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--SUHU afebrile
temperature is decreased compared to the previous state, with some worsening of clinical symptoms.
- Thyroid Enlargement
Here are some health problems that could cause an enlarged thyroid gland:
1. Graves Disease form of hyperthyroidism with autoimmune component. Antibodies in the immune
system mistakenly see thyroid as "the enemy" and launched this serangan.Hal cause glands become
stimulated excessive that produce excess thyroid hormone. At the end of the gland becomes worse
and mumps will be formed.
2. Hashimoto disease autoimmune disorders. However, instead of generating excess thyroid, this
condition causes the trigger hypothyroidism or thyroid gland does not produce a number of hormones
that cukup.Meskipun Thus, the pituitary gland continues to send thyroid-stimulating hormone (TSH)
to the thyroid, thus worsening the condition of the thyroid gland and causes it to have an enlarged .
3. Solitary Thyroid nodules and nodules (thyroid nodule) Pembesaran thyroid gland can produce
multiple nodule is solid or fluid-filled nodules that grow in both lobes of the thyroid or a single nodule
that grows only on one side tiroid.Pada most cases, these nodules benign and does not have the
potential to develop into cancer.
4. Tiroid cancer is less common than thyroid nodules. Type enlargement usually occurs only on one
side of the thyroid gland.
5. Tiroiditis inflammation of the thyroid gland that can be caused by medical conditions or
sometimes after pregnancy. Some forms of thyroiditis caused by a bacterial infection, but this is very
rare and only temporary.
6. Iodine deficiency fuel needed to produce thyroid hormones is iodine. Because iodine has been
added to table salt and other foods, people living in developed countries almost never have an
enlarged thyroid due yodium.Gondok deficiency is more common in people in developing countries
where access to foods rich in iodine and sea salt is still limited
7. Hyperthyroidism Other common symptoms include weight loss and unexplained diarrhea.
Hyperthyroidism most commonly affects women between the ages of 20 to 40 years. Patients may
experience erectile dysfunction men, while women berpontesi disturbed menstrual cycle.
8. Hypothyroidism occurs when the thyroid gland does not produce hormones that the thyroid gland
of the symptoms of hypothyroidism cukup.Sebagian a reversal of the symptoms of hyperthyroidism,
although not always. For example, a person with hypothyroidism find his heartbeat slowed, instead
meningkat.Pasien may also feel very lethargic, chills, increased body weight that can not be
explained, and constipation.
* Thyroid enlargement: enlargement of the thyroid gland, usually classified in a particular grade.
According to the classification perez,
Grade 0: no palpable
Grade 1: palpable and visible only with the head ditengadahkan
Grade 2: easy viewing, head in the normal position
Grade 3: visible from a certain distance
Iodine deficiency iodine meguras reserves and reduce the production of T4. Decreased levels of T4 in
the blood triggers the secretion of TSH which then increases the activity of the thyroid gland, to
further support the occurrence of thyroid hyperplasia

Iodine deficiency causes some intrathyroidal autoregulatory changes leading to increased
triiodothyronine (T (3)) production and secretion, at the expense of thyroxine (T (4)). It is
characterized by low serum T (4), normal or slightly higher T (3), and as a consequence of the latter,
normal thyrotropin (TSH). The network also hypothyroxinemic, but their T (3) concentration of most
of the normal and ensure clinical euthyroidism, except for those who rely on a high level in the local
generation of T (4) by a mechanism that extrathyroidal iodothyronine deiodinases involved
isoenzymes. Thus, unless so severe iodine deficiency and chronic intrathyroidal and extrathyroidal
mechanisms are no longer sufficient to maintain normal T (3) in most tissues, individual clinical and
biochemical euthyroid, but some networks may selectively hypothyroid (ie, brain). In adults both
intrathyroidal and extrathyroidal mechanisms react to iodine deficiency in full operation even when
the latter is mild. They contribute together to a high or normal maintenance of T (3) in such networks
is derived mostly from the plasma, to be very severe iodine deficiency. They depend to a large extent
on local generation of T (4), most of the interaction between type 2 iodothyronine deiodinase (D2)
and type 3 (D3), it may be T (3) -deficient (and hypothyroidism) with mild iodine deficiency.
Therefore, the status of the individual thyroid iodine-deficiency does not only depend on the level of
iodine deficiency, but most tissue-specific, and it is difficult to determine for the individual as a
whole: increased, normal, and low concentrations of T (3) were found simultaneously on the network
which is different from the same animal, even with the severe shortage. Most reversed the effects of
iodine deficiency in adults with adequate iodine prophylaxis, but the absence of T (4) during early
fetal life causes irreversible brain damage (neurological cretinism). Maternal thyroid hormone origin
available for embryos early in development and continue to contribute to the fetal thyroid hormone
status, even after the onset of fetal thyroid secretion. In the case of congenital hypothyroidism and
maternal T (4), the second transfer, along with an increase in D2 activity, protects the fetal brain from
the T (3) normal deficiency, even when it may not be enough to maintain euthyroidism in other fetal
tissues. Almost all of the T (3) was found in the fetal brain derived from local T (4), and instead of
circulating T (3). In the case of severe iodine deficiency, both the embryo and the mother is T (4) deficient; Therefore, the fetal brain exposed to T (3) -deficiency, both before and after onset of fetal
thyroid function. This causes irreversible changes and damage to the central nervous system (ie
abnormal corticogenesis). In addition, because the mechanism is not operative intrathyroidal
autoregulation in the fetus, both T (4) and T (3) continue to be very low to be born, and a fetus is not
only hypothyroxinemic, similar to its parent, but also clinical and biochemical hypothyroidism.
[PubMed - indexed for MEDLINE]


