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Il gozzo: quali sono le cause e la cura?

Che cos’è il gozzo?

Quando parliamo di gozzo (gozzo tiroideo) ci riferiamo in maniera molto generica ad un incremento del volume della tiroide, senza indicare una patologia specifica, in quanto si può verificare sia nei casi affetti da ipertiroidismo che in quelli di ipotiroidismo, anche perché è possibile che si verifichi anche in condizioni fisiologiche, per esempio quando la ghiandola è sottoposta ad uno sforzo maggiore, così come accade per esempio durante la gravidanza.

Il gozzo si può evidenziare durante l’adolescenza in quanto un lieve ingrandimento della tiroide può essere dovuto alla variazione del metabolismo ormonale tipico di questo periodo.
 Successivamente il fenomeno regredisce ma in alcuni casi (soprattutto nelle donne) può persistere o divenire nuovamente evidente nella gravidanza o in altri periodi della vita.

Tipologie di gozzo

  • Gozzo semplice: l’aumento di volume e di peso della tiroide si può verificare come fenomeno di compensazione, quando essa non è in grado di produrre adeguate quantità di ormoni tiroidei (carenza iodica) e in questo caso si parla perciò di gozzo endemico, che può verificarsi anche come conseguenza di una dieta povera di iodio o ricca di alimenti che impediscono l’assimilazione dello iodio.
  • Gozzo multinodulare: è l’evoluzione naturale del cosiddetto gozzo endemico, infatti la  stimolazione cronica della tiroide a crescere causata dalla carenza di iodio ha come conseguenza la selezione di gruppi di cellule all’interno della tiroide i quali si sviluppano in modo accelerato portando alla formazione dei noduli tiroidei.
  • Gozzo uninodulare tossico (morbo di Plummer): si tratta di una casistica ababstanza rara, ed è causata dalla presenza di un tumore benigno all’interno della tiroide che cresce e produce ormoni tiroidei in modo autonomo.
  • Gozzo multinodulare tossico: in questa fattispecie siamo in presenza di un gozzo multinodulare il quale al suo interno presenta uno o più noduli in grado di crescere e produrre ormoni tiroidei in modo autonomo e che nel tempo può causare ipertiroidismo, essendo una delle cause più frequenti di ipertiroidismo nelle aree iodio-carenti.
  • Gozzo diffuso tossico (morbo di Basedow): si tratta di una malattia autoimmune che colpisce di solito le donne e che porta in maniera molto frequente all’ipertiroidismo nelle aree iodio-sufficienti.

gozzo tiroideo

Le cause del gozzo

Come abbiamo già accennato più volte in precedenza la causa più frequente della formazione del gozzo è la carenza iodica.
In particolar modo si verificava molto spesso in passato in quanto le diete erano spesso carenti di iodio. L’attività primaria della ghiandola tiroidea è quella di concentrare iodio dal sangue e di trasformarlo in ormone tiroideo. La ghiandola non riesce a produrre abbastanza ormone tiroideo se non ha abbastanza iodio. Pertanto, con la carenza di iodio l’individuo diventa ipotiroideo. Conseguentemente, la ghiandola pituitaria (ipofosi) nel cervello avverte che il livello dell’ormone tiroideo è troppo basso e manda un segnale alla tiroide. Questo segnale è l’ ormone di stimolazione della tiroide (TSH).
Come spiega il nome stesso, questo ormone stimola la tiroide a produrre l’ormone tiroideo e ad aumentare in grandezza. Questa crescita abnorme delle dimensioni produce ciò che si definisce il gozzo.

In generale si può affermare che nei luoghi dove c’è carenza di iodio, sarà anche evidente la presenza del gozzo tiroideo.

La diagnosi del gozzo

La diagnosi di gozzo multinodulare è basata essenzialmente su:

  1. Esame obiettivo: consente di palpare la tiroide e di valutarne le dimensioni, la consistenza e l’eventuale presenza di noduli.
 Una tiroide di volume aumentato con più noduli ci indirizza verso la diagnosi di gozzo multinodulare.
  2. Esami di laboratorio: importante è la valutazione degli ormoni tiroidei in base ai quali è possibile distinguere il gozzo non tossico (FT3, FT4, TSH nella norma), il gozzo in ipertiroidismo subclinico (FT3 e FT4 nel range di normalità ma TSH leggermente soppresso in paziente asintomatico) e il gozzo tossico (alti valori di FT3 e FT4 e TSH soppresso in paziente spesso sintomatico): per maggiori informazioni su FT3, FT4 e TSH.
  3. Ecografia: questa metodica consente una descrizione anatomica più dettagliata dello struma tiroideo. 
Il sempre crescente utilizzo dell’ecografia nello studio della patologia tiroidea ha determinato un aumento del riscontro di patologia nodulare della tiroide.
  4.  Scintigrafia: consente una valutazione morfo-funzionale della tiroide.
 Si utilizzano dei radioisotopi che vengono captati dalla tiroide.
  5. Agoaspirato (FNAB): è una semplice procedura effettuata con ago sottile per prelevare del tessuto da sottoporre ad esame citologico.
 L’esperienza dell’operatore consente di ottenere un prelievo adeguato in una alta percentuale di casi.

