Goiter

Goiter leads to a swelling in the front of the neck, just below the Adam's apple or larynx, owing to an enlarged thyroid gland. This often results in the normal thyroid gland weighing 20 to 30 grams (0.75 ounces), turning into a goitrous gland which can swell to 1 kilogram (more than 2 pounds). The main cause of goiter is an iodine deficiency, and this is often called [Page 746]endemic goiter. It is curable by consumption of food heavily supplemented with iodine, in the form of iodate or iodide, and this remains largely a problem in poor countries. However, there are some other causes such as congenital hypothyroidism, thyroiditis, Hashimoto's thyroiditis, Graves-Basedow disease, and other relatively uncommon disorders. Goiter can also occur when the thyroid gland has the normally functioning tissue but enlarges for reasons that are currently unknown. All these disorders causing goiter tend to result in the thyroid gland not being able to secrete sufficient amounts of the thyroid hormone, and hence the gland grows larger to try to make more to compensate for this.

Goiter was common in parts of the English Midlands where there was an iodine deficiency in the soil. This led it to be called, colloquially, the “Derbyshire Neck.” For the same reason, goiter used to be found in the area around the Great Lakes, Midwest, and the Intermountain regions of the United States. It is also common in Tasmania. The man who realized that goiter should be treated with iodine was Jean-Bap-tiste-André Dumas, a professor at the University of Paris. Anton Freiherr von Eiselberg recognized that tetany cramps often resulted after a goiter operation. Nowadays, it is mainly found in India, Pakistan, central Asia, and central Africa. Peter Pitt, a doctor working in Nepal, spent many years curing people suffering from goiter in the Himalayan kingdom. Part of the reason for its prevalence there, it has been suggested, is because of the increased use of rock salt and/or sea salt which has not been fortified with iodine. People with goiter appear in many stories. In Little Dorrit by British writer Charles Dickens, there is a person “sunning his big goitre [sic].” Goiter also tends to be popular in novels set in imperial Rome.