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Goiter (Holistic)

Goiter (Holistic)

About This Condition

Stop the swelling in your neck by getting to the root of your thyroid problem. According to research or other evidence, the following self-care steps may be helpful.
  • Get a checkup

    Visit your doctor to find out if the swelling in your neck is caused by a treatable medical condition

  • Ask about iodine

    Ask your healthcare provider if your goiter may be caused by too little or too much iodine in your body

About

About This Condition

Goiter is an enlargement of the thyroid gland that often produces a noticeable swelling in the front of the neck.

This enlargement can be caused by iodine deficiency, inability of the body to use iodine correctly, or a variety of thyroid disorders, including infection , tumors, and autoimmune disease. Some environmental pollutants, heavy metal poisonings, and certain drugs can also contribute to goiter formation.1 , 2 , 3 Both iodine deficiency and inability to use iodine properly make the thyroid gland unable to produce thyroid hormone, a hormone that helps to regulate the body’s metabolic rate. This state is called hypothyroidism and the symptoms include fatigue, weight gain, heavy menstrual bleeding in women, dry skin and hair, as well as goiter.

Iodine-deficiency goiter can be common in regions where the soils and foods have insufficient iodine. Preschool children, adolescent girls, pregnant women, and the elderly are most vulnerable to goiter and other iodine-deficiency disorders.4 Areas where iodine supplies are inadequate see high rates not only of goiter but also of birth defects and retardation of both mental and physical development.5 While iodine deficiency is the leading cause of goiter worldwide, it is a rare cause of goiter in the developed world. For this reason, any goiter that occurs in the developed world must be evaluated by a healthcare provider and its cause determined before any treatment is given.

Symptoms

People with goiter may notice a soft swelling in the front of the neck.

Eating Right

The right diet is the key to managing many diseases and to improving general quality of life. For this condition, scientific research has found benefit in the following healthy eating tips.

Recommendation Why
Ask about iodine
Ask your healthcare provider if your goiter may be caused by too little or too much iodine in your body.

The most important dietary concern in treating iodine-deficiency hypothyroidism and preventing goiter is ensuring adequate intake of iodine . Iodine is found naturally in foods from the ocean, such as fish and seafood, kelp, and sea vegetables, and in plant and animal products produced in areas where soil and water contain sufficient iodine.6 , 7 In developed countries, commercial table salt has been fortified with iodine since the 1920s to prevent deficiency.8 Iodized salt contains approximately 100 micrograms of iodine per gram of salt. This fortified salt is used directly and is incorporated into animal feeds and processed foods making it easy to achieve the Recommended Dietary Allowance (RDA) of 150 mcg for adolescents and adults and 200 mcg daily for pregnant and breast-feeding women.9 Iodized salt has proven so effective it is recommended as the intervention of choice to eliminate iodine deficiency worldwide.10 , 11 Iodized oils, given as an annual injection or as food orally, have also been used effectively to treat iodine-deficiency goiter.12 , 13

Although iodine deficiency and goiter are now quite uncommon in developed countries, recent studies have found that the average dietary iodine intake in the United States has fallen below RDA guidelines.14 Long-term excessive dietary intake of iodine (1,000 to 2,000 micrograms daily), while less common than iodine deficiency, can occur in people who eat large amounts of kelp and other sea vegetables and can also cause goiter.15 , 16

A number of commonly eaten foods have been shown to interfere with the use of iodine by the thyroid, thus reducing production of thyroid hormone and causing goiter. These foods, known as goitrogens, include vegetables in the Brassica family such as broccoli, cabbage, kale and mustard,17 millet,18 soybeans,19 pine nuts20 and some seed meals used in animal feeds.21 , 22 These foods can be safely eaten in moderate amounts by people who consume adequate iodine.23 A combination of low iodine intake and high intake of goitrogenic foods increases the likelihood of goiter.24 , 25

Ensure proper nutrition
Nutrient deficiencies, including zinc, manganese, and vitamin A, and severe protein malnutrition contribute to an inability to use iodine well and to goiter development.

