Diffuse endemic goiter ICD code 10. Diffuse (endemic) goiter associated with iodine deficiency (E01.0). Unspecified nontoxic goiter

ICD-10: types of goiter

Types of goiter according to ICD 10

Diffuse endemic;
Multinodular endemic;
Non-toxic diffuse;
Non-toxic single-node;
Non-toxic multi-node;
Other specified species;
Endemic, unspecified;
Non-toxic, unspecified.

Patients experience:

weakness;
apathy;
suffocation;
difficulty swallowing;
Digestive problems.

This species has code E01.1.

hoarse, hoarse voice;
sore throat;
breathing is difficult;
dizziness.

ICD 10 code #8212; E04.0.

voice and breathing disorders;

Endemic goiter, unspecified

How will ICD 10 help?

ICD-10: types of goiter

ICD 10 #8212; The International Classification of Diseases, 10th revision, was created to systematize data on diseases according to their type and development.

To designate diseases, a special encoding has been developed, which uses capital Latin letters and numbers.

Thyroid diseases are classified as class IV.

Goiter, as a type of thyroid disease, is also included in ICD 10 and has several types.

Types of goiter according to ICD 10

Goiter #8212; a clearly defined enlargement of thyroid tissue, resulting from dysfunction (toxic form) or due to changes in the structure of the organ (euthyroid form).

The ICD 10 classification provides for territorial foci of iodine deficiency (endemic), due to which the development of pathologies is possible.

This disease most often affects residents of regions with iodine-poor soils - these are mountainous areas, areas far from the sea.

The endemic type of goiter can seriously affect thyroid function.

The classification of goiter according to ICD 10 is as follows:

Diffuse endemic;
Multinodular endemic;
Non-toxic diffuse;
Non-toxic single-node;
Non-toxic multi-node;
Other specified species;
Endemic, unspecified;
Non-toxic, unspecified.

A non-toxic form is one that, unlike the toxic one, does not affect the normal production of hormones; the reasons for the enlargement of the thyroid gland lie in the morphological changes of the organ.

An increase in volume most often indicates the development of a goiter.

Even with visual defects, it is impossible to immediately determine the cause and type of disease without additional tests and studies.

For an accurate diagnosis, all patients must undergo ultrasound examinations and donate blood for hormones.

Diffuse endemic process

Diffuse endemic goiter has ICD 10 code #8212; E01.0, is the most common form of the disease.

In this case, the entire parenchyma of the organ is enlarged due to acute or chronic iodine deficiency.

Patients experience:

weakness;
apathy;
headaches, dizziness;
suffocation;
difficulty swallowing;
Digestive problems.

Later, pain in the heart area may develop due to a reduced concentration of thyroid hormones in the blood.

In severe cases, surgery and goiter removal are indicated.

Residents of iodine-deficient areas are advised to regularly take iodine-containing foods, vitamins, and undergo regular examinations.

Multinodular endemic process

This species has code E01.1.

With pathology, several well-defined neoplasms appear on the tissues of the organ.

Goiter grows due to iodine deficiency, characteristic of a particular area. The symptoms are as follows:

hoarse, hoarse voice;
sore throat;
breathing is difficult;
dizziness.

It should be noted that only as the disease progresses do the symptoms become pronounced.

At the initial stage, fatigue and drowsiness are possible; such signs can be attributed to overwork or a number of other diseases.

Non-toxic diffusion process

ICD 10 code #8212; E04.0.

Enlargement of the entire thyroid gland area with no changes in functionality.

This happens due to autoimmune disorders in the structure of the organ. Signs of the disease:

Complications in the form of hemorrhages are possible.

A number of doctors believe that euthyroid goiter can not be treated until it narrows the esophagus and trachea and does not cause pain and spasmodic cough.

Non-toxic single-node process

This type of goiter is characterized by the appearance of one clear neoplasm on the thyroid gland.

The knot causes discomfort if it is treated incorrectly or untimely.

As the disease progresses, a pronounced bulge appears on the neck.

As the node grows, nearby organs are compressed, which leads to serious problems:

voice and breathing disorders;
difficulty swallowing, digestive problems;
dizziness, headaches;
improper functioning of the cardiovascular system.

The area of the node can be very painful, this is due to the inflammatory process and swelling.

Endemic goiter, unspecified

Has ICD 10 code #8212; E01.2.

This type is caused by territorial iodine deficiency.

