may only require monitoring.
  • Medication: Used to manage underlying hormone issues (e.g., levothyroxine for underactive, anti-thyroid meds for overactive).
  • Surgery: A thyroidectomy (partial or total removal) is required for large goiters causing breathing/swallowing issues or if cancer is suspected. 

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Prognosis
The prognosis for a goiter is generally good, especially when treated early. Most,, particularly simple goiters, are benign and do not cause long-term health issues once the underlying cause is addressed

Specimen Number
27