Hyperplasia of the thyroid gland

Hyperplasia of the thyroid gland - an increase in the size of the thyroid gland as a result of any disturbances.

An enlargement of the thyroid gland can accompany a number of certain diseases.

[1], [2], [3], [4]

Causes of the hyperplasia of the thyroid gland

Since in itself hyperplasia is an increase in the number of cells of the thyroid gland, most often it is associated with the deficiency of this or that function of the gland. That is, in general, the increase is compensatory. Such compensation most often occurs as a result of a shortage of certain substances, or as a result of insufficient synthesis of the necessary compounds by the thyroid gland itself.

The most common case is hyperplasia of the thyroid gland with insufficient intake of iodine. In such a situation, when there is not enough such an important element, an insufficient synthesis of thyroid hormones occurs. Thus, in order to get iodine from the blood as much as possible, the gland increases.

Also, the reason for the increase in the size of the thyroid gland may be an inadequate synthesis of hormones by the gland itself. The reasons for this defect may be a violation of the absorption of iodine, in a number of other disorders of the thyroid gland. But in this situation, the lack of synthesis of thyroid hormones tries to compensate for the increase in size.

There are autoimmune causes of hyperplasia of the thyroid gland. In particular, if the enzymes are broken in the work, specific substances appear in the blood, degeneration can occur in the thyroid gland. And to maintain normal functioning, the gland itself begins to increase in size.

But in fact, all causes of hyperplasia of the thyroid gland are compensatory.

[5], [6], [7]

Symptoms of the hyperplasia of the thyroid gland

Hyperplasia of the thyroid gland at various stages of its development has various symptoms. With a small degree of enlargement of the gland, the process passes asymptomatically. Although it is possible to detect an increase in the ultrasound investigation.

In the later stages of the development of thyroid hyperplasia, it can already be detected by palpation, and later visually, because the shape of the neck changes due to the increase in the size of the gland.

In addition to external signs of hyperplasia, there are other symptoms that point to these processes. These symptoms are associated with impaired functions of the gland itself and are manifested in changes in the body's work not localizing at the location of the thyroid gland. In particular, it can manifest itself in the form of increased sweating, a feeling of fatigue, changes in the pulse rate, headaches, the appearance of a feeling of heat in the face, and pain and discomfort in the heart can also occur. With a significant increase in the size of the gland, even difficulties in swallowing and breathing are possible.

Also, the symptoms of the same diseases that caused hyperplasia, for example hypothyroidism and thyrotoxicosis (a lack or excess of thyroid hormones) can also indicate the hyperplasia of the thyroid gland.

Hyperplasia of the right lobe of the thyroid gland

Hyperplasia of the thyroid gland can arise both in it entirely, and in its separate parts. The relationship between thyroid gland and mammary gland in women has been proved. So the right share of the thyroid gland is associated with the work of the right breast. In one lobe, hyperplasia of the thyroid gland of any type can develop. There can be both diffuse and nodal proliferation. The fact that the change in the size of the thyroid gland covers only the right share, does not give reason to say with certainty that such locality will persist in the future. Rather, on the contrary, if you do not take measures, then with a high degree of probability, the disease will spread to the entire organ. With right-sided hyperplasia of the thyroid gland, if the enlargement has reached the third stage, the asymmetric change in the shape of the neck is noticeably marked, protrusion into the right side.

The tactics of treatment for hyperplasia of the right lobe of the thyroid gland does not have any distinctive features, does not pose a greater threat than any other localization of the expanding thyroid tissue, therefore, the treatment tactic is standard, depending on the severity of the course of the disease.

[8], [9], [10], [11]

Hyperplasia of the left lobe of the thyroid gland

Hyperplasia of the left lobe of the thyroid gland by its external features differs little from the right. Externally, with a severe degree of hyperplasia of the thyroid gland, it is manifested by protrusions to the left, shifting the configuration of the neck to the left. But the special meaning of hyperplasia of the left lobe of the thyroid gland can be acquired in the case of cancer. In addition to the connection with the left mammary gland in women, the left side of the thyroid gland is in close proximity to such vital organs as the heart and the blood lines that drain from it. Therefore, in case of development of left thyroid cancer, if it metastasizes, there is a risk of entering these metastases into the heart. It is difficult and timely to diagnose such a situation because of late treatment of patients. But if hyperplasia of the left lobe of the thyroid gland is revealed, special attention should be paid to studying its structure, determining the nature of the growth for the presence of nodes. A biopsy and an analysis of these nodes in order to identify possible disorders that may affect the condition and work of the approximate organs, the most important of which is the heart. Although unilateral localization in the case of cancer does not guarantee the spread of metastasis to the more distant parts of the body.

