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Dr. Kennedy Goiter denotes a thyroid gland that is bigger than usual. A goiter is not cancerous and can be associated with levels of thyroid hormone that are normal (euthyroid), too high (hyperthyroid) or too low (hypothyroid). Diffuse toxic (DTG) (aka Graves disease is the most common cause of hyperthyroidism (overactivity of the thyroid gland), with generalized diffuse overactivity ("toxicity") of the entire thyroid gland which becomes enlarged into a goiter. There are three clinical components to Graves disease: (1) hyperthyroidism (the presence of too much thyroid hormone), (2) ophthalmopathy specifically involving exophthalmos (protrusion of the eyeballs), and (3) dermopathy with skin lesions. The ophthalmopathy can cause sensitivity to light and a feeling of "sand in the eyes." With further protrusion of the eyes, double vision and vision loss may occur. The ophthalmopathy tends to worsen with smoking. The dermopathy of Graves disease is a rare, painless, reddish lumpy skin rash that is an autoimmune process. DTG is caused by production of thyroid-stimulating (TSH) antibodies which bind to and activate the thyrotropin receptor on thyroid cells. Genes make only a moderate contribution to the susceptibility to Graves disease. No single gene is known to cause the disease or to be necessary for its development. Factors that can trigger the onset of Graves disease include stress, smoking, radiation to the neck, medications (such as interleukin-2 and interferon-alpha), and infectious organisms such as viruses. The diagnosis of Graves disease is made by a characteristic thyroid scan (showing diffusely increase uptake), the characteristic triad of ophthalmopathy, dermopathy, and hyperthyroidism, or blood testing for TSI (thyroid stimulating immunoglobulin) the level of which is abnormally high.

Iodide induced goiter reflects a deficiency of iodine which can cause thyroid disease. Prolonged intake of too much iodine can also lead to the development of goiter (swelling of the thyroid gland) and hypothyroidism (abnormally low thyroid activity). Certain foods and medications contain large amounts of iodine. Examples include seaweed; iodine-rich expectorants (such as SSKI and Lugol's solution) used in the treatment of cough, asthma, chronic pulmonary disease; and amiodarone (Cordarone), an iodine-rich medication used in the control of abnormal heart rhythms (cardiac arrhythmias).

Toxic multinodular goiter (aka Parry's disease or Plummer's disease) is a condition in which the thyroid gland contains multiple lumps (nodules) that are overactive and produce excess thyroid hormones.

Goitrogenic are foods that can affect thyroid function by inhibiting synthesis of thyroid hormones, resulting in enlargement of the gland (goiter) include Brussel sprouts, rutabaga, radishes, cabbage, kale, kohlrabi, turnips, and cauliflower.

The information in this article is not meant to be medical advice.�Treatment for a medical condition should come at the recommendation of your personal physician.

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