Health Dictionary
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Toxic multinodular goiter risk factors
Introduction
Overview
Overview
Common risk factors in the development of multinodular goiter include female sex, age over 50 years, areas with decreased iodine intake, iodine supplementation, natural goitrogens, vitamin A deficiency, iron deficiency and selenium deficiency.
Risk Factors
Risk Factors
- Common risk factors in the development of multinodular goiter include:
- Natural goitrogens associated with the development of multinodular goiter include:[3]
- Millet, soy beans, coconut, babassu contain flavonoids that impair thyroperoxidase enzyme.
- Cassava, sweet potato, sorghum contain cyanogenic glucosides metabolized to thiocyanates that inhibits thyroid iodine uptake.
- Cabbage, cauliflower, broccoli, turnips contain glucosinolates that impair thyroid iodine uptake.
- Seaweed (kelp) contains excess iodine that inhibits release of thyroid hormones.
- Vitamin A and iron deficiency increases TSH stimulation and reduces heme-dependent thyroperoxidase activity.
- Selenium deficiency accumulates peroxidase and causes deiodinase deficiency resulting in impaired thyroid hormone synthesis.
- Head or neck irradiation in an adult is associated with increased frequency of toxic nodular goiter.
- Iodine supplementation or iodinated contrast agents or iodinated drugs, such as amiodarone, may also induce hyperthyroidism in patients with underlying nontoxic multinodular goiter (Jod-Basedow effect).[4]
References
References
- ↑ Vestergaard P, Rejnmark L, Weeke J, Hoeck HC, Nielsen HK, Rungby J, Laurberg P, Mosekilde L (2002). “Smoking as a risk factor for Graves’ disease, toxic nodular goiter, and autoimmune hypothyroidism”. Thyroid. 12 (1): 69–75. doi:10.1089/105072502753451995. PMID 11838733.
- ↑ Laurberg P, Pedersen KM, Vestergaard H, Sigurdsson G (1991). “High incidence of multinodular toxic goitre in the elderly population in a low iodine intake area vs. high incidence of Graves’ disease in the young in a high iodine intake area: comparative surveys of thyrotoxicosis epidemiology in East-Jutland Denmark and Iceland”. J. Intern. Med. 229 (5): 415–20. PMID 2040867.
- ↑ Gaitan E (1988). “Goitrogens”. Baillieres Clin. Endocrinol. Metab. 2 (3): 683–702. PMID 2464986.
- ↑ Dunne P, Kaimal N, MacDonald J, Syed AA (2013). “Iodinated contrast-induced thyrotoxicosis”. CMAJ. 185 (2): 144–7. doi:10.1503/cmaj.120734. PMC 3563887. PMID 23148056.
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mazia Fatima, MBBS [2]