Hyperplasia of the thyroid isthmus

Even at the initial stages of the development of thyroid hyperplasia, when it still remains in the stage of cosmetic problems, the first can be found precisely the isthmus. It is located in such a way that when swallowing is closest to the surface of the skin. Because the hyperplasia of such a portion of the thyroid gland, like the isthmus, is noticeable in the first place. The isthmus is well palpated on examination and palpation. It has rather small dimensions, because its proliferation is quickly revealed. At the same time, the isthmus of the thyroid gland is located in such a way that it is the increase in its size that begins to affect the processes of swallowing and breathing. In the isthmus, as in other parts of the thyroid gland, all possible types of hyperplasia (diffuse, diffusive-nodal, focal) can develop, and all possible stages of increase in size. But because of the small size of this part of the thyroid gland, accurate diagnosis is very complicated in case of real problems, since possible nodes, growths will be located on a fairly small area. Particularly complex, this creates, if necessary, instrumental diagnostic methods or, if necessary, the selection of materials for biopsy.

Diffuse thyroid gland hyperplasia

Diffusive hyperplasia of the thyroid gland is a uniform increase in the entire thyroid gland or a separate part of it. With this kind of hyperplasia, there are no local formations inclined to growth. Speaking about the diffuse nature of the increase in the size of the thyroid gland, it is due to the manner in which the gland grows, the uniformity of this growth. But it has nothing to do with the stages of the development of thyroid hyperplasia. If the degree of increase in diffuse hyperplasia is small, endocrinologists most often do not attach importance to this situation. Since this state is not considered pathological. The only exceptions are those cases when, even with a diffuse nature, the increase reaches a third or more degree. In any case, it is necessary to regularly visit preventive examinations and conduct  ultrasound diagnostics to exclude intensive growth of the gland or in time to identify jumps in the dynamics of growth. And also to monitor does not appear except for diffuse growth and nodal formations. In addition, you need to conduct general tests that assess the state of the body, rather than rely solely on the size of the thyroid gland. Patients should pay attention to the characteristic changes in their body.

[12], [13]

Nodular hyperplasia of the thyroid gland

In addition to diffuse hyperplasia, nodular hyperplasia of the thyroid gland can also occur. Its main difference is that when the size of the thyroid gland increases, the growth of cells occurs unevenly. Therefore, in the gland itself dense, which are well defined by palpation, accumulation of cells, so-called nodes, are formed.

The appearance of the nodular hyperplasia of the thyroid gland is much more likely to cause doctors anxiety than diffuse hyperplasia. This is due to the fact that the nodes themselves can be oncogenic. Particular attention should be paid to the situation when, with nodular hyperplasia, only one node is allocated in the thyroid gland structure. It must be carefully examined. In addition to standard methods, studies can resort to a biopsy (removal of the tissue site) of this node.

Nodules can be formed both in the whole thyroid gland, and in its separate parts, for example, only in one of the lobes (right or left) or in the isthmus.

Mainly, if there is a nodular hyperplasia of the thyroid gland, doctors pay attention to the degree of the increase and the hormonal background. The general condition of the patient is also an important parameter.

Diffusive-nodular hyperplasia of the thyroid gland

There are several options for hyperplasia of the thyroid gland by the method of increasing the size. They can exist both independently of each other, and can be combined. To the case of such a combined increase, diffusive-nodular hyperplasia is involved.

This is a case of hyperplasia of the thyroid gland, when the latter diffusely increases in size, but nevertheless in its structure there are nodular accumulations of proliferating cells.

This case leads to a more serious attitude to the situation. It is necessary to understand all the details of the hormonal background, to conduct a separate analysis of the situation with a diffuse increase.

It is also necessary to observe the dynamics of diffuse and nodular growth of the thyroid gland. Since there can be a different development. Diffuse growth of the thyroid gland can be quite slow or even stop, while the nodes can grow much faster. Or on the contrary - the formed nodes do not show any activity, while the diffuse growth of the thyroid gland continues.