Nutrient deficiencies, including zinc ,26 manganese 27 and vitamin A ,28 , 29 and severe protein malnutrition30 also contribute to an inability to use iodine well and to the development of goiter.31 , 32 In the presence of adequate iodine supplies, it is less common for such factors to cause goiter;33 , 34 however, when iodine intake becomes deficient, even mild malnutrition can have such a negative impact on thyroid function.35 , 36 High levels of minerals such as calcium and magnesium, and certain bacteria in drinking water, have also been shown to be goitrogenic.37 , 38 Therefore, proper nutrition and a healthy water supply are crucial in the prevention and treatment of goiter.

Supplements

What Are Star Ratings?

Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

3 Stars Reliable and relatively consistent scientific data showing a substantial health benefit.

2 Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

1 Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

Supplement Why
3 Stars
Iodine
Use a mouthrinse or toothpaste containing zinc regularly
Iodine supplementation can be an effective treatment of iodine deficiency hypothyroidism and may halt goiter growth and, in early stages, shrink goiters.

Iodine supplementation can be an effective treatment of iodine deficiency hypothyroidism and can halt the growth of goiter if the cause is not complicated by malnutrition or environmental and dietary goitrogens.39 , 40 Iodine supplements will help to shrink goiters during early stages, but they have no effect in later stages.41 Ingestion of 2,000 to 6,000 mcg of iodine daily over long periods of time can be toxic to the thyroid and can be a cause of goiter.42 , 43

1 Star
Manganese
800 IU daily
Deficiencies of manganese can contribute to iodine-deficiency goiter. Supplementing with manganese may help.

When iodine deficiency is present, other nutrient levels become important in the development of goiter. Deficiencies of zinc 44 and manganese 45 can both contribute to iodine-deficiency goiter; however, an animal study found that manganese excess can also be goitrogenic.46 It has been suggested that selenium deficiency may contribute to goiter.47 However, when selenium supplements were given to people deficient in both iodine and selenium, thyroid dysfunction was aggravated, and it has been suggested that selenium deficiency may provide some protection when there is iodine deficiency.48 , 49 A study of the effects of selenium supplementation at 100 mcg daily in women without selenium deficiency but with slightly low iodine intake found no effect on thyroid function.50 The authors concluded that selenium supplementation seems to be safe in people with only iodine deficiency but not in people with combined selenium and iodine deficiencies. In those cases, iodine supplementation has been shown to be most useful.51 No studies have been done to evaluate the usefulness of supplementation with zinc or manganese to prevent or treat goiter.
1 Star
Vitamin A
Refer to label instructions
Vitamin A levels are lower in people with goiter than in those without. A combination of vitamin C, vitamin E, and beta-carotene prevented goiter formation in iodine-deficient conditions in some research.

Blood levels of vitamin A are lower in people with goiter than in similar people without goiter.52 , 53 The same relationship has been found for vitamin E and goiter.54 Animal research has found that, in iodine-deficient conditions, a supplement combination of vitamin C , vitamin E, and beta-carotene prevented goiter formation (though hypothyroidism was not improved), and vitamin E alone had a similar effect.55 No studies have been done to investigate this benefit in humans.
1 Star
Vitamin E
0.5 to 8 grams daily
Vitamin E levels are lower in people with goiter than in those without. Supplementing with vitamin E prevented goiter formation in iodine-deficient conditions in some research.

Blood levels of vitamin A are lower in people with goiter than in similar people without goiter.56 , 57 The same relationship has been found for vitamin E and goiter.58 Animal research has found that, in iodine-deficient conditions, a supplement combination of vitamin C , vitamin E, and beta-carotene prevented goiter formation (though hypothyroidism was not improved), and vitamin E alone had a similar effect.59 No studies have been done to investigate this benefit in humans.
1 Star
Zinc
Refer to label instructions
Deficiencies of zinc can contribute to iodine-deficiency goiter. Supplementing with zinc may help.