It does not have certain pronounced symptoms; the doctor cannot determine the type of disease even after the required tests.

The disease is assigned based on endemic characteristics.

Non-toxic multi-node process

The non-toxic multi-node type has code E04.2. in ICD 10.

Pathology of the structure of the thyroid gland. in which there are several clearly defined nodular neoplasms.

The lesions are usually located asymmetrically.

Other types of non-toxic goiter (specified)

Other specified forms of non-toxic goiter of the disease, which are assigned code E04.8, include:

Pathology in which both diffuse tissue proliferation and nodule formation are detected - diffuse #8212; nodal form.
The growth and adhesion of several nodes is a conglomerate form.

Such formations occur in 25% of cases of the disease.

Unspecified nontoxic goiter

For this type of goiter, code E04.9 is provided in ICD 10.

It is used in cases where the doctor, as a result of examination, rejects the toxic form of the disease, but cannot determine what kind of pathology of the thyroid gland structure is present.

The symptoms in this case are varied; tests do not provide the full picture.

How will ICD 10 help?

This classification was developed primarily for recording and comparing the clinical picture of diseases and for statistical analysis of mortality in individual territories.

The classifier benefits the doctor and the patient, helps to quickly make an accurate diagnosis and choose the most advantageous treatment strategy.

http://proshhitovidku.ru/zabolevaniya/zob-kod-po-mkb-10

Endemic goiter

People from regions where the amount of iodine in the environment is practically absent are especially susceptible to developing the disease. The normal development and functioning of the body largely depends on the endocrine system, in particular on the functioning of the thyroid gland.

With chronic iodine deficiency, thyroid tissue begins to grow, and its functionality changes, which leads to malfunctions of many internal organs and systems.

ICD-10 code

In ICD 10, this disease belongs to the class of endocrine system diseases E00-E90, subclass of thyroid diseases E00-E07, code E01.0 - diffuse goiter (endemic), caused by a lack of iodine in the body.

ICD-10 code

Causes of endemic goiter

The endocrine system ensures the normal functioning of the entire body. If there is not enough iodine in the body, the tissues of the thyroid gland begin to enlarge, the functioning of the endocrine system is disrupted, and with it the entire body.

Endemic goiter develops for two reasons: relative or absolute iodine deficiency in the body.

The cause of relative iodine deficiency may be certain medications, a violation of the absorption function of the intestine, due to which the body does not receive the required amount of iodine, congenital pathologies of the thyroid gland, and diseases of the digestive system.

Absolute iodine deficiency develops due to low iodine intake from food or water.

Also, the cause of the development of struma may be contaminated drinking water, which interferes with the absorption of iodine (especially water with nitrates, calcined), abnormalities in the production of thyroid hormones, and heredity.

Symptoms of endemic goiter

Endemic goiter in the early stages can cause headaches, weakness, fatigue, and the patient may feel discomfort in the heart area.

At the initial stages of the disease, the level of hormones is practically unchanged, but as the disease progresses, the amount of thyroid hormones in the body decreases, a suffocating dry cough, and difficulty swallowing or breathing appear.

In the later stages of the disease, various heart pathologies develop, in particular, hyperfunction of the right ventricle and atrium.

In childhood, the symptoms of the disease may be more pronounced.

Endemic goiter of the 2nd degree is clearly visible; a specialist can easily detect an increase by palpation.

Diffuse endemic goiter

Nodular endemic goiter

It is not a separate disease, but a group of diseases characterized by the development of voluminous nodular formations. Often the appearance of nodules in the thyroid gland is associated with a malignant process.

With nodular goiter, visible cosmetic defects on the neck and a feeling of suffocation are possible.

For treatment, suppressive drugs (thyroid hormones, radioactive iodine) and surgery are usually prescribed.

Nodular goiter is diagnosed in approximately half of the population, while in women the disease is several times more common. As a rule, uterine fibroids are often detected in women with nodular struma.

With nodular goiter, the thyroid gland produces a low amount of thyroid hormones, which in turn leads to an increase in the level of thyroid-stimulating hormones in the body and stimulation of the thyroid gland.

Endemic goiter in children

Endemic goiter often develops in those children who live in regions with insufficient iodine content in water or soil.

To determine the size and structure of the thyroid gland in children, ultrasonography, blood tests for hormone levels, etc. are prescribed.

Medications (antistumin, hormonal therapy) are prescribed as treatment.

