Toxic and diffuse goiters, in iodine deficiency

Treatment Regimens in Toxic and Diffuse Goiters in Iodine Deficiency Goiter and Hyperthyroidism in Iodine Deficiency... 

Diffuse and toxic goiters are among the main thyroid disorders caused by iodine deficiency (Figure 81.1). Lack of iodine, when present over a longer period of time, results in both morphological alterations and functional perturbations that affect the thyroid gland. 

Functionally, the state may be compensated up to a certain degree of iodine deficiency and for a considerable period of time, described in clinical terms as euthyroid diffuse or nodular goiter. Functional failure follows only in the presence of severe iodine deficiency, and hypothyroidism may then develop. Much more frequently and somewhat paradoxically, hyperthyroidism ensues after many years of iodine depletion. Rarely, hyperthyroidism may be found in cases of diffuse goiter, which are then termed as diffuse thyroid autonomy. Fiowever, hyperthyroidism frequendy occurs in conjunction with uninodular (toxic adenoma) and multinodular goiters (toxic multinodular goiter). 

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