Thyroid Goiter Treatments
Most small- to moderate-sized goiters can be treated with thyroid hormone in the       form of a pill.
 By supplying thyroid hormone in this fashion, the pituitary will make  
     less TSH, which should result in stabilization in size of the 
gland.
This technique often will       not cause the size of 
the goiter to decrease but will usually keep it from growing any       
larger. Patients who do not respond to thyroid hormone therapy are often
 referred for surgery       if it continues to grow.

A
 more common       indication for surgical removal of an enlarged 
thyroid is to remove those glands that are large enough to cause 
compression on other structures in the neck, such as       the trachea 
and esophagus.
 
These patients will typically complain of a cough, a 
slight change       in voice, or nighttime choking episodes because of 
the way that the gland compresses the       trachea while sleeping.
The x-ray on the right shows how an enlarged right 
thyroid lobe has moved       the trachea to the patient's left. The 
trachea (outlined in light yellow) should be straight       from the 
mouth down to the lungs. But in this patient, it is compressed and 
displaced far to       the left.
The enlarged gland can even compress the blood vessels 
of the neck, which is also       an indication for its removal. You may 
read more about this on our page examining 
sub-sternal thyroids.
As always, the suspicion of malignancy in an enlarged thyroid is an 
indication for removal       of the thyroid. There is often a dominant 
nodule within a 
multinodular goiter that can cause     
  concern for cancer. Remember, the incidence of malignancy within a    
   multinodular goiter is usually significantly less than 5%. If the 
nodule is cold on thyroid       scanning, then it may be slightly higher
 than this. 
For the vast majority of patients,       surgical removal of a goiter for fear of cancer is not warranted.
Another reason (although not a very common one) to remove a goiter is 
for cosmetic       reasons. Often, a goiter gets large enough that it 
can be seen as a mass in the neck. When       other people begin to 
notice the mass, it is usually big enough to begin causing compression  
     of other vital neck structures—but not always. Sometimes, the large
 goiter causes no       symptoms other than being a cosmetic problem. 
But if it's big enough to be       seen by your neighbors, you will need
 medications or surgery, or it will most       likely continue to get 
bigger.
 
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Natural Goiter Remedies and Thyroid Treatment
Whatever the 
cause of a goiter, several natural remedies serve as effective goiter 
and thyroid treatments. Apple cider vinegar taken daily works to shrink a
 goiter and regulate the body’s systems naturally. Kelp powder, 
bladderwrack and iodine supplements are also effective options for 
treating a goiter. Likewise, minimizing stress and participating in 
calming activities such as yoga help relieve fatigue and adrenal 
stimulation and may also help diminish a goiter or thyroid issue.
Hypothyroid diet should comprise of certain essential nutrients. 
These nutritional factors play an important role in increasing thyroid 
function.
Hypothyroid diet and Iodine
Iodine is a very vital
 mineral required for the proper functioning of the body. Iodine should 
form an essential part of a hypothyroid diet as it enhances thyroid 
function. Thyroid hormones constitute iodine as a major component and 
its deficiency can lead to hypothyroidism. Although iodine deficiency is
 the major cause of hypothyroidism worldwide, it isn’t the main cause 
for the disease in United States. In US, the primary cause of 
hypothyroidism is autoimmune disease. As a part of your hypothyroid 
diet, you should have foods rich in iodine such as iodized salt, 
seaweeds and seafoods, salt water fish, celtic sea salt, sushi etc.
Selenium in your hypothyroid diet
Selenium
 is found in the thyroid gland and is an inseparable component of many 
enzymes that are necessary for proper functioning of the thyroid glands.
 Selenium can help improve the immune system and fertility human beings.
 Having foods rich in selenium have been known to shown some very 
impressive results in people with hypothyroidism and selenium 
deficiency. The following food would be ideal to supplement the selenium
 requirement of your body.
