Euthyroid (non-toxic) goitre

Euthyroid (normal thyroid function) or non-toxic goitre occurs in two broad groups. These are endemic goitre, where a whole community or population may have a high incidence of goitre and sporadic goitre, where only some individuals are affected.

Endemic goitre

Endemic goitre is mainly due to deficiency of iodine in the diet due to an indigenous lack of iodine in the soil in which foods are grown. It is now more prevalent in developing countries and has been largely been eradicated in the developed world by the inclusion of iodine supplements in prepared foodstuffs. The condition was very prevalent in certain parts of England in the past. In Derbyshire the condition known as ‘Derbyshire neck’ was so widespread that it was thought to be hereditary until the link with iodine deficiency in the local water supply was recognised. In Japan the effect of excess iodine in the natural diet as well as consumption of iodine rich seaweed products was responsible for endemic goitre.

Sporadic goitre

Sporadic goitre may be due to an inherited familial tendency, poor individual diet, age (over 40 years) and gender (women are four times more susceptible than men). Certain foods such as cabbage, broccoli and cauliflower can neutralise iodine and excess intake or dependency on such foods can cause iodine deficiency. Some medication such as lithium salts, used to treat bi-polar depressive illness, can interfere with iodine uptake and cause goitre.

A form of sporadic goitre can occur in relation to changes in individual hormonal status such as during pregnancy, at puberty and from use of the oral contraceptive pill. These types usually cause a small diffuse swelling of the neck with no evident change in thyroid function.