To prevent the disease, the use of sea salt or iodine-enriched salt and food supplements with iodine are prescribed.

Diagnosis of endemic goiter

Diagnostic measures also include laboratory tests (blood, urine).

With a lack of iodine, the excretion of this trace element in the urine is reduced and is usually less than 50 mcg per day. A blood test allows you to determine the level of thyrotropin, T 3, T 4, thyroglobulin.

If a nodular form of struma is detected, a biopsy is prescribed, which will help determine the nature of the pathological process (malignant or benign).

Fine needle aspiration biopsy reveals homogeneous masses of colloid, the number of thyroid epithelial cells,

An enlarged thyroid gland is diagnosed if the volume of the thyroid gland exceeds the upper limits of normal (each age and each gender have their own normal values).

For men, the upper limits of thyroid volume are set at 25 ml (cm 3), for women – 18 ml (cm 3). In children, indicators range from 4.9 to 15.6 ml.

Another diagnostic method is radioisotope scanning, which determines diffuse enlargement of the gland, degree, presence of nodes, level of isotope accumulation in the thyroid gland, impurities and lymphoid elements.

What needs to be examined?

Who to contact?

Treatment of endemic goiter

Endemic goiter is a fairly serious disorder that should be treated by a specialist.

Treatment can be conservative (usually for small struma or in the initial stages of the disease) or surgical.

Good results with mild destructive changes in thyroid tissue are shown by hormonal therapy with thyroidin or triodothyronine.

Nodular forms of the disease can only be treated surgically, since in this case there is a high probability of developing a malignant process.

During drug treatment, the specialist selects drugs containing iodine and thyroid medications in each individual case, determines the regimen and dosage.

For iodine deficiency conditions, antistrumin or potassium iodide solution helps well. Such drugs are prescribed at the initial stage of the disease, with a moderate size of the thyroid gland.

It is prohibited to use Lugol's solution or iodine tincture to replenish iodine in the body, since iodine in high doses causes a number of negative reactions (allergies, chronic inflammation of the thyroid gland, etc.).

Thyroidin can also have a positive effect in some mixed forms of struma; the drug is also used in the nodular form during preparation for surgery.

For children, thyroid surgery is prescribed after conservative methods have failed. Emergency surgery is indicated in cases of compression of organs adjacent to the neck (if the size of the struma is too large).

In children, only excess thyroid tissue is removed, without affecting adjacent tissue. With nodular struma, surgery is also necessary, since the risk of developing a malignant process is quite high even in childhood.

If the goiter grows too quickly, adjacent organs are compressed, or there is a suspicion of a malignant process, surgery on the thyroid gland is prescribed immediately.

Prevention of endemic goiter

Prevention should include general health measures, improving living and working conditions of the population. The quality of drinking water and improvement of water supply sources are of no small importance.

As already mentioned, the disease develops as a result of iodine deficiency in the body, so it is necessary to carry out iodine prophylaxis, especially in regions where there is little natural iodine in the environment.

According to studies, it is the use of sea or iodized salt and iodine-containing preparations that is the main means of preventing thyroid diseases.

Prognosis of endemic goiter

The prognosis of endemic goiter depends on the stage at which the disease was diagnosed, the form, as well as on compliance with all recommendations prescribed by the doctor.

In most cases, thanks to modern technologies, the disease does not pose a threat to the life and health of the patient.

After treatment, the patient can continue his normal lifestyle.

Endemic goiter can lead to the development of many pathologies. In childhood, iodine deficiency can cause mental or physical retardation, and during pregnancy it can cause miscarriage or congenital anomalies of the fetus.

In addition, with an enlarged thyroid gland in both men and women, reproductive function is impaired.

Medical Expert Editor

Portnov Alexey Alexandrovich

Education: Kyiv National Medical University named after. A.A. Bogomolets, specialty - General Medicine

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The International Statistical Classification of Diseases and Related Health Problems is a document developed under the guidance of WHO to provide a uniform approach to the methods and principles of disease treatment.

Once every 10 years it is reviewed, changes and amendments are made. Today there is ICD-10, a classifier that makes it possible to determine an international protocol for the treatment of a particular disease.

Principles of classification of endocrine diseases

Class IV. E00 - E90. Diseases of the endocrine system, nutritional disorders and metabolic disorders also include diseases and pathological conditions of the thyroid gland. Nosology code according to ICD-10 - from E00 to E07.9.