When iodine deficiency is present, other nutrient levels become important in the development of goiter. Deficiencies of zinc 60 and manganese 61 can both contribute to iodine-deficiency goiter; however, an animal study found that manganese excess can also be goitrogenic.62 It has been suggested that selenium deficiency may contribute to goiter.63 However, when selenium supplements were given to people deficient in both iodine and selenium, thyroid dysfunction was aggravated, and it has been suggested that selenium deficiency may provide some protection when there is iodine deficiency.64 , 65 A study of the effects of selenium supplementation at 100 mcg daily in women without selenium deficiency but with slightly low iodine intake found no effect on thyroid function.66 The authors concluded that selenium supplementation seems to be safe in people with only iodine deficiency but not in people with combined selenium and iodine deficiencies. In those cases, iodine supplementation has been shown to be most useful.67 No studies have been done to evaluate the usefulness of supplementation with zinc or manganese to prevent or treat goiter.

References

1. Prescott E, Netterstrom B, Faber J, et al. Effect of occupational exposure to cobalt blue dyes on the thyroid volume and function of female plate painters. Scand J Work Environ Health 1992;18:101–4.

2. Gaitan E. Goitrogens. Baillieres Clin Endocrinol Metab 1988;2:683–702 [review].

3. Gaitan E. Goitrogens in food and water. Annu Rev Nutr 1990;10:21–39 [review].

4. Ingenbleek Y, De Visscher M. Hormonal and nutritional status: critical conditions for endemic goiter epidemiology? Metabolism 1979;28:9–19 [review].

5. Lamberg BA. Endemic goitre—iodine deficiency disorders. Ann Med 1991;23:367–72 [review].

6. Lamberg BA. Iodine deficiency disorders and endemic goitre. Eur J Clin Nutr 1993;47:1–8 [review].

7. Koutras DA. Iodine metabolism in endemic goitre. Ann Clin Res 1972;4:55–63 [review].

8. Lee K, Bradley R, Dwyer J, Lee S. Too much versus too little: The implications of current iodine intake in the United States. Nutr Rev 1999;57:177–81 [review].

9. Lee K, Bradley R, Dwyer J, Lee S. Too much versus too little: The implications of current iodine intake in the United States. Nutr Rev 1999;57:177–81 [review].

10. Lamberg BA. Endemic goitre—iodine deficiency disorders. Ann Med 1991;23:367–72 [review].

11. Dunn JT. Seven deadly sins in confronting endemic iodine deficiency, and how to avoid them. J Clin Endocrinol Metab 1996;81:1332–5 [review].

12. Ingenbleek Y, Jung L, Ferard G. Brassiodol, a new iodised oil for goitrous patients. Coll Antropol 1998;22:51–62.

13. Untoro J, Schultink W, Gross R, et al. Efficacy of different types of iodised oil. Lancet 1998;351:752–3.

14. Lee K, Bradley R, Dwyer J, Lee S. Too much versus too little: The implications of current iodine intake in the United States. Nutr Rev 1999;57:177–81 [review].

15. Franceschi S, Talamini R, Fassina A, Bidoli E. Diet and epithelial cancer of the thyroid gland. Tumori 1990;76:331–8 [review].

16. Wilson JD, Foster DW, Kronenberg HM, Larsen PR. Williams Textbook of Endocrinology, 9th edition. Philadelphia: WB Saunders Co, 1998, 469.

17. Stoewsand GS. Bioactive organosulfur phytochemicals in Brassica oleracea vegetables—a review. Food Chem Toxicol 1995;33:537–43 [review].

18. Sartelet H, Serghat S, Lobstein A, et al. Flavonoids extracted from fonio millet (Digitaria exilis) reveal potent antithyroid properties. Nutrition 1996;12:100–6.

19. Divi RL, Chang HC, Doerge DR. Anti-thyroid isoflavones from soybean: isolation, characterization and mechanisms of action. Biochem Pharmacol 1997;54:1087–96.

20. Gaitan E. Goitrogens in food and water. Annu Rev Nutr 1990;10:21–39 [review].

21. Mawson R, Heaney RK, Zdunczyk Z, Kozlowska H. Rapeseed meal-glucosinolates and their antinutritional effects. Part 4. Goitrogenicity and internal organs abnormalities in animals. Nahrung 1994;38:178–91.