In any case, for diffuse - nodular hyperplasia of the thyroid gland, the same series of standard studies should be carried out as with other types of hyperplasia.

[14], [15], [16]

Diffusive-focal hyperplasia of the thyroid gland

With the development of hyperplasia of the thyroid gland, its growth can be observed in a diffuse type, that is, a uniform increase in its size over the entire area of the gland or one of its parts. However, local changes in growth may occur. This is not necessarily the formation of nodes of proliferating tissue. Individual sites simply may have a different diffuse growth pattern than the general one. Such cases are called focal - diffuse hyperplasia. In this development of hyperplasia, foci develop, which differ from other tissues in terms of growth rate, tissue composition, form of education, and other characteristics. At what even if these foci are several, they are not necessarily similar to each other in all their characteristics. The foci present simultaneously in the thyroid gland during its growth, however, can have different nature, structure, speed and way of growth. Often such types of hyperplasia are also called nodal, since these centers themselves often have the appearance of nodes due to the fact that they are localized in tissues that differ in structure.

In such cases, it is worth paying special attention to each neoplasm, because because of their differences they can behave differently in the future.

[17], [18], [19]

Stages

Hyperplasia of the thyroid gland, depending on the degree of increase in the size of the gland is divided into stages, each of which has its own characteristics and processes.

So it is accepted to allocate degrees of an increase in the thyroid gland from zero to the fifth. At zero degrees, the increase is not noticeable at all. They are not detected by palpation and are not detected visually. With an increase in the first degree, iron is still not probed, but its isthmus is already probed, which can also be seen during swallowing. In the second stage, the increase in iron is already visible when swallowed and probed. In all these stages, despite the increase in the size of the gland and its visibility during swallowing acts, the very shape of the neck does not change. That is, in a state of rest, iron is not visible. At the third stage, the gland is fairly easy to detect when viewed. It is well palpated, and the shape of the neck begins to change due to hyperplasia of the thyroid gland. At the fourth stage, the thyroid gland is so enlarged that the configuration of the neck changes, the enlargement is very clearly visible. At the fifth stage, the size of the gland affects the neighboring organs - presses on the trachea and esophagus, thereby hampering the processes of breathing and swallowing.

Hyperplasia of the thyroid gland 0 - 2 degrees is considered a cosmetic defect, and 3 - 5 degrees already refers to pathology, even if this increase is of a malignant nature.

Moderate hyperplasia of the thyroid gland

Such an increase in the size of the thyroid gland, which does not reach the third degree, is called moderate. In this case, the size of the gland is slightly enlarged, but this increase is not of particular concern. But it is still reasonable to determine the nature of cell proliferation, diffuse or focal (nodular). Most often there is diffuse moderate hyperplasia of the thyroid gland. In any case, even with moderate growth criteria, follow-up should be carried out. An important factor in this situation will be not only a personal anamnesis of the patient, but also a family one. The risk of further development of the disease in more serious and pathological forms is increased if there are already patients with similar diagnoses in the patient's family, especially if the scale of the problem required surgical intervention. If any features of the development of moderate hyperplasia are not found, for example, active growth dynamics, the formation of new nodes, a violation of the hormonal background, then no other than prophylactic usually do not accept, recommending further regular observation. In some cases, iodine preparations may be prescribed for prophylactic purposes.

[20], [21], [22], [23], [24], [25], [26]

Hyperplasia of thyroid gland 1 degree

When considering hyperplasia of the thyroid gland, it is rarely a question of a zero degree of increase, since it is most often not detected. Sometimes this can happen with a routine examination or ultrasound. Because more often they speak about hyperplasia of the first degree. It is also most often detected by chance, but with ultrasound it can rarely be attributed to a variant of the norm for a particular patient. At this stage of the development of hyperplasia, the patient himself can consult a doctor, noticing that when swallowing on the neck there is a marked protrusion. In such cases, the doctor can palpationally determine the allocation of the isthmus when swallowed. Additional diagnostic methods can also be assigned for clarification. But at this stage, treatment is not assigned. It is recommended to carry out regular monitoring at the endocrinologist, in order to detect the possible growth of the gland in time. Attention is also drawn to the general condition of the body. Since despite a relatively small degree of hyperplasia of the thyroid gland, there may appear symptoms that indicate a violation of its functions, a disease that results in an increase in the size of the thyroid gland. Although at this stage violations in the work of the body are observed quite rarely.