Quali sono i sintomi del gozzo?

I principali sintomi del gozzo possono essere brevemente elencati:

  • difficoltà respiratoria
  • gonfiore di dimensioni variabili, da un piccolo nodulo a un grumo enorme nella parte anteriore del collo appena sotto il pomo d’Adamo
  • sensazione di tensione alla gola
  • raucedine
  • problemi nella deglutizione
  • vertigini quando si alzano le braccia sopra la testa
  • disturbi del ciclo mestruale
  • battito del cuore accelerato
  • sudorazione eccessiva
  • tremore
  • diarrea e nausea
  • aumento di peso

gozzo

Le informazioni qui fornite hanno lo scopo di informare, ma non possono in alcuna maniera sostituire la valutazione medica. Rivolgetevi sempre al vostro endocrinologo di fiducia.

124 Comments

  1. L’ipertiroidismo si cura con farmaci che bloccano la produzione ormonale e, nei casi in cui ГЁ richiesto il trattamento definitivo, mediante terapia radiometabolica con radioiodio o intervento chirurgico di tiroidectomia. Il gozzo nodulare ГЁ quasi sempre benigno e necessita solo di regolari controlli nel tempo. Nella patologia nodulare si puГІ ricorrere alla chirurgia che oggi si ГЁ molto evoluta sia nelle indicazioni (non operare se non si ГЁ sicuri del beneficio) sia nella tecnica (introduzione della chirurgia mini-invasiva e robotica). I noduli maligni della tiroide possono essere curati con successo nella maggior parte dei casi mediante tiroidectomia associata in casi selezionati alla terapia radiometabolica con radioiodio. Al fine di poter visuarizzare correttamente i centri partecipanti all’iniziativa, inviatiamo l’utente (nel momento in cui visualizza la mappa dell’ Italia-dopo aver cliccato su “iniziative nella tua cittГ “) di ingrandire l’immagine del punto di interesse per poter vedere singolarmente le farfalle rosa che sono i centri aderenti.

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  2. Ho gozzo miltinodulare che tengo sotto controllo con ecocolodoppler tiroideo annuale e visita endocrinologica .
    Assumo Eutirox 25 .
    Tutti i valori dei tsh sono sempre stati nella norma .

    Non capisco se la mia patologia rientra nell ipertiroidismo o ipotiroidismo .
    Non capisco inoltre se devo assumere poco o più sale e di che tipo .

    Assumo anche integratore fortilasa a base di bromelina dato dall’ endocrinologa.

    Ultimamente ho edema palpebrale fastidioso e leggermente rosso a tratti durante la giornata che mi porta la sensazione di avere un corpo estraneo nell’ occhio .

    Non ho altro sintomi

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  3. Buongiorno,
    ho 45 anni ed ho un gozzo di 4 cm ( colloidocistico e ipocaptante) con valori del sangue nella norma, è possibile farlo regredire ? con quali terapie
    non assumo terapie sostitutive. Molte grazie dell aiuto

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  4. : Buongiorno..mia figlia (14anni)da qualche giorno evidenzia un gonfiore alla tiroide..martedì ritiriamo esito esami del sangue.oggi ha fatto ecografiacon esito :tiroide in sede di dimensioni nettamente aumentate con spessori di entrambi i lobi di oltre 20 mm.il parenchima è francamente disomogeneo caratterizzato dalla presenza di aree ipo e iperecogenei in presenza di plurime nodularita’ infiammatoria.i margini sono bozzuti e irregolari. La vascolarizzazione al color doppler nettamente incrementata rispetto alla norma.non si apprezzano linfoadenopatie significative della regione laterò-cervicali.dottore sono molto preoccupata.

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  18. Come già accennato in precedenza, la carenza di iodio è la causa più comune della formazione del gozzo. È importante prestare attenzione alla propria dieta e assumere cibi ricchi di iodio per prevenire la formazione di questa patologia della tiroide.

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    創立時間 : 2019年
    博弈執照 : 馬爾他牌照(MGA)認證、英屬維爾京群島(BVI)認證、菲律賓(PAGCOR)監督競猜牌照
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    博弈執照 : 馬爾他牌照(MGA)認證、英屬維爾京群島(BVI)認證、菲律賓(PAGCOR)監督競猜牌照
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    網紅部落客推薦保證出金線上娛樂城
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    富遊娛樂城評價有哪些網紅推薦
    富遊娛樂城擁有多數網紅推薦,知名度是目前數一數二的娛樂城平台,玩家也可無需擔心娛樂城出金問題,有眾多玩家的評價保證,又有娛樂城體驗金可以免費試玩。詳細可觀看富遊娛樂城評價推薦人,數十位網紅評價推薦

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    提供四大超商(全家、7-11、萊爾富、ok超商)
    虛擬貨幣ustd存款
    銀行轉帳(各大銀行皆可)
    網站內申請提款及可匯款至綁定帳戶
    現金1:1出金