22. Bell JM. Nutrients and toxicants in rapeseed meal: a review. J Anim Sci 1984;58:996–1010 [review].

23. Gaitan E. Goitrogens. Baillieres Clin Endocrinol Metab 1988;2:683–702 [review].

24. Gaitan E. Goitrogens. Baillieres Clin Endocrinol Metab 1988;2:683–702 [review].

25. Gaitan E. Goitrogens in food and water. Annu Rev Nutr 1990;10:21–39 [review].

26. Ozata M, Salk M, Aydin A, et al. Iodine and zinc, but not selenium and copper, deficiency exists in a male Turkish population with endemic goiter. Biol Trace Elem Res 1999;69:211–6.

27. Kawada J, Nishida M, Yoshimura Y, Yamashita K. Manganese ion as a goitrogen in the female mouse. Endocrinol Jpn 1985;32:635–43.

28. Ingenbleek Y, Luypaert B, De Nayer P. Nutritional status and endemic goitre. Lancet 1980;1:388–91.

29. Osman AK, Fatah AA. Factors other than iodine deficiency contributing to the endemicity of goitre in Darfur Province (Sudan). J Hum Nutr 1981;35:302–9.

30. Ingenbleek Y, Luypaert B, De Nayer P. Nutritional status and endemic goitre. Lancet 1980;1:388–91.

31. Osman AK, Fatah AA. Factors other than iodine deficiency contributing to the endemicity of goitre in Darfur Province (Sudan). J Hum Nutr 1981;35:302–9.

32. Gaur DR, Sood AK, Gupta VP. Goitre in school girls of the Mewat area of Haryana. Indian Pediatr 1989;26:223–7.

33. Gaitan E. Goitrogens. Baillieres Clin Endocrinol Metab 1988;2:683–702 [review].

34. Lamberg BA. Endemic goitre--iodine deficiency disorders. Ann Med 1991;23:367–72 [review].

35. Centanni M, Maiani G, Vermiglio F, et al. Combined impairment of nutritional parameters and thyroid homeostasis in mildly iodine-deficient children. Thyroid 1998;8:155–9.

36. Filteau SM, Sullivan KR, Anwar US, et al. Iodine deficiency alone cannot account for goitre prevalence among pregnant women in Modhupur, Bangladesh. Eur J Clin Nutr 1994;48:293–302.

37. Gaur DR, Sood AK, Gupta VP. Goiter in school children of the Mewat area of Haryana. Indian Pediatr 1989;26:223–7.

38. Gaitan E. Goitrogens in food and water. Annu Rev Nutr 1990;10:21–39 [review].

39. Koutras DA. Iodine metabolism in endemic goitre. Ann Clin Res 1972;4:55–63 [review].

40. Lee K, Bradley R, Dwyer J, Lee S. Too much versus too little: The implications of current iodine intake in the United States. Nutr Rev 1999;57:177–81 [review].

41. Cotran RS, Kumar V, Robbins SL. Robbins Pathologic Basis of Disease, 4th edition. Philadelphia: WB Saunders Co, 1989, 1227–8.

42. Gaitan E. Goitrogens in food and water. Annu Rev Nutr 1990;10:21–39 [review].

43. Wilson JD, Foster DW, Kronenberg HM, Larsen PR. Williams Textbook of Endocrinology, 9th edition. Philadelphia: WB Saunders Co, 1998, 469.

44. Ozata M, Salk M, Aydin A, et al. Iodine and zinc, but not selenium and copper, deficiency exists in a male Turkish population with endemic goiter. Biol Trace Elem Res 1999;69:211–6.

45. Kawada J, Nishida M, Yoshimura Y, Yamashita K. Manganese ion as a goitrogen in the female mouse. Endocrinol Jpn 1985;32:635–43.

46. Kawada J, Nishida M, Yoshimura Y, Yamashita K. Manganese ion as a goitrogen in the female mouse. Endocrinol Jpn 1985;32:635–43.

47. Untoro J, Ruz M, Gross R. Low environmental selenium availability as an additional determinant for goiter in East Java, Indonesia? Biol Trace Elem Res 1999;70:127–36.

48. Corvilain B, Contempre B, Longombe AO, et al. Selenium and the thyroid: how the relationship was established. Am J Clin Nutr 1993;57:244S–248S [review].

