A goiter is a condition where the thyroid gland is enlarged. However, an enlarged thyroid gland is not always visible from the outside, so you may not even notice you have a goiter. One type of goiter that is dangerous is a deep goiter or Basedow's goiter. This condition is characterized by characteristic eye disordersand an increase in thyroid hormone.
The thyroid gland is a butterfly-shaped gland located under the Adam's apple in the neck. The thyroid gland produces hormones whose function is to regulate the body's metabolism. An enlarged thyroid gland, also known as a goiter, is an abnormal condition. Although usually painless, a goiter can cause coughing, difficulty swallowing, or difficulty breathing, if it is large.
Causes of Deep Goiter or Goitre Basedow
Goiter occurs due to a disorder of the thyroid gland. The cause can be because the thyroid gland produces too much thyroid hormone (hyperthyroidism) or a lack of thyroid hormone (hypothyroidism).
Medically, there is no term goiter in. By Indonesians, deep goiter is defined as a goiter that widens to the side accompanied by bulging eyes. This condition resembles the signs and symptoms of one of the thyroid diseases, Graves' disease. Graves' disease is a thyroid disease caused by the immune system producing too much thyroid hormone (hyperthyroidism).
Thyroid produces hormones after receiving orders from thyroid sstimulating hormone (TSH) secreted by the pituitary gland in the brain. In Graves' disease, a malfunction in the immune system releases abnormal antibodies that mimic the function of TSH. Driven by these false signals, the thyroid gland then produces excessive amounts of the hormone. This overstimulation can cause the thyroid gland to enlarge.
Other Factors That Can Cause Enlarged Thyroid
Conditions that can also cause swelling of the thyroid gland and mimic a deep goiter include:
- Iodine deficiencyIodine is a chemical that plays an important role in the formation of thyroid hormones in the body. In people who are iodine deficient, a goiter forms because the thyroid enlarges in an attempt to get more iodine.
- Hashimoto's Disease
Hashimoto's disease is a disease caused by inflammation of the thyroid gland so that it produces too little hormone (hypothyroidism).. Low thyroid hormone causes the pituitary gland to produce TSH to stimulate thyroid production. This then causes the thyroid gland to enlarge.
- Multinodular goiterIn this condition, several solid or fluid-filled lumps, called nodules, develop on both sides of the thyroid gland. This causes enlargement of the thyroid gland. The cause of multinodular goiter is not known with certainty, but this condition is associated with other thyroid diseases, such as Hashimoto's disease, iodine deficiency, and thyroid cancer.
- Solitary thyroid nodule
In this condition, a thyroid lump occurs in only one part of the thyroid gland.
- Thyroid cancerThyroid cancer is an abnormal cell growth that occurs in the thyroid gland. Thyroid cancer is more common than thyroid nodules.
Goiter is more common in women than men. In addition, people who are pregnant, over the age of 40, have a family history of autoimmune diseases, are taking certain medications (such as drugs for heart disease or lithium to treat mental health disorders), and are exposed to radiation, are also at increased risk of developing heart disease. goiter.
Symptoms of Deep Goiter or Goitre Basedow
Not all mumps produce typical signs and symptoms. However, common symptoms that can appear in a goiter include:
- Neck swells.
- A feeling of stiffness or lump in the throat.
- Difficulty breathing.
- Difficulty swallowing.
In Graves' disease, some other symptoms that can appear in addition to an enlarged thyroid gland are shaking hands and fingers (tremors), bulging or bulging eyes, weight loss, menstrual cycle changes, reddened skin on the feet, irregular heartbeat, and decreased libido.
Of all these symptoms, the most characteristic felt by people with Graves' disease are protruding eyes (exophthalmos). This condition is generally followed by a stinging and painful sensation in the eye, swollen eyelids, inflamed eyes, and becoming more sensitive to light.
In the case of exophthalmos In severe cases, the swollen eye muscles can put intense pressure on the optic nerve. This allows the occurrence of partial blindness (partial). Eye muscles that experience long-term inflammation will slowly lose the ability to control movement, causing double vision (double vision).
Diagnosis of Deep Goiter or Goitre Basedow
In determining the diagnosis of a deep goiter or Basedow's goiter, the first step taken by the doctor is to trace the patient's medical history. Furthermore, a physical examination is carried out to check for clinical signs, including checking blood pressure and heart rate, as well as palpation of the thyroid gland.
Because Graves' disease is related to thyroid hormone, your doctor will recommend a blood test to determine levels of thyroid sstimulating hormon (TSH) and thyroid hormone. People with Graves' disease generally have TSH levels below normal and thyroid hormone levels above normal.
Further examination is done by giving iodine. This is done by measuring the iodine contained in the thyroid gland after being given iodine by injection into a vein or orally. The amount of iodine in the thyroid gland determines whether the goiter is due to Graves' disease or hypertoidism due to other causes. Radiological examination, such as ultrasound, CT scan, and MRI, may also be required for a more accurate diagnosis.
Deep Goiter Treatment
Treatment of a deep goiter depends on its size, signs and symptoms, and the underlying cause. The goal of treatment for a goiter or Basedow's goiter is to inhibit the production of excess thyroid hormone and block the effects of these hormones on the body. Treatment for a deep goiter includes:
- Administration of drugsTo treat inflammation of the thyroid gland, the doctor will give pain relievers and anti-inflammatory drugs, such as aspirin and corticosteroids. To treat hyperthyroidism that occurs due to Basedow's goiter, drugs are needed to control hormone levels.
- Radioactive iodine therapyRadioactivity works by destroying overactive thyroid cells. As a result, the swelling will decrease and other symptoms will gradually decrease.
- Antithyroid medicationThis drug works by blocking the use of iodine to produce thyroid. Antithyroid drugs may be used before or after radioactive iodine therapy as an adjunct treatment.
Surgical procedures are the last option to remove the entire thyroid gland (total thyroidectomy) or part of the thyroid (subtotal thyroidectomy), depending on the stage of the disease. This procedure is quite risky, because it can damage the nerves that control the vocal cords and the small glands adjacent to the thyroid gland (parathyroid glands).
After surgery, you may need thyroid hormone replacement therapy. Another very dangerous risk of surgical removal of the thyroid is thyrotoxicosis or thyroid storm.thyroid storm). This condition has a fairly high mortality rate.
Consult a doctor immediately if you experience neck swelling accompanied by dizziness, difficulty swallowing, weight loss, visual disturbances, and hoarseness. If left untreated, a deep goiter or Basedow's goiter can put pressure on the jugular vein (blood vessel that carries blood from the face, head, brain, and neck, to the heart), throat, esophagus, or nerves in the throat voice box. Early detection is very important so that treatment can be done immediately to prevent the development of the disease and the occurrence of complications.