Question

1. What factors can lead to the development of a goiter?

2. What are treatmen options for Hypo and Hyperthyroidism?

3. What are treatment options for Cushings vs Addisons?

Answer 1

Goiter is a disease that occurs when the thyroid gland produces too much thyroid hormone.

Factors lead to development of goiter.

Iodine deficiency causes enlarged thyroid gland, known as goiter. A goiter can be caused by a variety of factors and conditions. They are

• Grave's disease: auto immune disease. The immune system attacks the thyroid gland and the thyroid grows larger.
• Hashimoto's disease: autoimmune disease. It causes inflammation of thyroid gland. This causes it to produce fewer thyroid hormones, resulting in a goiter.
• Nodular goiter: nodules occur on both sides of the thyroid gland, causes enlarged thyroid.
• Thyroid cancer: Cancer of the thyroid gland often enlarges the thyroid.
• Pregnancy: Human chorionic gonadotrophin is pragnancy hormone. That causes enlarged thyroid.
• Thyroiditis: Inflammation of the thyroid gland itself can cause the thyroid gland to grow.
• Exposure to radiation: Patients with medical treatment of radiation to the head and neck has the high risk for goiter.
• Other risk factors: Hereditary, female gender and age over 40.

Treatment for hypo and hyperthyroididsm

Hypothyroidism

Hypothyroidism means deficiency of thyroid hormone.

The treatment for hypothyroidism involves the daily intake of levothyroxin tablets. It restores the adequate thyroid hormone levels. The permanent hypothyroidism can be effectively treated , not cured.

Hyperthyroidism

• Hyperthyroidism occurs as a result of increased hormone levels.
• Medications: Antithyroid medications such as Tapazole, Radioactive iodine.
• Surgery: Thyroidectomy. That is surgical removal of thyroid gland.

Treatment options for Cushings Vs Addisons

Cushing's syndrome:

Cushing's syndrome means hypercortisolism. It occurs due to the excessive production of cortisol.

Treatment

• Medications: to control excessive production of cortisol at the adrenal gland includes ketconazole, mitotane and metyrapone. Then Mifepristone, does not decrease cortisol production, but it blocks the effect of cortisol on tissues.
• Radiation therapy: It is used in conjunction with surgery. Because a pituitary tumour can't remove completely. So radiation therapy is needed to reduce the size of the tumour.
• Surgery: Removal of tumour from adrenal gland, pancreas or lungs. The pituitary tumours are removed by Neurosurgeon.

Addison's disease

Addison's disease means hypocortisolism. That is inadequate production of cortisol.

Treatment:

• Medications: Hydrocortisone, prednisolone, or methylprednisolone to replace cortisol.
• Fludocortisone acetate to replace aldosterone.
• Glucocorticoid injection kit.
• Annual checkup is needed.