Hyperplasia of thyroid gland 2 degrees

The next stage of hyperplasia of the thyroid gland is an increase in its size of the second degree. With such an increase, the thyroid gland itself can be quite well distinguished by palpation. When swallowing acts, it also becomes visible, in contrast to the first stage, on which only an isthmus can be allocated during swallowing. Although the second stage of hyperplasia of the thyroid gland, the shape of the neck does not change at rest.

This increase is detected much more often, because the patients themselves turn to the doctor because of concern, when they themselves discover that the neck is clearly changing during swallowing. Although there is still no difficulty in breathing or swallowing with such an increase in the size of the gland. Also, an unambiguous answer can be given by an ultrasound study that will provide information on the exact size of the gland. Especially informative is such a study, if the patient turned to the endocrinologist at earlier stages of the development of thyroid hyperplasia. Thus, data on the existing size of the gland can be compared with the previous ones. Thus, we can draw conclusions about the dynamics of the growth of the thyroid gland, make some predictions about the further development of the situation.

Hyperplasia of thyroid gland 3 degrees

At this stage of increasing the size of the gland it can already be seen during routine examination, the shape of the neck changes (it becomes thicker at the location of the thyroid gland). When palpating iron is also well defined. Previous stages of the increase are more likely to be cosmetic defects if there is no active dynamics of the development of thyroid hyperplasia. Pathological such dimensions do not count. And since the third stage, hyperplasia of the thyroid gland is referred to pathological processes. At this stage, the term "goiter" is more often used. Therefore, in this case, it is advisable to carry out a more detailed study of not only the size of the thyroid gland, but also its functional processes, to study the features of iodine metabolism in the body, to analyze the content of thyroid hormones in the body.

An important feature is the determination of how the gland increases. The enlargement can take place evenly over the entire area of the organ or active growth can occur in separate areas of the thyroid gland. Depending on this, a diffuse and nodular goiter is distinguished.

The third stage of hyperplasia of the thyroid gland also raises the question of the malignancy of the process.

Forms

The International Classification of Diseases is a normative document used by the entire world health system. This document classifies all recognized diseases and health disorders, in addition, the ICD provides general international methodological approaches, the correlation of materials and information.

Thus, according to ICD-10, thyroid hyperplasia occurs (or is highly likely) in diseases that are classified as Class IV "Diseases of the endocrine system, eating disorders and metabolic disorders", E.01. Diseases of the thyroid gland associated with iodine deficiency, and similar conditions. Excluded: the syndrome of congenital iodine deficiency (E.00), subclinical hypothyroidism due to iodine deficiency (E.02), such subtopics as: 

• E01.0 Diffusive (endemic) goiter associated with iodine deficiency.
• E01.1 Multi-node (endemic) goiter associated with iodine deficiency. Nodular goiter associated with a deficiency of iodine. 
• E01.2 Goiter (endemic) associated with iodine deficiency, unspecified Endemic goiter.

E04. Other forms of nontoxic goiter.

Excluded: congenital goiter: BDU, diffuse, parenchymal goiter associated with iodine deficiency (E00 - E02), its subheadings: 

• E04.0 Non-toxic diffuse goiter. Goiter is non-toxic: diffuse (colloidal), simple.
• E04.1 Non-toxic single-nodular goiter. Colloidal node (cystic), (thyroid). Non-toxic mononodal goiter. Thyroid (cystic) node of the BDU. 
• E04.2 Non-toxic multinodal goiter. Cystic goiter. Polynodozny (cystic) goiter of the BDU. 
• E04.8 Other specified forms of non-toxic goiter.
• E04.9 Non-toxic goiter, unspecified. Goiter of the BDU. Nodular goiter (non-toxic) BDU.

