False alarm, this kind of goiter turned out to be not a disease

*Only for medical professionals to read and talk about clinical examples of adolescent goiter.
Xiaomei is 14 years old this year.
She looks sweet, slim, and has a lively and lovely personality.
She is recognized as a beautiful girl.

However, Xiaomei has recently encountered an annoyance.
The "swan neck" she is proud of has become thicker at some point.
Although there are no symptoms of discomfort, it has also brought a lot of psychological burden to Xiaomei who loves beauty, and her parents even more.
I am worried about this.

This morning, my mother specially asked for leave and brought her to the outpatient clinic to see me.
After a detailed understanding of the medical history and related examinations, organic thyroid disease was ruled out, and she was finally diagnosed as physiological "adolescent goiter".

1 Why does goiter appear during adolescence? The thyroid gland is the largest endocrine gland in the human body.
The thyroid hormone it secretes plays an important role in regulating the body's metabolism and promoting growth and development.

After entering puberty, due to accelerated growth and development and strong metabolism, the body's requirement for thyroid hormones increases significantly.

Therefore, the intake of iodine must be increased to synthesize more thyroxine to meet the physiological needs of the body.

If the intake of iodine is insufficient, it can lead to compensatory swelling of the thyroid, thereby promoting the intake of iodine and the synthesis of thyroxine.

2 What are the characteristics of "adolescent goiter"? "Adolescent goiter" usually occurs in adolescents from 12 to 18 years old, and it is more common in girls.

Not only in iodine-deficient areas, it can also occur in adolescent boys and girls in non-iodine-deficient areas.

Usually there is no clinical symptoms of thyroid function abnormality, but mainly manifested as symmetrical diffuse thyroid enlargement of varying degrees, soft texture, and generally no nodules can be felt.

Thyroid function test: T3, T4, TSH levels are in the normal range, and the level of thyroid autoantibodies (such as thyroid peroxidase antibody, thyroglobulin antibody, etc.
) is not high. Thyroid uptake 131 iodine rate check: Although the iodine uptake rate has increased, the peak of iodine intake has not moved forward, which is obviously different from hyperthyroidism.

3 Is neck thickening a physiological change? But in fact, it's not.

There are many reasons for goiter.
In addition to the "adolescent goiter" mentioned above, Hashimoto's thyroiditis, Graves' hyperthyroidism, subacute thyroiditis, thyroid nodules, etc.
can all cause goiter.

In addition, obese people can thicken their necks due to the accumulation of fat in the neck, local lymphadenopathy due to inflammation and other reasons, and jugular venous swelling caused by heart failure.

Therefore, it is necessary to pay attention to the differential diagnosis for thickening of the neck.

4Does "adolescent goiter" need medication? What is the prognosis? If it is a purely physiological adolescent goiter, appropriate supplementation of iodine-rich foods (such as kelp, jellyfish skin, seaweed and various marine fish, shrimps, etc.
) is sufficient, usually without medication.

The main measure to prevent adolescent goiter is to supplement iodine, especially in iodine-deficient areas, we must insist on eating iodized salt.

The prognosis of adolescent goiter is good, and as puberty is over, most of them will slowly recover on their own.