Congenital iodine deficiency syndrome (E00 – E00.9)
Thyroid diseases associated with iodine deficiency and similar conditions (E01 – E01.8).
Subclinical hypothyroidism due to iodine deficiency (E02).
Other forms of hypothyroidism (E03 – E03.9).
Other forms of non-toxic goiter (E04 – E04.9).
Thyrotoxicosis (hyperthyroidism) (E05 – E05.9).
Thyroiditis (E06 – E06.9).
Other diseases of the thyroid gland (E07 – E07.9).

All these nosological units are not one disease, but a whole series of pathological conditions that have their own characteristics - both in the causes of occurrence and in diagnostic methods. Consequently, the treatment protocol is determined based on the totality of all factors and taking into account the severity of the condition.

The disease, its causes and classic symptoms

First, let us remember that the thyroid gland has a special structure. It consists of follicular cells, which are microscopic balls filled with a specific liquid - keloid. Due to pathological processes, these balls begin to grow in size. The developing disease will depend on the nature of this growth, whether it affects the production of hormones by the gland.

Despite the fact that thyroid diseases are varied, their causes are often similar. And in some cases it is not possible to establish it precisely, since the mechanism of action of this gland is still not fully understood.

Heredity is called a fundamental factor in the development of pathologies of the endocrine glands.
Environmental impact - unfavorable environmental conditions, radiological background, iodine deficiency in water and food, use of food chemicals, additives and GMOs.
Diseases of the immune system, metabolic disorders.
Stress, psycho-emotional instability, chronic fatigue syndrome.
Age-related changes associated with hormonal changes in the body.

Often, the symptoms of thyroid diseases also have a general tendency:

feeling of discomfort in the neck, tightness, difficulty swallowing;
losing weight without changing your diet;
disruption of the sweat glands - excessive sweating or dry skin may occur;
sudden mood swings, susceptibility to depression or excessive nervousness;
decreased thinking acuity, memory impairment;
complaints about the gastrointestinal tract (constipation, diarrhea);
disruptions in the functioning of the cardiovascular system - tachycardia, arrhythmia.

All these symptoms should suggest that you need to see a doctor - at least a primary care physician. And after conducting initial research, he will, if necessary, refer you to an endocrinologist.

Some thyroid diseases are less common than others due to various objective and subjective reasons. Let's look at those that are statistically the most common.

Types of thyroid pathologies

Thyroid cyst

A small benign tumor. It is generally accepted that a cyst can be called a formation that exceeds 15 mm. in diameter. Everything below this border is an expansion of the follicle.

This is a mature benign tumor, which many endocrinologists classify as a cyst. But the difference is that the cavity of the cystic formation is filled with keloid, and the adenoma is made up of epithelial cells of the thyroid gland.

Autoimmune thyroiditis (AIT)

A disease of the thyroid gland, characterized by inflammation of its tissue caused by a malfunction of the immune system. As a result of this failure, the body produces antibodies that begin to “attack” its own thyroid cells, saturate them with leukocytes, which causes inflammatory processes. Over time, your own cells are destroyed, they stop producing the required amount of hormones, and a pathological condition called hypothyroidism occurs.

Eutheriosis

This is an almost normal condition of the thyroid gland, in which the function of producing hormones (TSH, T3 and T4) is not impaired, but there are already changes in the morphological state of the organ. Very often, this condition can be asymptomatic and last a lifetime, and the person will not even suspect the presence of the disease. This pathology does not require specific treatment and is often detected by chance.

Nodular goiter

Nodular goiter code according to ICD 10 - E04.1 (with a single node) is a neoplasm in the thickness of the thyroid gland, which can be either cavitary or epithelial. A single node is rarely formed and indicates the beginning of the process of neoplasms in the form of multiple nodes.

Multinodular goiter

Multinodular goiter ICD 10 - E04.2 is an uneven enlargement of the thyroid gland with the formation of several nodes, which can be either cystic or epithelial. As a rule, this type of goiter is characterized by increased activity of the internal secretion organ.

Diffuse goiter

It is characterized by uniform growth of the thyroid gland, which affects the decrease in the secretory function of the organ.

Diffuse toxic goiter is an autoimmune disease characterized by diffuse enlargement of the thyroid gland and persistent pathological production of excessive amounts of thyroid hormones (thyrotoxicosis).

