Toxic multinodular goiter risk factors: Difference between revisions

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{{Toxic multinodular goiter}}
{{CMG}}; {{AE}}


{{CMG}}; {{AE}} {{Mazia}}
==Overview==
==Overview==
*There are no established risk factors for [disease name].
Common risk factors in the development of multinodular goiter include female sex,age over 50 years,areas with decreased iodine intake,iodine supplementation, natural goitrogens,vitamin A and iron deficiency,selenium deficiency.
OR
 
*The most potent risk factor in the development of [disease name] is [risk factor 1]. Other risk factors include [risk factor 2], [risk factor 3], and [risk factor 4].
*Common risk factors in the development of [disease name] include [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].
*Common risk factors in the development of [disease name] may be occupational, environmental, genetic, and viral.
==Risk Factors==
==Risk Factors==
*There are no established risk factors for [disease name].
OR
*The most potent risk factor in the development of [disease name] is [risk factor 1]. Other risk factors include [risk factor 2], [risk factor 3], and [risk factor 4].


*Common risk factors in the development of [disease name] include [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].
*Common risk factors in the development of multinodular goiter include:
===Common Risk Factors===
**Female sex
*Common risk factors in the development of [disease name] may be occupational, environmental, genetic, and viral.
**Age over 50 years
*Common risk factors in the development of [disease name] include:
**Smoking<ref name="pmid11838733">{{cite journal |vauthors=Vestergaard P, Rejnmark L, Weeke J, Hoeck HC, Nielsen HK, Rungby J, Laurberg P, Mosekilde L |title=Smoking as a risk factor for Graves' disease, toxic nodular goiter, and autoimmune hypothyroidism |journal=Thyroid |volume=12 |issue=1 |pages=69–75 |year=2002 |pmid=11838733 |doi=10.1089/105072502753451995 |url=}}</ref>
**[risk factor 1]
**Areas with decreased iodine intake<ref name="pmid2040867">{{cite journal |vauthors=Laurberg P, Pedersen KM, Vestergaard H, Sigurdsson G |title=High incidence of multinodular toxic goitre in the elderly population in a low iodine intake area vs. high incidence of Graves' disease in the young in a high iodine intake area: comparative surveys of thyrotoxicosis epidemiology in East-Jutland Denmark and Iceland |journal=J. Intern. Med. |volume=229 |issue=5 |pages=415–20 |year=1991 |pmid=2040867 |doi= |url=}}</ref>
**[risk factor 2]
*Natural goitrogens associated with the development of multinodular goiter include:<ref name="pmid2464986">{{cite journal |vauthors=Gaitan E |title=Goitrogens |journal=Baillieres Clin. Endocrinol. Metab. |volume=2 |issue=3 |pages=683–702 |year=1988 |pmid=2464986 |doi= |url=}}</ref>
**[risk factor 3]
**Millet, soy beans, coconut, babassu contain flavonoids that impair thyroperoxidase.
**Cassava, sweet potato, sorghum contain cyanogenic glucosides metabolized to thiocyanates that Inhibits iodine thyroidal uptake.
**Cabbage, cauliflower, Broccoli, turnips contain glucosinolates that impair iodine thyroidal uptake.
**Seaweed (kelp) contains excess iodine that inhibits release of thyroidal hormones.
*Vitamin A and Iron deficiency increases TSH stimulation and reduces heme-dependent thyroperoxidase thyroidal activity.
*Selenium deficiency accumulates peroxidase and causes deiodinase deficiency resulting in impaired thyroid hormone synthesis.
*Iodine supplementation or iodinated contrast agents or iodinated drugs, such as amiodarone, may also induce hyperthyroidism in patients with underlying nontoxic multinodular goiter(Jod-Basedow effect).<ref name="pmid23148056">{{cite journal |vauthors=Dunne P, Kaimal N, MacDonald J, Syed AA |title=Iodinated contrast-induced thyrotoxicosis |journal=CMAJ |volume=185 |issue=2 |pages=144–7 |year=2013 |pmid=23148056 |pmc=3563887 |doi=10.1503/cmaj.120734 |url=}}</ref>


===Less Common Risk Factors===
==References==
*Less common risk factors in the development of [disease name] include:
**[risk factor 1]
**[risk factor 2]
**[risk factor 3]


==References==
{{Reflist|2}}
{{Reflist|2}}
 
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Revision as of 17:19, 9 October 2017


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mazia Fatima, MBBS [2]

Overview

Common risk factors in the development of multinodular goiter include female sex,age over 50 years,areas with decreased iodine intake,iodine supplementation, natural goitrogens,vitamin A and iron deficiency,selenium deficiency.

Risk Factors

  • Common risk factors in the development of multinodular goiter include:
    • Female sex
    • Age over 50 years
    • Smoking[1]
    • Areas with decreased iodine intake[2]
  • Natural goitrogens associated with the development of multinodular goiter include:[3]
    • Millet, soy beans, coconut, babassu contain flavonoids that impair thyroperoxidase.
    • Cassava, sweet potato, sorghum contain cyanogenic glucosides metabolized to thiocyanates that Inhibits iodine thyroidal uptake.
    • Cabbage, cauliflower, Broccoli, turnips contain glucosinolates that impair iodine thyroidal uptake.
    • Seaweed (kelp) contains excess iodine that inhibits release of thyroidal hormones.
  • Vitamin A and Iron deficiency increases TSH stimulation and reduces heme-dependent thyroperoxidase thyroidal activity.
  • Selenium deficiency accumulates peroxidase and causes deiodinase deficiency resulting in impaired thyroid hormone synthesis.
  • Iodine supplementation or iodinated contrast agents or iodinated drugs, such as amiodarone, may also induce hyperthyroidism in patients with underlying nontoxic multinodular goiter(Jod-Basedow effect).[4]

References

  1. ↑ Vestergaard P, Rejnmark L, Weeke J, Hoeck HC, Nielsen HK, Rungby J, Laurberg P, Mosekilde L (2002). "Smoking as a risk factor for Graves' disease, toxic nodular goiter, and autoimmune hypothyroidism". Thyroid. 12 (1): 69–75. doi:10.1089/105072502753451995. PMID 11838733.
  2. ↑ Laurberg P, Pedersen KM, Vestergaard H, Sigurdsson G (1991). "High incidence of multinodular toxic goitre in the elderly population in a low iodine intake area vs. high incidence of Graves' disease in the young in a high iodine intake area: comparative surveys of thyrotoxicosis epidemiology in East-Jutland Denmark and Iceland". J. Intern. Med. 229 (5): 415–20. PMID 2040867.
  3. ↑ Gaitan E (1988). "Goitrogens". Baillieres Clin. Endocrinol. Metab. 2 (3): 683–702. PMID 2464986.
  4. ↑ Dunne P, Kaimal N, MacDonald J, Syed AA (2013). "Iodinated contrast-induced thyrotoxicosis". CMAJ. 185 (2): 144–7. doi:10.1503/cmaj.120734. PMC 3563887. PMID 23148056.

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