8 Patho
8 Patho
8 Patho
PATHOPHYSIOLOGY
Predisposing Factors
Modifiable: Non-modifiable:
- Age (34)
Cellular changes
Two of the most common types of goiter are toxic and non-toxic goiter. The toxic
type is associated to hyperthyroidism-like symptoms. On the other hand, hypothyroidism-
like symptoms are usually attributed to the non-toxic type. However, certain cases of non-
toxic goiter exhibit normal levels of thyroid hormones. Goiter can also be diffuse - which
means a plain enlargement of the thyroid gland, or nodular – which means that aside from
being enlarged, the thyroid gland contains nodules. This discussion will tackle about the
nodular type.
The development of thyroid nodules sprang from overgrowths of the normal thyroid
tissue brought about by cellular changes. These nodules gradually grow and enlarge over
time. This will result to a subsequent enlargement of the thyroid gland itself, accompanied
by occasional production of thyroid hormones by the thyroid nodules. The enlargement in
the thyroid gland causes the sensation of having a painless enlargement in the neck
accompanied by hoarseness of voice and increased respiratory effort. Because the nodules
on the gland have the ability to produce thyroid hormones at unpredictable times, the TSH
level is low although the T3 and T4 levels are within normal range. This string of symptoms
leads to what is known as nodular non-toxic colloid goiter, euthyroid gland. This implies an
enlargement of the thyroid gland brought about by nodules of colloid cyst type, as
aggravated by the nodules’ ability to occasionally secrete thyroid hormones. Euthyroid
gland means that this goiter doesn’t carry hyperthyroidism and hypothyroidism effect on
thyroid hormone levels, since the levels are maintained in normal range.