Diffuse toxic goiter, also known as endemic goiter, is an autoimmune disease characterized by overproduction of thyroid hormones causing damage to organs like the nervous and cardiovascular systems. It is caused by iodine deficiency in the environment, especially in soil and water. People in iodine-deficient areas can develop an enlarged thyroid gland with a reduction in its function over time, along with symptoms like difficulty swallowing and changes to heart function. Treatment options include thyroid drugs, surgery to remove part of the thyroid gland, and preventing future cases by providing iodized salt and foods to populations.

1. DIFFUSE TOXIC
&
ENDEMIC GOITER

3.  This disease is an autoimmune nature
characterised by overproduction of thyroid
hormoneby the thyroid gland and the
development of thyrotoxicosis with damage to
many organs and symptoms,espicially the
nervous and cardiovascular system.
 CLASSIFICATION:-
diffuse goiter
multi-noduler goiter
Solitary noduler goiter

4.  More Commonly Non-Toxic.
 May be Toxic.

5.  Compensatory Hypertrophy & Hyperplasia
due to Decrease in T3 & T4.
 Diffusely Involves Whole Gland.
 Not Associated With
Hypo OR Hyperthyroidism.

6.  Progression from Diffuse Simple Goitre.
 Upto 2 kg.
 Multinodular Focal Hyperplasia.
 Mostly Euthyroid.

7.  Physiological Goitre:
 Puberty OR Pregnancy.
 Dietary Iodine Deficiency:
 In Areas Far From Sea.
 Dietary Goitrous Agents:
 Cabbage & Turnips.
 Calcium or Flouride in water.
 PAS, Lithium, Phenylbutazone, Thiouracil,
Carbimazol.

8.  Hereditary.
 Treated Graves’ Disease.
 Rare Cause:
 Lymphoma.
 Anaplastic.
 Thyroiditis (Autoimmune or de-Quervain’s).
 Amyloidosis.

9.  Cosmetic.
 Discomfort..
 Irritating Cough.
 Dysphagia.
 Wish to Exclude Malignancy.
 Hyperthyroidism.
 Hoarseness.

10.  Most Sensible & Universal Investigations;
 Ultrasound.
 FNAC.

11.  Medical:
 Thyroxine.
 Surgery:
 Total Thyroidectomy.
 Near-Total Thyroidectomy.

12.  Small:
 No Treatment.
 Reassurance.
 Iodine Support.
 Large/Pressure Symptoms OR Cosmesis:
 Near-Total Thyroidectomy.

13.  This disease is accompined by a progressive
increase in the thyroid gland with subsequent
reduction of its functions.
endemic goiter is observed in people living in
areas of iodine deficency in the
environment,espicially in soil and water.

14.  Lack of iodine in food due to a lack of its in the
soil and water.
 SYMPTOMATOLOGY:-
 diffuse or noduler thyroid enlargement.
 feeling difficulty during swaloing.
 severe cases mental decline.
 difficulty to turn head.
 cardiovasculer system distrabences.

15.  PALPATION:-
0 -no goiter (visually and by
palpation)
1 –determined on palpation
2 – determined visually by palpation.
Levels of thyroid hormone:-
t4,t3 and TSH above normal.

16.  The use of thyroid drugs in theraputic doses
 Treatment of hypothyroidism
 Surgery(subtotal resection of the thyroid gland)
 PREVENTION:-
 Providing the population with iodized salt and
iodised food
 Drug(thyroid drug in small doses)