    富遊娛樂城是否安全?
    富遊娛樂城非常注重玩家的安全性。他們使用與銀行相同的《TLS加密技術》來保護玩家的財物,並且持有合法的國際認證執照。官方也承諾確保會員的個人資料安全。各大部落客也實測網站存取款狀況,富遊娛樂城是一個相當安全的線上賭場平台。

    如何判斷娛樂城評價是否詐騙?
    網站架構及經營方式
    金流三方提供取道皆為有公信力三方平台
    合理優惠流水洗碼量
    畢竟博弈市場不斷開新的線上娛樂城,每一家特色都不同,還不知道如何選擇娛樂城的玩家,透過我們專業分析介紹,建議可以加入富遊娛樂城體驗看看,保證出金、畫面操作簡單、遊戲豐富多元。

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  81. 富遊娛樂城評價:2024年最新評價
    推薦指數 : ★★★★★ ( 5.0/5 )

    富遊娛樂城作為目前最受歡迎的博弈網站之一,在台灣擁有最高的註冊人數。RG富遊以安全、公正、真實和順暢的品牌保證,贏得了廣大玩家的信賴。

    富遊線上賭場不僅提供了豐富多樣的遊戲種類,還有眾多吸引人的優惠活動。在出金速度方面,獲得無數網紅和網友的高度評價,確保玩家能享有無憂的博弈體驗。

    推薦要點
    新手首選: 富遊娛樂城,2024年評選首選,提供專為新手打造的豐富教學和獨家優惠。
    一存雙收: 首存1000元,立獲1000元獎金,僅需1倍流水,新手友好。
    免費體驗: 新玩家享免費體驗金,暢遊各式遊戲,開啟無限可能。
    優惠多元: 活動豐富,流水要求低,適合各類型玩家。
    玩家首選: 遊戲多樣,服務優質,是新手與老手的最佳賭場選擇。
    免費試玩

    富遊娛樂城詳情資訊
    賭場名稱 : RG富遊
    創立時間 : 2019年
    賭場類型 : 現金版娛樂城
    博弈執照 : 馬爾他牌照(MGA)認證、英屬維爾京群島(BVI)認證、菲律賓(PAGCOR)監督競猜牌照
    遊戲類型 : 真人百家樂、運彩投注、電子老虎機、彩票遊戲、棋牌遊戲、捕魚機遊戲
    存取速度 : 存款5秒 / 提款3-5分
    軟體下載 : 支援APP,IOS、安卓(Android)
    線上客服 : 需透過官方LINE
    富遊娛樂城優缺點
    優點 缺點
    台灣註冊人數NO.1線上賭場
    首儲1000贈1000只需一倍流水
    擁有體驗金免費體驗賭場
    網紅部落客推薦保證出金線上娛樂城
    需透過客服申請體驗金
    富遊娛樂城存取款方式
    存款方式 取款方式
    提供四大超商(全家、7-11、萊爾富、ok超商)
    虛擬貨幣ustd存款
    銀行轉帳(各大銀行皆可)
    網站內申請提款及可匯款至綁定帳戶
    現金1:1出金
    富遊娛樂城平台系統
    真人百家 — RG真人、DG真人、歐博真人、DB真人(原亞博/PM)、SA真人、OG真人、WM真人
    體育投注 — SUPER體育、鑫寶體育、熊貓體育(原亞博/PM)
    彩票遊戲 — 富遊彩票、WIN 539
    電子遊戲 —RG電子、ZG電子、BNG電子、BWIN電子、RSG電子、GR電子(好路)、ATG電子
    棋牌遊戲 —ZG棋牌、亞博棋牌、好路棋牌、博亞棋牌、RG棋牌
    捕魚遊戲 —ZG捕魚、RSG捕魚、好路GR捕魚、DB捕魚
    富遊娛樂城優惠活動
    優惠 獎金贈點 流水要求
    免費體驗金 $168 1倍 (儲值後) /36倍 (未儲值)
    首儲贈點 $1000 1倍流水
    返水活動 0.3% – 0.7% 無流水限制
    簽到禮金 $666 20倍流水
    好友介紹金 $688 1倍流水
    回歸禮金 $500 1倍流水
    免費試玩

    專屬富遊VIP特權
    黃金 黃金 鉑金 金鑽 大神
    升級流水 300w 600w 1800w 3600w
    保級流水 50w 100w 300w 600w
    升級紅利 $688 $1080 $3888 $8888
    每週紅包 $188 $288 $988 $2388
    生日禮金 $688 $1080 $3888 $8888
    反水 0.4% 0.5% 0.6% 0.7%

    娛樂城常見問題解答(FAQ)
    Q1:如何在富遊娛樂城進行首次存款?
    A1:可以透過超商、虛擬貨幣或銀行轉帳進行存款,過程簡單快速。( 詳細可查看:富遊娛樂城存款教學)

    Q2:富遊娛樂城提款需要多久時間?
    A2:提款過程一般在3-5分鐘內完成,保證快速到賬。( 詳細可查看:富遊娛樂城提款教學)

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