De La Salle University - Dasmarias

COLLEGE OF SCIENCE AND COMPUTER STUDIES

GENETICS FINAL ELGA

Lomeda, Rocel Mae M.

Reyes, Ma. Lealyn L.
HUB33
May 30, 2017

Ms. Jonnacar S. San Sebastian

Genetics Lecture
A.Y. 2016-2017: 2nd semester

Page 1 of 8
I. INTRODUCTION
A goiter (GOI-tur) is an abnormal enlargement of your thyroid gland. Your thyroid is a
butterfly-shaped gland located at the base of your neck just below your Adam's apple. Although
goiters are usually painless, a large goiter can cause a cough and make it difficult for you to
swallow or breathe.
The most common cause of goiters worldwide is a lack of iodine in the diet. In the United
States, where the use of iodized salt is common, a goiter is more often due to the over- or
underproduction of thyroid hormones or to nodules that develop in the gland itself. Treatment
depends on the size of the goiter, your symptoms and the underlying cause. Small goiters that
aren't noticeable and don't cause problems usually don't need treatment.

Symptoms
Not all goiters cause signs and symptoms. When signs and symptoms do occur they may
include:
A visible swelling at the base of your neck that may be particularly obvious when
you shave or put on makeup
A tight feeling in your throat
Coughing
Hoarseness
Difficulty swallowing
Difficulty breathing

Causes
Your thyroid gland produces two main hormones thyroxine (T-4) and triiodothyronine
(T-3). These hormones circulate in your bloodstream and help regulate your metabolism.
They maintain the rate at which your body uses fats and carbohydrates, help control your
body temperature, influence your heart rate, and help regulate the production of proteins.

Page 2 of 8
 Your thyroid gland also produces calcitonin a hormone that helps regulate the amount
of calcium in your blood. Your pituitary gland and hypothalamus control the rate at which
these hormones are produced and released.

The process begins when the hypothalamus an area at the base of your brain that acts
as a thermostat for your whole system signals your pituitary gland to make a hormone
known as thyroid-stimulating hormone (TSH). Your pituitary gland also located at the
base of your brain releases a certain amount of TSH, depending on how much thyroxine
and T-3 are in your blood. Your thyroid gland, in turn, regulates its production of hormones
based on the amount of TSH it receives from the pituitary gland.

Having a goiter doesn't necessarily mean that your thyroid gland isn't working normally.
Even when it's enlarged, your thyroid may produce normal amounts of hormones. It might
also, however, produce too much or too little thyroxine and T-3.

A number of factors can cause your thyroid gland to enlarge. Among the most common are:

Iodine deficiency. Iodine, which is essential for the production of thyroid hormones, is
found primarily in seawater and in the soil in coastal areas. In the developing world, people
who live inland or at high elevations are often iodine deficient and can develop goiters
when the thyroid enlarges in an effort to obtain more iodine. The initial iodine deficiency
may be made even worse by a diet high in hormone-inhibiting foods, such as cabbage,
broccoli and cauliflower. Although a lack of dietary iodine is the main cause of goiters in
many parts of the world, this is not often the case in countries where iodine is routinely
added to table salt and other foods.

Hereditary factors - some people inherit a tendency for a thyroid to swell. Risk factors for
the development of a goiter include female sex, age over 40 years, inadequate dietary
intake of iodine, residence in an endemic area, and a family history of goiter. In particular,
it may swell at times of life when you may make more thyroxine and T3 - for example,
when you are pregnant, or during puberty.

Graves' disease. A goiter can sometimes occur when your thyroid gland produces too
much thyroid hormone (hyperthyroidism). In Graves' disease, antibodies produced by your
immune system mistakenly attack your thyroid gland, causing it to produce excess
thyroxine. This overstimulation causes the thyroid to swell.
Hashimoto's disease. A goiter can also result from an underactive thyroid
(hypothyroidism). Like Graves' disease, Hashimoto's disease is an autoimmune disorder.
But instead of causing your thyroid to produce too much hormone, Hashimoto's damages
your thyroid so that it produces too little. Sensing a low hormone level, your pituitary
gland produces more TSH to stimulate the thyroid, which then causes the gland to enlarge.

Page 3 of 8
 Multinodular goiter. In this condition, several solid or fluid-filled lumps called nodules
develop in both sides of your thyroid, resulting in overall enlargement of the gland.

Solitary thyroid nodules. In this case, a single nodule develops in one part of your
thyroid gland. Most nodules are noncancerous (benign) and don't lead to cancer.

Thyroid cancer. Thyroid cancer is far less common than benign thyroid nodules. A
biopsy of a thyroid nodule is very accurate in determining if it's cancerous.

Pregnancy. A hormone produced during pregnancy, human chorionic gonadotropin

(HCG), may cause your thyroid gland to enlarge slightly.

Inflammation. Thyroiditis is an inflammatory condition that can cause pain and swelling
in the thyroid. It may also cause an over- or underproduction of thyroxine.

