Prophylaxis goiter
The iodine-enriched table salt has contributed to a decrease in the frequency of struma in recent years.Due to the extreme spread of iodine deficiency in the Alpine region, Switzerland has decided to enrich its drinking water with iodine. This measure has enormously reduced the occurrence of goiter there. However, patients suffering from hyperthyroidism (hyperthyroidism) should be careful with products that have an increased iodine content. During pregnancy and breastfeeding, the iodine requirement is generally increased.
Prognosis
The non-malignant goiter can be treated well, so that the symptoms usually disappear. However, an already existing protrusion of the eyeball from the orbit (exophthalmos) does not regress even after normalization of hormone levels. The two most common types of thyroid cancer, follicular and papillary thyroid carcinoma, have the best prognosis of all cancers of the human body thanks to radioiodine therapy.
In almost all cases a complete cure is achieved here. Unfortunately, this is not the case with undifferentiated (anaplastic) thyroid cancer. The prognosis in this situation is very limited.
Struma nodosa colloides
About 20-30% of the adult population has nodes in the thyroid gland. They are often discovered by chance, for example during a routine ultrasound examination of the neck. If the nodular changes also cause an enlargement of the thyroid gland, the physician speaks of a “Struma nodosa colloides”.
With increasing age, the probability of thyroid nodules increases. Gender (women are more often affected) and family predisposition also play a role. Iodine deficiency is also closely related to the development of thyroid nodules.
Studies have shown a decrease under improved iodine supply. In addition to random findings, patients occasionally palpate a nodule or show symptoms of dysfunction. Understandably, there is great concern at the beginning of the clarification.
But 95% of all detected thyroid nodules are benign! After the function of the thyroid gland has been assessed with a blood test (measurement of the hormone TSH) and the nodes have been checked by ultrasound image, a so-called thyroid scintigraphy is usually performed. Using a special nuclear medicine procedure, it shows the activity of the individual nodes: a distinction is made between “cold nodes”, “hot nodes” and “indifferent nodes”.
Cold nodules have a low metabolic activity, and in rare cases can be an indication of malignant neoplasms. On the other hand, hot nodules have an increased activity and can cause hyperthyroidism. Indifferent nodules are either not present or do not allow any decisive conclusions to be drawn.
However, it is generally true that only a fine needle puncture can provide absolute certainty. For this purpose, tissue samples are taken from the thyroid gland node with a thin needle. This small procedure only takes a few seconds and causes no pain.
The therapy of a Struma nodosa colloides is manifold. Depending on the type of node, surgery, radioiodine therapy or long-term drug therapy may be the right choice. If, for example, there is a well-founded suspicion of a malignant new formation, such as a thyroid carcinoma, surgical removal is indicated.
However, it is not uncommon for the doctor and patient to opt for the so-called “wait and watch” method: if a benign lump is present with normal thyroid function and the patient complains of no symptoms, nothing is done at first. Only when abnormalities are observed during regular check-ups will a decision be made about a possible therapy.
