The thyroid gland - an organ whose function is controlled by the neuroendocrine system. By reducing the thyroid neuroendocrine system "makes" its function by stimulating the proliferation of breast tissue (proliferation). Iron increases in volume, it may also be formed nodes.

Why develop nodular hyperplasia of the thyroid gland

The term "hyperplasia" (or goiter) - means a growth of tissue. Thyroid hyperplasia occurs with a decrease in its function when the iron starts to produce enough thyroid hormone. This happens with a lack of food and water iodine - it is necessary for the synthesis of hormones.

To understand why the thyroid gland grows, it is necessary to know how the regulation of its functions. Regulates the function of the thyroid gland by means of pituitary hormones, which in turn affects the hypothalamus. At deficiency of thyroid hormones in the blood of the hypothalamus produces hormones that stimulate the pituitary secretion of thyroid stimulating hormone (TSH). TSH stimulates the thyroid gland, increasing the production of its hormones. If it fails to do and indicators TSH kept elevated for a long time, then it begins proliferation (growth of) tissue cancer.

Breast tissue typically increases uniformly, but sometimes it happens more than one lobe, i.e. from one side. In some cases, the cancer tissue wherein the formed nodes. Hyperplasia - is basically a benign disease, but the appearance of nodes creates the danger of degeneration into a malignant tumor. Especially dangerous in this respect single (solitary) nodes.

Signs

Hyperplasia may develop in different ways, but if the first is always a benign disease, with prolonged duration, and especially if there are hardware components, increases the risk of benign transition process in malignant.

Gipreplazii sign is the increase in thyroid Increase in thyroid - that underlies the disease . First, it is not too much, but then the deformation of the neck becomes more noticeable. Thyroid enlargement can compress organs, blood vessels and nerves in the neck that leads to disturbances of breathing, swallowing, hoarseness, appearance of pain (while squeezing the nerves).

As revealed

Nodular hyperplasia of the thyroid gland Thyroid hyperplasia - prevalence of endocrine pathology   it is desirable to identify as early as possible - depends on the outcome of the disease. Identify it can be a doctor during the examination. He will appoint a full inspection. The first gives blood for thyroid hormones - decrease the blood levels of thyroid hormones Thyroid hormones: mechanism of action and physiological effects   and a simultaneous increase of the pituitary thyroid stimulating hormone (TSH) says that hyperplasia developed against the backdrop of a lack of thyroid function.

It held as ultrasound prostate by which determined its size and structure. In the US, you can also see the nodes to determine their size and structure.

If the thyroid gland revealed nodes performed needle biopsy - fine-needle puncture iron and take to study the contents of the site. Histologically determine the nature of education (benign or malignant).

Finally, if a scanning units thyroid radioiodine. This allows to identify so-called "cold" nodes, which do not produce hormones and do not absorb radioactive iodine. Such sites tend to degenerate into a malignant tumor.

Treatment

Treatment of hyperplasia is prescribing, which include thyroid hormones. Other treatment is given according to the survey.

If found "cold" nodes, and histological examination of suspect, the nodes are removed surgically. Nodes that have not previously raised concerns, but which, nevertheless, tend to increase also removed.

During surgery to remove thyroid nodules Removal of thyroid nodules - special readings   necessarily performed histological examination of tissue remote node until the patient is on the operating table. If you find abnormal tissue (cancer) cells removed all the iron and nearby lymph nodes.

Prevention of nodular hyperplasia of the thyroid gland is a daily intake of iodine in an amount corresponding to age standards, especially in areas where there is a deficiency in the environment. Daily rate of iodine recommended by the World Health Organization: children - 100 mcg, adults - 200 mg, pregnant and lactating women - 250 mcg.

Galina Romanenko

The pathology on the part of the endocrine system is quite common among the population, respectively, on treatment of these diseases is important. Thyroid medication involves the use of several treatment options, including medication and surgery, depending on the availability of evidence.

