The thyroid gland is located roughly in the center of the neck. It is composed of a right and left lobe, that are linked together by the isthmus. The thyroid gland produces T3 and T4, thyroid hormones, that influence a wide range of metabolic processes in the body. They are under the control of the hypothalamus and pituitary gland. These areas of the brain secrete a hormone, TSH or thyroid stimulating hormone, that stimulates the production of the thyroid hormones. The gland also has cells that produce the hormone calcitonin. Focal enlargement of the thyroid gland is usually from neoplastic disorders, either benign or malignant. Generalized enlargement is more commonly the result of excessive stimulation. Multiple nodules may form within the enlarged gland. Multinodular goiter may be associated with hyperthyroidism and lead to toxic multinodular goiter. This disorder commonly arises from chronic simple goiter and is, therefore, a disorder or aging or the elderly. Tenderness of the thyroid associated with firm nodules more commonly suggests the diagnosis of subacute thyroiditis.
Causes of Nodular Goiter
Problems with the production of thyroid hormones can lead to excessive levels of TSH from the pituitary gland. This can produce enlargement of the thyroid gland. Sometimes, localized nodules develop. Inflammatory conditions can cause enlargement of the thyroid gland and the production of firm nodularity. This type of change is seen most frequently with subacute thyroiditis. Multinodular goiter frequently develops from chronic enlargement of the thyroid, or goiter. Some of the nodules may be cystic and occasionally can be transluminated with a light.
Signs and Symptoms of Nodular Goiter
Nodular goiter usually produces multiple lumps within the thyroid gland. The gland, itself, is enlarged and often forms a mass in the front of the neck. Serious enlargement of the gland can lead to difficulties with breathing and with swallowing. Various functional states can be associated with nodular goiter, including normal thyroid levels, elevated thyroid levels and reduced thyroid levels. Hyperthyroidism produces anxiety, palpitations, sweating, weight loss and cold intolerance. Hypothyroidism produces fatigue, slow pulse, heat intolerance and weight gain.
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Medical Content Last Updated on 07/12/2008
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