This is an increase in the size of the thyroid gland, which does not affect the production of normal amounts of thyroid hormones and is not a consequence of inflammation or neoplastic formations.

Thyroid disease caused by iodine deficiency in the body. There are euthyroid (increase in organ size without affecting hormonal function), hypothyroid (decreased hormone production), hyperthyroid (increased hormone production) endemic goiter.

An increase in the size of the organ, which can be observed both in a sick person and in a healthy one. The neoplasm is benign and is not considered a tumor. It does not require specific treatment until changes in the organ or an increase in the size of the formation begin.

Separately, it is necessary to mention such a rare disease as hypoplasia of the thyroid gland. This is a congenital disease, which is characterized by underdevelopment of the organ. If this disease occurs during life, it is called atrophy of the thyroid gland.

Thyroid cancer

One of the less common pathologies, which is detected only through specific diagnostic methods, since the symptoms are similar to all other thyroid diseases.

Diagnostic methods

Almost all pathological neoplasms rarely develop into a malignant form (thyroid cancer), only if they are very large in size and untimely treatment.

The following methods are used for diagnosis:

medical examination, palpation;
analysis of antibody titer to thyroid tissue
ultrasound examination of the thyroid gland;
hormone analysis;
if necessary, fine-needle biopsy.

In some cases, treatment may not be required at all if the tumors are very small. The specialist simply monitors the patient's condition. Sometimes the neoplasms spontaneously resolve, and sometimes they rapidly begin to increase in size.

The most effective treatments

Treatment can be conservative, that is, medication. Drugs are prescribed in strict accordance with laboratory tests. Self-medication is unacceptable, since the pathological process requires monitoring and correction by a specialist.

If there are clear indications, surgical measures are carried out when a part of an organ that is susceptible to a pathological process, or the entire organ, is removed.

Treatment of autoimmune thyroid diseases has several differences:

medicinal – aimed at destroying excess hormones;
treatment with radioactive iodine or surgery leads to destruction of the gland, which leads to hypothyroidism;
Computer reflexology is designed to restore the functioning of the gland.

Thyroid diseases, especially in the modern world, are quite common. If you consult a specialist in time and carry out all the necessary therapeutic measures, you can significantly improve your quality of life, and in some cases completely get rid of the disease.

Endemic goiter is characterized by an enlargement of the thyroid gland, which can cause the neck to become deformed. The disease develops as a result of low levels of iodine in the body. In childhood, this disease occurs quite often; in some cases, the disease can only be detected in adolescence, after puberty.

With chronic iodine deficiency, thyroid tissue begins to grow, and its functionality changes, which leads to malfunctions of many internal organs and systems.

ICD-10 code

In ICD 10, this disease belongs to the class of endocrine system diseases E00-E90, subclass of thyroid diseases E00-E07, code E01.0 - diffuse goiter (endemic), caused by a lack of iodine in the body.

ICD-10 code

E01.2 Endemic goiter associated with iodine deficiency, unspecified

Causes of endemic goiter

Endemic goiter develops for two reasons: relative or absolute iodine deficiency in the body.

Absolute iodine deficiency develops due to low iodine intake from food or water.

Chronic infectious and inflammatory processes (especially worms), poor living or working conditions, taking medications that impede the supply of iodine to the thyroid gland, and eating foods low in selenium, molybdenum, manganese, and zinc, which help the body absorb iodine, contribute to the development of the disease.

Symptoms of endemic goiter

Endemic goiter in the early stages can cause headaches, weakness, fatigue, and the patient may feel discomfort in the heart area.

In the later stages of the disease, various heart pathologies develop, in particular, hyperfunction of the right ventricle and atrium.

In childhood, the symptoms of the disease may be more pronounced.

Endemic goiter of the 1st degree is detected by a specialist by palpation of the thyroid gland. In a normal state, the struma is almost impossible to see at this stage of development of the disease, but with the neck extended and the head pulled back, it is clearly visible.

Endemic goiter of the 2nd degree is clearly visible; a specialist can easily detect an increase by palpation.

Diffuse endemic goiter

It most often affects women between 20 and 50 years old. The disease is characterized by enlargement and increased work of the thyroid gland due to attacks by the body's own immune system. The causes of the development of diffuse goiter are considered to be a pathological state of immunity, in which the body produces an increased amount of autoantibodies that enlarge the gland and stimulate its production of hormones. Treatment is predominantly medicinal; surgical treatment is prescribed if the size of the struma is too large. While taking medications, remission occurs in approximately 70% of cases.

