VIII.

PATHOPHYSIOLOGY

NODULAR NON-TOXIC COLLOID GOITER, EUTHYROID GLAND

Predisposing Factors

Modifiable: Non-modifiable:

- Stress - Gender (F)

- Age (34)

Cellular changes

Overgrowths of normal thyroid tissue

Development of colloid nodules in the thyroid gland

Gradual enlargement of nodules

Occasional production of thyroid Enlargement in the thyroid gland

hormones by nodules on gland

Normal T3 and T4 level, Painless neck enlargement,

low TSH level hoarseness of voice

Increased breathing effort

NODULAR NON-TOXIC COLLOID GOITER, EUTHYROID GLAND

PATHOPHYSIOLOGY

Two of the most common types of goiter are toxic and non-toxic goiter. The toxic
type is associated to hyperthyroidism-like symptoms. On the other hand, hypothyroidism-
like symptoms are usually attributed to the non-toxic type. However, certain cases of non-
toxic goiter exhibit normal levels of thyroid hormones. Goiter can also be diffuse - which
means a plain enlargement of the thyroid gland, or nodular – which means that aside from
being enlarged, the thyroid gland contains nodules. This discussion will tackle about the
nodular type.

Development of thyroid nodules is usually associated with a lot of factors. In the

case of the patient, the applicable predisposing factors include stress, age and gender
(being female). Stress is a modifiable factor for this disease, as it has been known to affect
cellular function though it may be controlled. The non-modifiable factors include age and
gender. Because the likelihood of developing thyroid nodules increases as you grow older,
some changes in thyroid tissue may occur as a normal part of aging. Women are also more
likely to develop thyroid nodules than men are, maybe due to the hormonal changes.

The development of thyroid nodules sprang from overgrowths of the normal thyroid
tissue brought about by cellular changes. These nodules gradually grow and enlarge over
time. This will result to a subsequent enlargement of the thyroid gland itself, accompanied
by occasional production of thyroid hormones by the thyroid nodules. The enlargement in
the thyroid gland causes the sensation of having a painless enlargement in the neck
accompanied by hoarseness of voice and increased respiratory effort. Because the nodules
on the gland have the ability to produce thyroid hormones at unpredictable times, the TSH
level is low although the T3 and T4 levels are within normal range. This string of symptoms
leads to what is known as nodular non-toxic colloid goiter, euthyroid gland. This implies an
enlargement of the thyroid gland brought about by nodules of colloid cyst type, as
aggravated by the nodules’ ability to occasionally secrete thyroid hormones. Euthyroid
gland means that this goiter doesn’t carry hyperthyroidism and hypothyroidism effect on
thyroid hormone levels, since the levels are maintained in normal range.