Questions replacement therapy

As one of the options for medical treatment in endocrinology practice in insufficient production of thyroid hormone replacement therapy is used. For this purpose, formulations are used successfully thyroid hormones. Of produced domestic drugs most widely used drug thyroidin. It is made from animal thyroid gland (dried iron cattle). In known forms thyroidin contained different amounts and ratio of the active ingredient (iodothyronine), so in some cases it may be difficult in the early stages of treatment to choose an effective dose of the drug. With the aim of substitution can be used in addition to thyroidin following medications:

• thyroxine Thyroxine - the main thyroid hormone
• triiodothyronine
• Thyreocombum
• tireotom
• Fort tireotom

Perform replacement therapy in patients with hypothyroidism should be for life .  The exception may be a situation where there was an overdose thyreostatics the treatment of goiter or early after surgery for prostate removal .  It can recommend to combine a combination thyreostatics and thyroid hormones to prevent the goitrogenic effect of the therapy .  At the present stage, this approach to therapy is the most reasonable .  Consideration should be given to the appointment of unnecessarily high doses of drugs, the dose should be quite deliberate so as not to harm the patient .  In the case of replacement therapy for hypothyroidism, there are several basic principles, the implementation of which will enhance the efficiency of medical actions .  Titration is dependent on the severity of the patient's condition, presence of concomitant diseases, age and main pharmacological characteristics of the drug .  The drug should be injected slowly at first, a mistake to think that the young patients tactics dose selection should be more aggressive .  The main points that need to be supported, it is the severity of the disease and its duration .  Many professionals prefer to use thyroxine at the initial dosage of 25 mg and gradually increasing the dose of 25 mg for four weeks .  Any proposed regimen is indicative, as each clinical case deserves an individual approach .

When combined with hypothyroidism and pregnancy should be required to carry out substitution therapy for the prevention of complications (the threat of termination on any terms, miscarriage, the development of the fetus anomalies or malformations). Pregnant should be seen by a doctor and take endocrinologist dynamic control thyroid hormone levels, which will be an indication for dose adjustment of prescription drugs.

Justification surgery

In some cases there is a need for surgical treatment, which involves the removal of the entire gland or organ (total resection). For this to be strict indications:

• the development of large goiter
• compression of adjacent thyroid due to the increased size (may offset the esophagus, trachea, or blood vessels)
• retrosternal goiter form
• complications or severe thyrotoxicosis (against the background of the development of the disease arrhythmias Arrhythmia - when we hear your heart Lack of persistent clinical remission during drug therapy)
• idiosyncrasy thyreostatics

Thyroid surgery The thyroid gland - is responsible for your hormones   It should be carried out after pre-drug preparation. For this purpose, patients are assigned tireostatiki, corticosteroid hormones. If the patient can not take thyreostatics (presence of intolerance or allergic reactions), the necessary preoperative preparation can be carried out taking hormones Hormonal treatments - not only contraceptives   from the group consisting of corticosteroids and blockers. Fulfilling all requirements of training the patient for surgery ensures good results and favorable during the period after the surgery without complications. Depending on the volume of surgical intervention should be carried out in the future replacement therapy. Dose prescribed drugs should contribute to drug compensation condition caused by removing a portion or the entire organ.

Surgical treatment is indicated for surgical repair evolved in the craw of complications, such as severe cases of eye disease. It noted positive results of treatment in combination with the method of plasmapheresis. This method allows one to quickly withdraw from the human thyroid hormone excess amount, as well as circulating immune complexes which contribute to the development of autoimmune processes. Plasmapheresis should be combined with the appointment of steroids and immunosuppressive drugs.

Methods of physical effects deserve special attention in the treatment of pathological conditions of the thyroid gland. It has been proven the existence of positive results in the appointment of an alternating magnetic field, which can directly affect the pathological focus. Magnetic therapy can be recommended for complex treatment with the development of complications of the eyes. Biological effects on the eye tissues can reduce the severity of clinical manifestations of ophthalmopathy.

Marina Solovyov