Meat
Chicken
Tuna
Dairy Products
Garlic and Onion
Salmon
Avoid Goitrogenic foods
You
 should steer clear of goitrogenic foods while planning your 
hypothyroidism diet. These foods suppress the production of thyroid 
hormone and increase the risks of hypothyroidism. Goitrogenic foods can 
inhibit the body’s ability to absorb iodine and as a result, your 
thyroid glands swell resulting in goiter. Bamboo shoots, soybeans, 
canola oil etc. are some goitrogenic foods that one with hypothyroidism 
should avoid at all costs. Some goitrogenic foods that you should avoid 
at all costs to plan a healthy hypothyroid diet are as follows:
Cabbage, broccoli
Trunips
Rutabaga
Mustard
Spinach
Brussels Sprouts
Peaches
Strawberries
Cauliflower
Hale
Pears
Millet
Garden Kres
Foods with Gluten
Garden Kres
Tempeh
Bamboo shoots
Soybeans and related products
Canola Oil
Horseradish
Bok Choy
Babassu
Goitrogenic Chemicals should be excluded from a Hypothyroid diet
There
 are some chemicals that have been known to cause goitre. You should 
avoid Amiodarone, Oxazolidines, Propylthiouracil etc. as these are known
 to hinder the functioning of thyroid glands. Some other goitrogenic 
chemicals to be avoided for hypothyroidism include:
Lithium
Oxazolidines
Iopanoic acid
Minocycline (MN)
Propylthiouracil
Thioureylene
Sulfadimethoxine
Carbamazepine
Phenobarbitone
Hypothyroidism diet: How many times per day should you eat?
Ones
 suffering from hypothyroidism should take smaller frequent meals. As 
stated earlier, it is advisable to take around 7 meals per day. This not
 only helps control hypothyroidism but also helps you lose weight and 
improve your metabolism. Have healthy snacks including fruits at regular
 intervals.
Having a proper balanced hypothyroid diet not only 
helps control hypothyroidism but also helps in improving your body’s 
metabolism. Hypothyroidism leads to low metabolism and therefore, it is 
necessary to have foods that help in proper functioning of your thyroid 
glands and help improve your metabolism. The aforementioned tips on 
hypothyroidism should help you plan your hypothyroid diet in a better, 
healthier way
Toxins are of particular concern, especially those 
created from petrochemicals. Many plastics (all those bottles of water 
we drink), pesticides, fertilizers, dioxin, body care products, not to 
mention what’s in the air and tap water we ingest, all contain 
substances that mimic our own body’s estrogen. These xenoestrogens are 
powerful endocrine disruptors, affecting the balance of all our 
hormones, and are thought to contribute to the rise in autoimmune 
conditions in general (Plapp, 2002) and to Hashimoto’s Thyroiditis 
specifically (Shames, private conversation; May, 2007). Mercury (from 
fish and dental amalgams) and fluoride (in toothpastes and water) are 
also endocrine disruptors. Mercury amalgams, especially, since they sit 
so close to the throat, can pose a serious threat to the thyroid gland, 
making mercury detoxification imperative (Bauman, in Shomon, N.D.).
roteins:
 Julia Ross, M.A. advises 20 grams of lean animal protein (3-4 oz.) at 
each meal (1999; p. 170). Also, shoot for 1-2 oz. at snack time. 
Cold-water fish is a good choice, as it also contains Omega-3 fatty 
acids. Tempeh is a good source of vegetable protein, and whey protein, 
though more processed, can be very useful. It contains immunoglobulins 
and L-Glutamine that can help heal a distressed digestive tract.
Antioxidant-rich
 foods: “Push the antioxidants,” says Richard Shames, M.D. (private 
conversation, May, 2007). Antioxidant-rich foods are necessary to combat
 free radical damage caused by the inflammatory process. Emphasis on 
vitamin-A containing foods is especially helpful, since vitamin A is 
often deficient in people with any type of autoimmune condition (Plapp, 
2002). Other nutrients with antioxidant qualities often deficient in 
Hashimoto’s Thyroiditis include vitamins C and E, iodine, zinc and 
selenium. (A more complete listing of foods and their nutrient content 
is available at www.whfoods.org)
Vitamin A-rich foods: Raw 
carrots; cooked calf’s liver; lightly cooked spinach, kale, collard 
greens and Swiss chard; winter squashes; red bell peppers; apricots; 
cantaloupe; sweet potato
Vitamin C-rich foods: Red bell peppers; parsley; broccoli; citrus fruits; romaine
Vitamin E-rich foods: Lightly steamed mustard greens and Swiss chard; sunflower seeds; almonds
Iodine-rich
 foods: Seaweeds, especially dulse and kelp (be sure it’s very high 
quality); seafood (free of mercury and wild, not farmed)
Zinc-rich foods: Oysters; crab; beef (organic and/or grass-fed); sesame and pumpkin seeds
Selenium-rich foods: Crimini mushrooms; cod; shrimp; halibut; snapper; oats; sunflower seeds; brown rice.
