Goiter causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Various factors have been associated with the cause of goiter such as hereditary, hormonal, dietary, pharmacological, physiological, environmental and pathological factors. The most common causes being, iodine deficiency, grave's disease and hashimoto's disease. Goiter may be caused by a mutation in the genes such as the thyroglobulin (Tg) gene, thyroid-stimulating hormone receptor (TSHR) gene and the Na+/I- symporter (NIS) gene.

Causes

• Factors associated with goiter can be classified as follows:-
  • Hereditary factors
  • Hormonal factors
  • Dietary factors
  • Pharmacological factors
  • Physiological factors
  • Environmental factors
  • Pathological factors

• Hereditary factors:
  • Inherited defect(Familial goitre) of thyroid hormone synthesis such as:
    • Enzymatic defect deficiency
    • Dyshormonogenesis

• Hormonal factors:
  • Thyroid hormone dysfunction:
    • Hyperthyroidism (overproduction of thyroid hormones)
    • Hypothyroidism (underproduction of thyroid hormones)

• Dietary factors:
  • Dietary iodine deficiency
  • Goitrogens (play a major role in endemic goitre)

• Pharmacological factors:
  • Use of goitrogen drugs like para-aminosalicylic acid (PAS), thiocyanate and antithyroid drugs [e.g. thiouracil, carbimazole] → hypothyroidism

• Physiological factors:
  • Increased metabolic demand of thyroid hormones e.g. during pregnancy or puberty → physiological goitre

• Environmental factors:
  • Exposure to radiations leading to:
    • Thyroid cancer
    • Hypothyroidism

• Pathological factors:
  • Intrinsic thyroid gland diseases
    • Inflammatory goitres
    • Neoplastic goitres
      • Benign adenoma (follicular adenoma)
      • Malignant
        • Primary: Well differentiated, Poorly differentiated, Arising from parafollicular cells
        • Secondary

Common Causes

Goiter may be caused by:

• Iodine deficiency
• Grave's disease
• Hashimoto's disease

Less Common Causes

Less common causes of Goiter include:

• Pregnancy
• Radiation exposure
• Thyroid cancer
• Multinodular goiter
• Solitary thyroid nodules

Genetic Causes

• Goiter may be caused by a mutation in the following genes which vary from one family to the other:

• Thyroglobulin (Tg) gene
• Thyroid-stimulating hormone receptor (TSHR) gene
• Na+/I- symporter (NIS) gene

• Multinodular goitre marker 1 (MNG1) on chromosome 14