The first class of a Goiter is one that can be felt with palpation or via ultrasound but not noticeable. The second class is noticeable by palpation and also visible. Palpation just means feeling the neck. The third class is very large and its creating pressure behind the thyroid itself. There are often marks that are formed from that and then changes in swallowing and speaking.
Now the general idea behind a goiter is that it is formed by some combination of inflammation and an exaggerated growth signal. So inflammation just means that something is irritating the thyroid tissue. The growth signal in the cycle is that there is thyroid stimulating hormone that is made to help the thyroid produce hormone so when the gland has a low point of this activity the body makes more thyroid stimulating hormone, TSH, to stimulate the gland and what that does is causes the cells of the gland to divide. So the gland actually gets larger.
So a healthy gland with this slight increase in size will end up creating extra hormone and the body will be satisfied with that and the thyroid stimulating hormone will go back down again. So the size change is not very substantial. If the gland is inflamed especially from an autoimmune attack like Hashimoto’s or if there is an iodine deficiency then that signal on the gland can keep on getting higher and higher and the gland can get larger and larger. So it can reach a point that even though it has grown substantially it is still not making enough hormone and it keeps on growing and growing.
Now, this has been recognized as a condition for quite some time. The Chinese physicians from 2 Millennia ago had writings discussing Goiter. Pretty wild that they knew that you could effectively treat Goiter with the powder from burnt seaweed or by giving thyroid tissue from animals. They would dissect animals and remove there thyroid glands and then minced them up and fed them to people with Goiter. Pretty wild that they were able to cure them and that they had this knowledge. So it has been known about for quite some time.
So the most common causes of Goiter. The two most common by far would be iodine deficiency and then Hashimoto’s disease. Iodine deficiency is the most common global cause and that is because most of the world does not have iodized salt. Many areas that do not have high intakes of seafood can become low in iodine. You know iodine ultimately comes from the sea. So crops that are raised near the sea that have some sea water or iodine in the soil or food directly from the sea you know sea vegetables, fish, shellfish those are all things that have more iodine. We do also find iodine in dairy foods and bread products. Not because it is naturally occurring but in dairy foods sometimes iodine is used to sanitize the tits where they milk the cows from and that ends up causing some to be in the milk. For bread products sometimes iodine is used as a dough conditioner, not always but in some circles, it is used that way and that causes bread to have a bit more iodine. So those are the big sources.
Areas that do not have coastal access or do not have iodine in the foods or dairy foods they can get low in that and in those cases there is more tendencies towards Goiter. It turns out that certain foods can make iodine a little bit harder to absorb. So if you do live in an area that has an endemic iodine deficiency and your diet is high in certain foods you may have an impairment of iodine absorption.
Now, this is a long list of foods and a lot of things can possibly do this. A lot of these foods that are on these lists you will see a lot of these foods have not been shown to do this in humans. They either have shown to do it in animals or it is theorized they could do it in humans. Some ones that have been documented would include cassava and cabbage. Also Pinenuts, peanuts, millet, cruciferous type vegetables which include broccoli, bok choy, Brussels sprouts, cabbage, cauliflower, collard greens, kale, mustard greens, radishes, rutabagas, turnips. Rutabagas are good foods. When we grew up on the farm we had those quite a bit. We will also see other foods possibly having this activity such as spinach, bamboo chutes, sweet potatoes, peaches and berries and strawberries, and millet. Wow, so what do you do. Those are all really good foods.