E05. Thyrotoxicosis, its subheadings: 

• E05.0 Thyrotoxicosis with diffuse goiter. Exophthalmic or toxic goiter. BDU. Graves disease. Diffuse toxic goiter. 
• E05.1 Thyrotoxicosis with toxic single-nodular goiter. Thyrotoxicosis with toxic mononoadic goiter. 
• E05.2 Thyrotoxicosis with toxic multinodular goiter. Toxic nodular goiter. 
• E05.3 Thyrotoxicosis with ectopy of thyroid tissue. 
• E05.4 Artificial thyrotoxicosis. 
• E05.5 Thyroid crisis or coma. 
• E05.8 Other forms of thyrotoxicosis. Hypersecretion of thyroid stimulating hormone. 
• E05.9 Unspecified thyrotoxicosis. Hyperthyroidism of the BDU. Thyrotoxic heart disease (I43.8 *). 
• E06. Thyroiditis.

Excluded: postpartum thyroiditis (O90.5) 

• E06.0 Acute thyroiditis. Abscess of the thyroid gland. Thyroiditis: pyogenic, purulent. 
• E06.1 Subacute thyroiditis. Thyroiditis de Kervena, giant cell, granulomatous, non-pyrenic. Excluded: autoimmune thyroiditis (E06.3). 
• E06.2 Chronic thyroiditis with transient thyrotoxicosis.

Excluded: autoimmune thyroiditis (E06.3) 

• E06.3 Autoimmune thyroiditis. Thyroiditis Hashimoto. Hasitoxicosis (transient). Lymphadenomatous goiter. Lymphocytic thyroiditis. Lymphocytic Stoma 
• E06.4 Medical thyroiditis. 
• E06.5 Thyroiditis chronic: BDU, fibrous, woody, Riedel. 
• E06.9 Thyroiditis, unspecified.

E 07 "Other thyroid diseases", subheadings E07.0 "Calcitonin hypersonia" C-cell hyperplasia of the thyroid gland, hypersecretion of thyrocalcitonin; E07.1 "Dyshormonal goiter" is a family dyshormonal goiter, Pendred's syndrome. (excluded: transient congenital goiter with normal function (P72.0)); E07.8 "Other specified diseases of the thyroid gland" defect of tyrosine-binding globulin, hemorrhage, infarction (in) thyroid gland (y), syndrome of euthyroidism disorder; E07.9 "Thyroid disease, unspecified"

This information is internationally recognized and is used in all areas of health care.

Hyperplasia of the thyroid gland in children

Like any other disease, thyroid hyperplasia is of particular concern if it develops in children.

Hyperplasia of the thyroid gland in a child can be both acquired and inherent in nature. The latter may be due to the peculiarities of intrauterine development. These often include problems with the thyroid gland in the mother during pregnancy. Then the child in most cases will have diffuse hyperplasia. If the disease began to develop after birth, then most often this is attributed to the lack of iodine in the child's body. But even if there is a certain small degree of hyperplasia thyroid hormone level in the patient's body is normal and there are no violations in this part, then this growth is not considered pathological. Although there is still a need for regular monitoring, since in childhood these disorders are especially dangerous in that they can cause disturbances in the child's psychoneurological development.

It should be noted that when analyzing the situation, not only the results of instrumental and laboratory research are taken into account, but also the behavior of the child in the team, his academic performance, the general condition.

It is also important to remember that the norm values, as well as the doses of drugs in children, differ from adults.

[27], [28], [29]

Hyperplasia of the thyroid gland in pregnancy

The period of pregnancy is one of the most important and difficult periods in a woman's life. It is known that diseases of the thyroid gland, and in particular hyperplasia of the thyroid gland, are found in women much more often than in men. And pregnancy even more increases the risk of these pathologies. In addition to violations of work in the body of a woman, in pregnancy, hyperplasia of the thyroid gland poses a danger for the development of the fetus. In particular, the normal functioning of the thyroid gland of the mother, the adequate production of hormones, affect the development of the child's respiratory system. This is especially true in the first half of pregnancy. But the development of hyperplasia is quite common in pregnant women. Most often it manifests itself in the form of a diffuse toxic goiter.

In addition to possible complications of fetal development, the negative impact of symptoms on the condition of the mother, hyperplasia of the thyroid increases the risk of spontaneous abortion. The probability can reach 50%. Most often this situation occurs at the earliest stages of pregnancy. The reason for this is increased production of thyroid hormones, which in turn negatively affect the attachment of the fetus in the uterus, the development of the embryonic egg.