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Nodular endemic goiter

With nodular goiter, visible cosmetic defects on the neck and a feeling of suffocation are possible.

For treatment, suppressive drugs (thyroid hormones, radioactive iodine) and surgery are usually prescribed.

Multinodular endemic goiter usually develops against the background of a normally functioning thyroid gland. The causes of the appearance of nodes are insufficient intake of iodine from food or impaired absorption of this microelement due to diseases of the liver, digestive system or poor nutrition (large amounts of soy, cabbage, rutabaga in the diet).

When the body's need for thyroid hormones decreases, colloid accumulates in the gland, resulting in the appearance of follicles. If the need for thyroid hormones reappears, the thyroid tissue grows, as a result of which, after a few years, multiple nodules appear in the thyroid gland.

Endemic goiter in children

Endemic goiter often develops in those children who live in regions with insufficient iodine content in water or soil.

Iodine deficiency in the body leads, just like in adults, to disruption of the production of thyroid hormones and an enlargement of the thyroid gland. In infancy, an enlarged thyroid gland can compress the trachea, leading to the death of the child. Also, with iodine deficiency in the body, the child lags behind in development, both mentally and physically; in addition, the development of endemic cretinism (dementia, stunting, disproportionate physique) is possible.

To determine the size and structure of the thyroid gland in children, ultrasonography, blood tests for hormone levels, etc. are prescribed.

Medications (antistumin, hormonal therapy) are prescribed as treatment.

To prevent the disease, the use of sea salt or iodine-enriched salt and food supplements with iodine are prescribed.

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Diagnosis of endemic goiter

Endemic goiter is mainly diagnosed by ultrasound examination, which establishes the shape, stage, the number of nodular formations, contours, tissue structure, etc. Ultrasound can reveal accumulation of colloid or hemorrhages in the node, calcifications, adenomas, carcinomas.

Diagnostic measures also include laboratory tests (blood, urine).

If a nodular form of struma is detected, a biopsy is prescribed, which will help determine the nature of the pathological process (malignant or benign).

Fine needle aspiration biopsy reveals homogeneous masses of colloid, the number of thyroid epithelial cells,

An enlarged thyroid gland is diagnosed if the volume of the thyroid gland exceeds the upper limits of normal (each age and each gender have their own normal values).

For men, the upper limits of thyroid volume are set at 25 ml (cm 3), for women – 18 ml (cm 3). In children, indicators range from 4.9 to 15.6 ml.

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Treatment of endemic goiter

Endemic goiter is a fairly serious disorder that should be treated by a specialist.

Treatment can be conservative (usually for small struma or in the initial stages of the disease) or surgical.

Good results with mild destructive changes in thyroid tissue are shown by hormonal therapy with thyroidin or triodothyronine.

Nodular forms of the disease can only be treated surgically, since in this case there is a high probability of developing a malignant process.

During drug treatment, the specialist selects drugs containing iodine and thyroid medications in each individual case, determines the regimen and dosage.

For iodine deficiency conditions, antistrumin or potassium iodide solution helps well. Such drugs are prescribed at the initial stage of the disease, with a moderate size of the thyroid gland.

With the right treatment, the size of the thyroid gland decreases (it is important to complete the full course of treatment). If after a few months the thyroid gland does not decrease in size, then iodine-containing drugs are replaced with thyroidin (the dosage and course of administration are selected by a specialist in each case).

Thyroidin can also have a positive effect in some mixed forms of struma; the drug is also used in the nodular form during preparation for surgery.

If the goiter grows too quickly, adjacent organs are compressed, or there is a suspicion of a malignant process, surgery on the thyroid gland is prescribed immediately.

Prevention of endemic goiter

According to studies, it is the use of sea or iodized salt and iodine-containing preparations that is the main means of preventing thyroid diseases.

Iodized salt is obtained by adding potassium iodide to regular salt; for storage you need to use containers that close tightly (otherwise the iodine may erode, and with it all the benefits). It is especially important to prevent goiter in childhood, since physiological hyperplasia of the thyroid gland is observed before the age of 12, which can be the onset of the disease.

Prognosis of endemic goiter

The prognosis of endemic goiter depends on the stage at which the disease was diagnosed, the form, as well as on compliance with all recommendations prescribed by the doctor.