49. Vanderpas JB, Contempre B, Duale NL, et al. Selenium deficiency mitigates hypothyroxinemia in iodine-deficient subjects. Am J Clin Nutr 1993 Feb;57(2 Suppl):271S–275S [review].

50. Roti E, Minelli R, Gardini E, et al. Selenium administration does not cause thyroid insufficiency in subjects with mild iodine deficiency and sufficient selenium intake. J Endocrinol Invest 1993;7:481–4.

51. Zimmermann MB, Adou P, Torresani T, et al. Effect of oral iodized oil on thyroid size and thyroid hormone metabolism in children with concurrent selenium and iodine deficiency. Eur J Clin Nutr 2000;3:209–13.

52. Keyvani F, Yassai M, Kimiagar M. Vitamin A status and endemic goiter. Int J Vitam Nutr Res 1988;58:155–60.

53. Mesaros-Kanjski E, Kontosic I, Kusic Z, et al. Endemic goitre and plasmatic levels of vitamins A and E in the school-children on the island of Krk, Croatia. Coll Antropol 1999;23:729–36.

54. Mesaros-Kanjski E, Kontosic I, Kusic Z, et al. Endemic goitre and plasmatic levels of vitamins A and E in the school-children on the island of Krk, Croatia. Coll Antropol 1999;23:729–36.

55. Mutaku JF, Many MC, Colin I, et al. Antigoitrogenic effect of combined supplementation with dl-alpha-tocopherol, ascorbic acid and beta-carotene and of dl-alpha-tocopherol alone in the rat. J Endocrinol 1998;156:551–61.

56. Keyvani F, Yassai M, Kimiagar M. Vitamin A status and endemic goiter. Int J Vitam Nutr Res 1988;58:155–60.

57. Mesaros-Kanjski E, Kontosic I, Kusic Z, et al. Endemic goitre and plasmatic levels of vitamins A and E in the school-children on the island of Krk, Croatia. Coll Antropol 1999;23:729–36.

58. Mesaros-Kanjski E, Kontosic I, Kusic Z, et al. Endemic goitre and plasmatic levels of vitamins A and E in the school-children on the island of Krk, Croatia. Coll Antropol 1999;23:729–36.

59. Mutaku JF, Many MC, Colin I, et al. Antigoitrogenic effect of combined supplementation with dl-alpha-tocopherol, ascorbic acid and beta-carotene and of dl-alpha-tocopherol alone in the rat. J Endocrinol 1998;156:551–61.

60. Ozata M, Salk M, Aydin A, et al. Iodine and zinc, but not selenium and copper, deficiency exists in a male Turkish population with endemic goiter. Biol Trace Elem Res 1999;69:211–6.

61. Kawada J, Nishida M, Yoshimura Y, Yamashita K. Manganese ion as a goitrogen in the female mouse. Endocrinol Jpn 1985;32:635–43.

62. Kawada J, Nishida M, Yoshimura Y, Yamashita K. Manganese ion as a goitrogen in the female mouse. Endocrinol Jpn 1985;32:635–43.

63. Untoro J, Ruz M, Gross R. Low environmental selenium availability as an additional determinant for goiter in East Java, Indonesia? Biol Trace Elem Res 1999;70:127–36.

64. Corvilain B, Contempre B, Longombe AO, et al. Selenium and the thyroid: how the relationship was established. Am J Clin Nutr 1993;57:244S–248S [review].

65. Vanderpas JB, Contempre B, Duale NL, et al. Selenium deficiency mitigates hypothyroxinemia in iodine-deficient subjects. Am J Clin Nutr 1993 Feb;57(2 Suppl):271S–275S [review].

66. Roti E, Minelli R, Gardini E, et al. Selenium administration does not cause thyroid insufficiency in subjects with mild iodine deficiency and sufficient selenium intake. J Endocrinol Invest 1993;7:481–4.

67. Zimmermann MB, Adou P, Torresani T, et al. Effect of oral iodized oil on thyroid size and thyroid hormone metabolism in children with concurrent selenium and iodine deficiency. Eur J Clin Nutr 2000;3:209–13.

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