Healthy
 Fats: 4-6 tablespoons per day of the good fats found in avocados, nuts 
and seeds (especially pumpkin, chia and flax), organic butter, olive oil
 and coconut and its oil. Coconut is very thyroid friendly. The lauric 
acid it contains is soothing to the endocrine system (Bauman, in Shomon,
 N.D.) and its medium-chain fatty acids digest quickly and provide a 
superior energy source for the body. It can also be helpful for weight 
loss (Calbom et al, 2003). The milk from the coconut can be used in 
place of other milks.
Vegetables: At least 4 cups per day (Ross, 
1999; p. 171). Choose a wide variety of colorful veggies and eat them 
lightly cooked or raw. Note: Avoid eating the brassica family raw, as 
these inhibit thyroid function. Brassicas include broccoli, cauliflower,
 turnips, etc. Don’t overdo these, in general, though they should be 
fine in moderation (Shames, private conversation, May, 2007).
Carbohydrates: Go
 easy on the fruit, grains and starchy vegetables. Two 1/2 cup servings 
of fruit per day, plus 1/2 to 1 cup, one or two times per day, of whole 
grains or starchy vegetables (Ross, 1999; p. 171). Note: Soaking grains 
(excepting brown rice) for seven hours in water with 1 tablespoon of 
lemon juice will make them much more digestible – very important for 
those with impaired digestion, which is common with hypothyroid.
Water: At
 least 8 cups pure, filtered water daily. Avoid water with chlorine and 
fluoride, as these are halogens and compete with iodine, the halogen in 
the body. This can disrupt thyroid function. And remember, it is not 
wise to purchase water in plastic bottles.
THINGS TO AVOID
Aspartame: Aside
 from its other known toxic effects, Aspartame appears to be 
particularly problematic for the thyroid gland (Bauman, in Shomon, 
N.D.).
Iodized Salt: Even though the thyroid gland depends on 
iodine to produce hormones, this is not the way to get it. It is not 
possible to eat enough salt, in the first place, to get the daily 
recommended dosage of iodine (150mcg). Nor is it advisable to consume 
such a highly processed product, the grocery store versions of which 
often contain aluminum and dextrose (Bauman, in Shomon, N.D.). Sea salt,
 unprocessed and containing trace minerals, is a far better choice.
Unsaturated
 Oils (including canola oil): There is speculation that these contribute
 to hypothyroidism. Whether it is because they contain so much 
inflammation-promoting Omega-6 fatty acids, or because they are 
generally rancid even before they are bottled (or go rancid in their 
clear glass bottles) is not known.
Soy: Also disruptive to the 
endocrine system, and considered a toxin by some, is soy, though it is 
the isolated and concentrated isoflavones that pose the greatest risk, 
according to Ken Blanchard, M.D. (2004; p. 190). He points out that 
infants fed soy formulas are more likely to develop autoimmune 
conditions later in life than those who are not. Depending on soy as a 
primary source of protein is not recommended. Even small amounts have 
been shown to have powerful hormone disrupting powers and can lower 
concentrations of T3 (Ross, 1999; pp. 204-205). The exception to this is
 fermented soy foods, such as tempeh, natto and miso.
SUPPLEMENTATION
Because
 Hashimoto’s Thyroiditis can result in reduced digestive capabilities, 
it is a good idea to support digestion with enzymes, HCl and probiotics 
when necessary and to supplement with extra quantities of the nutrients 
most often found lacking with this condition.
High potency, high bioavailability multi-vitamin and mineral: Take as directed, preferably in divided doses.
Extra antioxidants: Take as directed daily (Shames et al, 2006; p. 97).
Extra
 essential fatty acids: From fish or flax; 1000-2000mg per day, two 
divided doses (Shames et al, 2006; p. 97; Ross, 1999; p. 245).
Extra B vitamins: Either in supplement form or, preferably, use nutritional yeast.
Calcium:
 250-300mg (1-2 at bedtime) (Ross, 1999; p. 245). Calcium and iron need 
to be taken two hours before or after thyroid medications so as not to 
interfere with its absorption.