Risk factors

Goiters can affect anyone. They may be present at birth and occur at any time throughout
life. Some common risk factors for goiters include:

A lack of dietary iodine. People living in areas where iodine is in short supply and who
don't have access to iodine supplements are at high risk of goiters.

Being female. Because women are more prone to thyroid disorders, they're also more
likely to develop goiters.

Your age. Goiters are more common after age 40.

Medical history. A personal or family history of autoimmune disease increases your risk.

Pregnancy and menopause. For reasons that aren't entirely clear, thyroid problems are
more likely to occur during pregnancy and menopause.

Certain medications. Some medical treatments, including the heart drug amiodarone
(Cordarone, Pacerone, others) and the psychiatric drug lithium (Lithobid, others), increase
your risk.

Radiation exposure. Your risk increases if you've had radiation treatments to your neck
or chest area or you've been exposed to radiation in a nuclear facility, test or accident.

Complications

Page 4 of 8
Small goiters that don't cause physical or cosmetic problems aren't a concern. But large
goiters can make it hard to breathe or swallow and can cause a cough and hoarseness.

Goiters that result from other conditions, such as hypothyroidism or hyperthyroidism, can be
associated with a number of symptoms, ranging from fatigue and weight gain to unintended
weight loss, irritability and trouble sleeping.

Page 5 of 8
III. PROGNOSIS OF THE DISEASE
Goiter treatment depends on the size of the goiter, your signs and symptoms, and the
underlying cause. Your doctor may recommend:

Observation. If your goiter is small and doesn't cause problems, and your thyroid is
functioning normally, your doctor may suggest a wait-and-see approach.

Medications. If you have hypothyroidism, thyroid hormone replacement with

levothyroxine (Levoxyl, Synthroid, Tirosint) will resolve the symptoms of hypothyroidism
as well as slow the release of thyroid-stimulating hormone from your pituitary gland, often
decreasing the size of the goiter.

For inflammation of your thyroid gland, your doctor may suggest aspirin or a corticosteroid
medication to treat the inflammation. For goiters associated with hyperthyroidism, you may
need medications to normalize hormone levels.

Surgery. Removing all or part of your thyroid gland (total or partial thyroidectomy) is an
option if you have a large goiter that is uncomfortable or causes difficulty breathing or
swallowing, or in some cases, if you have a nodular goiter causing hyperthyroidism.

Surgery is also the treatment for thyroid cancer.

You may need to take levothyroxine after surgery, depending on the amount of thyroid
removed.

Radioactive iodine. In some cases, radioactive iodine is used to treat an overactive

thyroid gland. The radioactive iodine is taken orally and reaches your thyroid gland through
your bloodstream, destroying thyroid cells. The treatment results in diminished size of the
goiter, but eventually may also cause an underactive thyroid gland.

IV. DIAGNOSTIC TOOL TO DETERMINE THE DISEASE

Page 6 of 8
 Diagnosing a goiter may also involve:

Hormone test. Blood tests can determine the amount of hormones

produced by your thyroid and pituitary glands. If your thyroid is underactive, the level of
thyroid hormone will be low. At the same time, the level of thyroid-stimulating hormone
(TSH) will be elevated because your pituitary gland tries to stimulate your thyroid gland to
produce more thyroid hormone. A goiter associated with an overactive thyroid usually
involves a high level of thyroid hormone in the blood and a lower than normal TSH level.

An antibody test. Some causes of a goiter involve production of

abnormal antibodies. A blood test may confirm the presence of these antibodies.

Ultrasonography. A wand-like device (transducer) is held over your

neck. Sound waves bounce through your neck and back, forming images on a computer
screen. The images reveal the size of your thyroid gland and whether the gland contains
nodules that your doctor may not have been able to feel.

A thyroid scan. During a thyroid scan, you'll have a radioactive

isotope injected into the vein on the inside of your elbow. You then lie on a table with your
head stretched backward while a special camera produces an image of your thyroid on a
computer screen. The time needed for the procedure may vary, depending on how long it
takes the isotope to reach your thyroid gland. Thyroid scans provide information about the
nature and size of your thyroid, but they're more invasive, time-consuming and expensive
than are ultrasound tests.

A biopsy. During a fine-needle aspiration biopsy, ultrasound is used to

guide a needle into your thyroid to obtain a tissue or fluid sample for testing.

V. REFERENCES
Clinic Staff M. Goiter. Mayo Clinic. 2016 Nov 9 [accessed 2017 May 27].
http://www.mayoclinic.org/diseases-conditions/goiter/symptoms-causes/dxc-20264595
Harding DM. Goitre (Thyroid Swelling) | Health. Health | Patient. [accessed 2017 May
27]. https://patient.info/health/goitre-thyroid-swelling
Thyroid Goiter. UCLA Endocrine Center. [accessed 2017 May 27].
https://www.uclahealth.org/endocrine-center/thyroid-goiter

Page 7 of 8
Page 8 of 8