In most cases, thanks to modern technologies, the disease does not pose a threat to the life and health of the patient.

After treatment, the patient can continue his normal lifestyle.

In addition, with an enlarged thyroid gland in both men and women, reproductive function is impaired.

The main reason for the development of endemic goiter is insufficient iodine intake into the body.
Iodine is a trace element necessary for the biosynthesis of thyroid hormones - thyroxine and triiodothyronine. Iodine enters the human body with food, water, and air. 90% of the daily iodine requirement is provided by food, 4-5% by water, and about 4-5% by air. Iodine is found in fish, meat, seaweed, shrimp and other seafood, milk and dairy products, water, including mineral, iodized table salt, buckwheat and oatmeal, beans, lettuce, beets, grapes, milk chocolate, eggs, potatoes.
When iodine enters the body in smaller quantities than the required daily requirement, a compensatory enlargement of the thyroid gland develops, i.e. goiter.
A distinction is made between absolute iodine deficiency (i.e., deficiency in iodine intake from food and water) and relative iodine deficiency, which is caused not by iodine deficiency in the external environment and food, but by diseases of the gastrointestinal tract and impaired absorption of iodine in the intestines, blockade of iodine uptake by the thyroid gland by some drugs (cordarone, potassium perchlorate, nitrates, lithium carbonate, sulfonamides, some antibiotics), a congenital defect in the biosynthesis of thyroid hormones in the thyroid gland.
Factors predisposing to the development of endemic goiter:
- heredity aggravated by goiter;
- genetic defects in the biosynthesis of thyroid hormones;
- water contamination with urochrome, nitrates, high content of calcium and humic substances, which makes it difficult to absorb iodine;
- deficiency in the environment and food of microelements zinc, manganese, selenium, molybdenum, cobalt, copper and excess calcium. Copper deficiency reduces the activity of iodinase, which is involved in the addition of iodine to the tyrosyl radical, and also reduces the activity of cytochrome oxidase and ceruloplasmin. Cobalt deficiency reduces the activity of iodine peroxidase in the thyroid gland. An imbalance of microelements contributes to disruption of the biosynthesis of thyroid hormones;
- use of drugs that block iodide transport into thyroid cells (periodate, potassium perchlorate);
- the use of drugs that disrupt the organization of iodine in the thyroid gland (thiourea derivatives, thiouracil, some sulfonamides, para-aminobenzoic acid, aminosalicylic acid);
- the presence of goitrogenic factors in products. Natural strumogens can be divided into two groups. One group is thiocyanates and isocyanates, found mainly in plants of the Crucifera family (white cabbage, cauliflower, broccoli, Brussels sprouts, turnips, turnips, horseradish, lettuce, rapeseed). Thiocyanates and isocyanates block the uptake of iodides by the thyroid gland and accelerate its release from the gland. Another group of strumogens are cyanogenic glycosides found in cassava, corn, sweet potatoes, lima beans;
- exposure to infectious and inflammatory processes, especially chronic helminthic infestations, unsatisfactory sanitary, hygienic and social conditions. In these situations, the compensatory capabilities of the thyroid gland to maintain the optimal level of thyroid hormones in the blood are sharply reduced.

Included: endemic conditions associated with iodine deficiency in the natural environment, both directly and as a result of iodine deficiency in the mother’s body. Some of these conditions cannot be considered true hypothyroidism, but are a consequence of inadequate secretion of thyroid hormones in the developing fetus; there may be a connection with natural goitrogenic factors. If necessary, identify concomitant mental retardation, use an additional code (F70-F79). Deleted: subclinical hypothyroidism due to iodine deficiency (E02)

- E00.0 Congenital iodine deficiency syndrome, neurological form. Endemic cretinism, neurological form
- E00.1 Congenital iodine deficiency syndrome, myxedema form Endemic cretinism: hypothyroid, myxedema form
- E00.2 Congenital iodine deficiency syndrome, mixed form. Endemic cretinism, mixed form
- E00.9 Congenital iodine deficiency syndrome, unspecified. Congenital hypothyroidism due to iodine deficiency NOS. Endemic cretinism NOS
E01 Thyroid diseases associated with iodine deficiency and similar conditions. Excluded: congenital iodine deficiency syndrome (E.00-), subclinical hypothyroidism due to iodine deficiency (E02)
- E01.0 Diffuse (endemic) goiter associated with iodine deficiency
- E01.1 Multinodular (endemic) goiter associated with iodine deficiency. Nodular goiter associated with iodine deficiency
- E01.2 Goiter (endemic), associated with iodine deficiency, unspecified Endemic goiter NOS
- E01.8 Other thyroid diseases associated with iodine deficiency and similar conditions. Acquired hypothyroidism due to iodine deficiency NOS
E02 Subclinical hypothyroidism due to iodine deficiency
E03 Other forms of hypothyroidism.