Magnesium: 200mg 2 times daily (Ross, 1999; p. 245; Shames et al, 2006; p. 97).
Selenium:
 200 mcg per day has been shown to reduce thyroid autoantibodies 
(Gartner et al, 2002; Turker et al, 2006; Duntas et al, 2003). NOTE: Do 
not exceed 40mcg daily if pregnant (Balch, 2000; p. 452).
Iodine: 
If the multiple doesn’t contain 150-200 mcg iodine, kelp supplementation
 — 2-3 grams daily — should provide adequate amounts (Balch, 2000; p. 
451). Dr. Mercola (in Shomon, N.D.) recommends 5 grams daily. 
(Supplementing directly with iodine is very controversial, with 
physicians obtaining erratic results, and should be either avoided or 
done with extreme caution until more is known about it.) Daily low-dose 
iodine supplementation (200mcg a day) has been shown to reduce antibody 
levels in people with Hashimoto’s (Rink et al, 1999).
Vitamin D3: 
Often low in those with autoimmune conditions, it is necessary for 
optimal immune function (Hayes et al, 2003). It is also required for 
thyroid hormone production (Shames, in Shomon, 2007). 1000-2000mg daily 
to bring up levels. Maintenance doses will vary.
L-Tyrosine: One 
of the thyroid’s hormone building blocks. Many sources recommend 500mg 
twice daily; levels of this amino acid are rarely low enough to warrant 
supplementation (Shames et al, 2006; p. 108).
Chromium: 200mcg daily, if it’s not included in the multiple (Ross, 1999; p. 245).
Iron: If
 testing shows a deficiency. Calcium and iron need to be taken two hours
 before or after thyroid medication so as not to interfere with its 
absorption.
Zinc: If testing shows a deficiency. 50mg daily (Balch, 2000; p. 452).
Thyroid
 glandulars: These have been shown to be very effective; 50-100mg twice 
daily. They are made from desiccated thyroid glands of either pigs or 
cows (use those from non-BSE cow-raising countries), from which most of 
the hormone has been removed. Dr. Shames likens them to decaffeinated 
coffee: there’s still a little bit in there (private conversation, May, 
2007). Because of this, they also contain T1 and T2, other thyroid 
hormones that may exert a physiological effect.
Additional 
supplements, recommended by Dr. Shames, are extra free-form amino acids 
daily (two 500mg capsules), taurine (two 500mg daily), and proteolytic 
enzymes for inflammation (2006; p. 97).
Vegans may have to add the
 nutrients commonly missing in adequate amounts from an animal-free 
diet: extra B12, D, some L-Carnitine, zinc and selenium (Ross, 1999; p. 
244).
HERBS
Many herbs are available (often combined in one 
supplement) to support overall endocrine function and the thyroid gland 
particularly. These include:
Ashwagandha (Withania somnifera)
Asian Ginseng (Panax ginseng)
Bladderwrack (Fucus vesiculosus)
Coleus forskholii root
Guggul (Commiphora mukul)
Holy Basil Leaf (Ocimum sanctum)
Maca
 root (not raw, as it’s a brassica). No research exists to date about 
its effect on the thyroid, but anecdotal evidence from 
www.thyroid.about.com (Shomon, 2007), and from some of the producers of 
maca products, suggest it has a beneficial effect on the thyroid. Since 
it is an adaptogenic, endocrine-balancing herb (Walker, 1998), this 
would not be surprising.
Rosemary (Rosmarinus officinalis)
The Shames’ recommend a Tibetan herbal product called Padma Basic (2006; p. 122).
HOMEOPATHY
Thyroidinum
 6 times or 6c, three pellets under the tongue 3 times daily for one 
week, may be helpful to initiate thyroid balance (Shames et al, 2006; 
pp. 122-123).
Calcarea carbonica may increase thyroid function (Balch, 2000; p. 452).
OTHER CONSIDERATIONS
Acupuncture may be very effective to support the thyroid (Ehrlich, 2006).
Lymph massage (Bauman, in Shomon, N.D.) or exercise that includes gentle jumping
Contrast hydrotherapy (hot and cold applications) to the neck and throat may stimulate thyroid function (Ehrlich, 2006).
Stress reduction
Overall detoxification
Good sleep
Exercise, to tolerance
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You hope to inspire others to be fearless, then be fearless "MB". ;)
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