Goiter: Therapy

General measures

  • Review of permanent medication due topossible effect on existing disease.

Conventional non-surgical therapy methods

  • Radioiodine therapy-indications:
    • Recurrent goiter (recurrence of a goiter).
    • Refusal of surgery or if the risk of surgery is high.
    • Multifocal thyroid autonomy – multiple autonomous nodules (synonyms: Hot nodule; focal autonomy; Plummer’s disease); an autonomous adenoma also produces the thyroid hormones triiodothyronine (T3) and thyroxine (T4), but is no longer subject to normal regulation by the pituitary gland; the autonomous nodules are distributed throughout the thyroid gland in the case of multicocal thyroid autonomy (two to three nodules circa 50 percent; more than three nodules another 20 percent)
  • Alternative therapies for benign (benign) thyroid nodules:
    • High-intensity focused ultrasound (HIFU) therapy – focusing ultrasound waves on a single point. Thus, local heating of the tissue to at least 60 to a maximum of 85 °C without damaging the overlying skin and surrounding tissue.
      • The therapy is performed on an outpatient basis under mild local anesthesia (local anesthesia). Depending on the size of the node, the treatment lasts between 15 to 45 minutes.
      • By means of HIFU, benign hypofunctional (“cold“), indifferent and hyperfunctional (“hot”) thyroid nodules can be successfully treated.
      • With a single HIFU treatment, the volume of the nodule is reduced by about 50% after 3 months (initial volume to about 10 ml).
    • Therapy with radiofrequency ablation (radiofrequency ablation) – under local anesthesia, a small probe is inserted through the skin under sonographic control (ultrasound) into the thyroid nodule. A radiofrequency generator is then used to generate a high-frequency alternating current. This is directed through the probe to the nodule and heats or destroys it. The treated tissue is then broken down by the body on its own.
      • Approximately 15 minutes must be allowed per milliliter of tissue to be removed. Depending on the size of the node, the treatment takes between 15 to 45 minutes.
    • Therapy with microwaves (= microwave ablation): procedure as previously described; only one minute is needed per milliliter of tissue to be removed.

Regular checkups

  • Regular medical checkups

Nutritional medicine

  • Nutritional counseling based on nutritional analysis
  • Nutritional recommendations according to a mixed diet taking into account the disease at hand. This means, among other things:
    • A total of 5 servings of fresh vegetables and fruit daily (≥ 400 g; 3 servings of vegetables and 2 servings of fruit).
    • High-fiber diet (whole grain products).
  • Observance of the following special dietary recommendations:
    • Since a goiter in the majority of cases is caused by an iodine deficiency supply, attention should be paid to an adequate iodine intake, i.e. 1-2 times per week a meal with fresh sea fish (preferably fatty sea fish such as salmon, herring, mackerel, as this simultaneously the important omega-3 fatty acids are included) and the use of iodized table salt.
    • Avoid: Intake of strumigenic substances such as cassava roots (edible African root), soy products, vegetables from the Crucifeae family (cruciferous family) such as cauliflower, Brussels sprouts, Savoy cabbage, as well as milk from areas with grass that contains strumigens.
  • Selection of appropriate foods based on the nutritional analysis
  • See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
  • Detailed information on nutritional medicine you will receive from us.