How do You Get a Nodular Goiter?

How do You Get a Nodular Goiter?

How do You Get a Nodular Goiter?

How do You Get a Nodular Goiter?

  1. Low level TSH stimulation and goitrogens in environment cause the first step.
  2. Resulting hyperplasia,hypertrophy forms the Diffuse Goiter.
  3. Further TSH stimulation along with somatic mutations leads to follicular cell proliferation and the first sign of nodule formation.These nodules do not produce hyperthyroidism in early phase. Simple goiter is a euthyroid condition at first.
  4. Continuing proliferation is associated with the appearance of  activating mutations of the TSH receptor.
  5. This leads to thyroid gland autonomy and eventually toxic nodular goiter in some cases of simple euthyroid goiter.
  6. Further gland growth results in compressive symptoms and degenerative changes such as cyst formation, hemorrhage, calcification, and Hurthle cell metaplasia, not Hurthle cell neoplasms.

Comments: Simple goiter is not so simple as it seems but short of cancer in a goiter there are non-surgical alternatives to treat your enlarging nodular goiter. If you have a large symptomatic solid nodule in a goiter there is radiofrequency ablation RFA therapy available to you now.If it is a big thyroid or parathyroid cyst we treat those also without surgery with ethanol ablation PEI. Call Matthew at 1310-3938860 for details about the evaluation needed for both procedures.

Richard Guttler MD.FACE,ECNU

www.thyroid.com

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