Diagnostics of the hyperplasia of the thyroid gland

Diagnosis of the development of hyperplasia of the thyroid gland is performed by a doctor endocrinologist. The main diagnostic methods are primary examination, palpation of the gland location area, ultrasound examination of the thyroid gland, analysis for the maintenance of thyroid hormones in the blood, assessment of the general condition of the patient.

Much also depends on how the disease proceeds, what symptoms the patient feels, and what kind of complaints he addressed to the doctor.

The earlier the patient turned to specialists, the less often the disease is diagnosed. Since the first stages of hyperplasia of the thyroid gland do not exhibit external signs, they do not give noticeable symptoms. Although this situation can be detected if ultrasound diagnostics is used as prophylactic methods of research.

In other cases, the doctor can detect the development of hyperplasia when feeling, observe the swallowing act to notice the possible allocation of the gland or isthmus with such actions. Sometimes, in the late stages of the disease, the enlargement of the thyroid gland can be detected simply visually, if its dimensions are such that the configuration of the neck changes. You can also assume the presence of hyperplasia due to indirect signs, which speak of violations in her work.

[30], [31], [32], [33]

Echoes of hyperplasia of the thyroid gland

One of the most reliable methods for determining hyperplasia of the thyroid gland is ultrasound diagnosis. It is with her on a number of ECHO signs can reveal changes in the thyroid gland.

Even at the initial stages of development, cells that expand, increasing the total volume of the gland, react differently to the ECHO signal than normal healthy cells. If there is diffuse hyperplasia, the signs of such different cells are not seen locally, but are common throughout the gland or part of it. If the growth of the thyroid gland tissue occurs with the formation of nodes, then the ECHO signal will display this brightly, since only certain zones will respond to it differently. Diffuse-focal hyperplasia of the thyroid gland is also determined. Against the background of the general reaction of the cells, with more diffuse growth, more bright areas will be allocated. When interpreting received responses to ECHO signals, one can also judge how similar the nodes are to each other, whether they have the same origin and structure.

In addition to data on the structure of the thyroid gland and the structure of possible neoplasms in it, ECHO signals report information on the shape, size, shape of the edge, the total volume of the thyroid gland. It is clearly shown which part is susceptible to hyperplasia.

[34], [35], [36],

Treatment of the hyperplasia of the thyroid gland

When choosing the tactics of treating thyroid hyperplasia, special attention is paid to many different factors. In particular, the degree of enlargement of the thyroid gland is of prime importance. Depending on this, hyperplasia is considered a pathological or non-pathological process. If the dimensions are not considered pathological, then treatment as such is not prescribed. Prescribe some preventive measures, it is recommended to conduct regular examinations and ultrasound. If the increase is considered pathological, whether due to size or because of the rate of growth, then the tactics of treatment are chosen. It can vary from prescribing iodine to surgery.

The next important factor is the age of the patient. Approaches to diagnosis and treatment of thyroid hyperplasia in adults and children are different. Whereby children have a more active influence on the process, it is much more important, as violations of the thyroid gland may adversely affect the overall level of development of the child.

It is also very important to take into account the patient's condition (for example, pregnancy), and the accompanying diseases that affect the situation.

Treatment of diffuse hyperplasia of the thyroid gland

It is diffuse hyperplasia of the thyroid gland that occurs in most cases. It is determined by probing or ultrasound diagnosis. If an increase in the size of the thyroid gland in diffuse hyperplasia is not of particular concern, then in addition to regular regular monitoring, an increase in the level of iodine intake is prescribed. Among these recommendations, there are two types - pharmaceutical and natural. The most frequent case is a recommendation on the transition to the use of iodized salt. Not just its periodic application, but a complete replacement in the household is usually salt iodized. Also, iodine levels can increase iodine-containing foods in the diet. These include seaweed (sprulina, kelp), as well as other marine products. In particular, fish - cod, halibut, salmon, known and popular in our herring. I also have a lot of iodine in squid, scallops, mussels. Iodine is also found in a number of other products. An alternative to this replenishment of iodine in the body is the administration of preparations containing iodine, such as iodomarine, potassium iodide.

In more complex cases, when the hyperplasia of the thyroid gland is accompanied by hormonal imbalance, prescribe hormonal medication.

In particularly difficult cases, with significant increases in size, surgical intervention may be necessary.