Excluded: hypothyroidism associated with iodine deficiency (E00 - E02), hypothyroidism following medical procedures (E89.0)

- E03.0 Congenital hypothyroidism with diffuse goiter. Goiter (non-toxic) congenital: NOS, parenchymal, Deleted: transient congenital goiter with normal function (P72.0)
- E03.1 Congenital hypothyroidism without goiter. Aplasia of the thyroid gland (with myxedema). Congenital: thyroid atrophy, hypothyroidism NOS
- E03.2 Hypothyroidism caused by drugs and other exogenous substances
- E03.3 Post-infectious hypothyroidism
- E03.4 Thyroid atrophy (acquired) Excluded: congenital atrophy of the thyroid gland (E03.1)
- E03.5 Myxedema coma
- E03.8 Other specified hypothyroidisms
- E03.9 Hypothyroidism, unspecified. Myxedema NOS
E04 Other forms of non-toxic goiter.

Excluded: congenital goiter: NOS, diffuse, parenchymal goiter associated with iodine deficiency (E00 - E02)

- E04.0 Non-toxic diffuse goiter. Non-toxic goiter: diffuse (colloid), simple
- E04.1 Non-toxic uninodular goiter. Colloid node (cystic), (thyroid). Non-toxic mononodous goiter. Thyroid (cystic) nodule NOS
- E04.2 Non-toxic multinodular goiter. Cystic goiter NOS. Polynodous (cystic) goiter NOS
- E04.8 Other specified forms of non-toxic goiter
- E04.9 Non-toxic goiter, unspecified. Goiter NOS. Nodular goiter (non-toxic) NOS
E05 Thyrotoxicosis [hyperthyroidism]
- E05.0 Thyrotoxicosis with diffuse goiter. Exophthalmic or toxic goiter. NOS. Graves' disease. Diffuse toxic goiter
- E05.1 Thyrotoxicosis with toxic uninodular goiter. Thyrotoxicosis with toxic mononodous goiter
- E05.2 Thyrotoxicosis with toxic multinodular goiter. Toxic nodular goiter NOS
- E05.3 Thyrotoxicosis with ectopia of thyroid tissue
- E05.4 Artificial thyrotoxicosis
- E05.5 Thyroid crisis or coma
- E05.8 Other forms of thyrotoxicosis. Hypersecretion of thyroid stimulating hormone
- E05.9 Thyrotoxicosis, unspecified. Hyperthyroidism NOS. Thyrotoxic heart disease (I43.8*)
E06 Thyroiditis.

Deleted: postpartum thyroiditis (O90.5)

- E06.0 Acute thyroiditis. Abscess of the thyroid gland. Thyroiditis: pyogenic, purulent
- E06.1 Subacute thyroiditis. De Quervain's thyroiditis, giant cell, granulomatous, non-purulent. Deleted: autoimmune thyroiditis (E06.3)
- E06.2 Chronic thyroiditis with transient thyrotoxicosis.

Deleted: autoimmune thyroiditis (E06.3)

- E06.3 Autoimmune thyroiditis. Hashimoto's thyroiditis. Chasitoxicosis (transient). Lymphadenomatous goiter. Lymphocytic thyroiditis. Lymphomatous struma
- E06.4 Drug-induced thyroiditis.
- E06.5 Chronic thyroiditis: NOS, fibrous, woody, Riedel
- E06.9 Thyroiditis, unspecified
E07 Other thyroid diseases
- E07.0 Hypersecretion of calcitonin. C-cell hyperplasia of the thyroid gland. Hypersecretion of thyrocalcitonin
- E07.1 Dyshormonal goiter. Familial dishormonal goiter. Pendred's syndrome.

Deleted: transient congenital goiter with normal function (P72.0)

- E07.8 Other specified diseases of the thyroid gland. Tyrosine-binding globulin defect. Hemorrhage, infarction in the thyroid gland.
- E07.9 Thyroid disease, unspecified