Treatment of nodular hyperplasia of the thyroid gland

Nodular hyperplasia of the thyroid gland is always of greater concern than diffuse. If there are nodes in the thyroid gland, it is difficult to predict their further behavior, it will be difficult to determine their possible effect. Moreover, it is with the development of nodular hyperplasia that the probability of developing a malignant process is more likely. For the correct choice of treatment tactics, in addition to ultrasound analysis, examinations and feelings, analyzes for the maintenance of thyroid-stimulating hormones in the blood, in a number of cases a biopsy of the knot formed, and sometimes several, if there is a suspicion that their nature is different.

With nodal hyperplasia, iodine preparations are always prescribed. But in this case, the administration of hormonal preparations is also much more often, since it is during the formation of the nodes, especially in the case of diffusive-nodal hyperplasia, that functional changes in the thyroid gland functioning are observed. Also quite common in nodular hyperplasia is the surgical removal of the nodes or even the removal of a part, and sometimes of the whole, of the thyroid gland. In such operations, hormone replacement therapy is prescribed. Even after surgery, the thyroid gland (if not completely removed) requires very scrupulous control.

Prevention

As you know, prevention is always better than treatment. Therefore, the prevention of thyroid diseases should also play an important role. This is especially true for residents of those regions that were exposed to radiation (Chernobyl tragedy, Fokushima), as well as residents of regions with endemic iodine deficiency.

As the main type of prophylaxis of problems with the thyroid gland, in particular the prevention of hyperplasia of the thyroid gland, is the use of iodized salt. In many countries of the world today, eating iodized and sea salt is not something special. Because it is worth entering into a lifestyle. In addition, it will be useful to eat marine products, which also contain a large amount of iodine. But besides the seafood, the iodine reserve also replenishes the eggs, milk, beef, garlic, spinach and many other things that are familiar to us. If there is a serious iodine deficiency in the region of residence or there is no possibility to consume iodine-rich foods, then it will be advisable to take a course of preparations replenishing the iodine reserve.

In addition to the direct balance of iodine, the development of hyperplasia of the thyroid gland is influenced by such factors as overweight. The relationship between overweight and thyroid disorders has been proven. Therefore, it is worthwhile to monitor this, especially if a person is at risk for some other indicator.

Also important are the environmental conditions - clean drinking water, healthy foods that do not contain chemical toxins, the total balance of nutrients, minerals and vitamins.

[37], [38], [39], [40]

Forecast

Hyperplasia of the thyroid gland is a fairly studied and controlled disease to date. But nevertheless, the important role in the forecasts of its development is occupied by the stage at which it was discovered. It is quite rare to detect hyperplasia of the thyroid gland at the earliest stages. This is due to the fact that patients do not seek help until the condition of the thyroid gland starts to cause them anxiety. More often than not, attention is drawn to the secretion of the thyroid gland during swallowing, difficulty with swallowing, a feeling of sagging in the throat, a change in the configuration of the neck. But even at such stages, patients often write off all this symptomatology for the state of the environment (the consequences of Chernobyl) and believe that such changes can be the norm and can not be corrected. This is not only an erroneous, but also a rather dangerous decision for health. The increase in the size of the gland to such a size, which actively attracts attention, is often accompanied by the appearance of disturbances in the production of thyroid hormones, which inevitably entails a disruption in the work of the whole organism. This is especially dangerous for children.

In addition, the growth of the gland, which is accompanied by the formation of nodes can develop into a  cancer of the thyroid gland. To underestimate the danger of cancer is difficult today. Therefore, the prognosis of treatment directly depends on the condition that occurs at the time of treatment. In the event that even nodular hyperplasia of the thyroid gland was detected at a fairly early stage, there were no changes in the hormonal background, then the predictions are quite optimistic. If the situation turned out to be neglected, sprawl complicates breathing and swallowing, serious surgical and medication interventions are required, then the predictions worsen significantly. After all, even if in the case of complete removal of the gland or a significant part of it, the problem of disorders from the thyroid gland is solved, it generally disables the person, forcing to constant intake of hormonal preparations, negatively affects the general state of the organism. Therefore, it is recommended to undergo preventive examinations at least once a year for timely detection of the problem, if any.

[41], [42], [43], [44], [45]