The thyroid is a gland located at the back of the neck. Utamanyamemproduksi function of thyroid
hormones (T3 and T4) of iodine and tyrosine, and set aktivitasmetabolisme tubuh.Produksi or
secretion of T4 and T3, governed by the amount of stimulating hormone (TSH) is released from the
pituitary gland and is received by the thyroid gland. Thyroid dysfunction can disrupt the body's
metabolism and adverse effects on the brain, liver, intestine, sistemreproduksi, heart, and thyroid
ginjal.Kelainan in women 4-5 times more than in men and mostly occurs when a pregnant woman. A
variety of hormonal and metabolic changes occur during pregnancy, causes complex changes in
maternal thyroid function. During normal pregnancy levels of thyroid binding globulin (TBG) in the
circulation increases and eventually T3 danT4 also increased. Thyroid hormone is essential for the
development of the baby's brain and nervous system during the first trimester of pregnancy
kehamilan.Kelainan thyroid deficiency can be either (hypothyroidism) or excess (hyperthyroidism)
thyroid hormone. Especially in the first trimester

because during the period of fetal thyroid hormone can only gain from his mother. Thyroid disorders
can affect the fetus ibudan. Thyroid Stimulating Immunoglobulin (TSH) that attach to and activate
thyrotropin receptors that cause hyperfunctioning on the growth of the thyroid gland.
* Recent research has shown, T4 transfer from mother to fetus in early pregnancy is critical for fetal
brain development. When the mother of iodine deficiency since the beginning of her pregnancy, the
transfer will be reduced T4 to the fetus before the fetal thyroid gland berfungsi.Jadi fetal brain
development is highly dependent on maternal thyroid hormone in the first trimester of pregnancy,
when maternal iodine deficiency may result in low thyroid hormone levels in the mother and the
fetus. In the second and third trimesters of pregnancy, the fetus is able to make its own thyroid
hormones, but due to lack of iodine in this period then it will also result in a lack of formation of
thyroid hormone, resulting in hypothyroidism in the fetus.
--HUB Mountainous area with GAKI

Natural Iodine sourced from:

1. Groundwater dependent on water originating from a particular rock type (highest levels derived
from igneous rock, 900 ug / kg of material).
2. Sea water contains very little iodine, as well as salt in general.
3. Plankton and marine algae high iodine levels because these organisms concentrate iodine from
the surrounding environment.
4. Sources of organic matter that is within the oxidant, disinfectant, yodoform, dye for food and
cosmetics, and today many vitamins that adding this element as well.
5. Sea fish, dried squid contains a lot of iodine (Mercy Gatie Luh, 2006).
* In the mountains krna iodine content in water and soil is low or no iodine at sekali ga caused
flooding mknya to take it to the lower mainland / beach. Some of the possible causes for the low
iodine content in the soil include:
a. Erosion which causes iodine lost to the sea,
b. Soil nests (ground lava, limestone) that can not store water, along with water seingga iodine
dissolved in it will seep deeper soil kelapisan. This causes root crops and vegetables could not reach
it, so that the iodine content in the plant will be low.
c. Over exploitation of soil and waste pollution in agricultural soil so that the soil becomes too acidic
or alkaline (Sulistiyani, 2011).
Most iodine is in the oceans / seas, because iodine (through melting snow and rain) on the surface of
the ground, then carried by wind, river flow and floods into the sea. This condition, especially in the
mountainous regions around the world, although it can also occur in the river valley. Iodine in the
soil and the sea in the form of iodide. Iodide ions are oxidized by the sun into the element iodine is
very volatile, so that each year approximately 400,000 tons of iodine is lost from the surface of the
sea. Levels of iodine in sea water approximately 50 micrograms / liter, in the air is approximately 0.7
micrograms / cubic meter. Iodine that is in the atmosphere will be returned to the soil through rain,
with levels in the range of 1.8 to 8.5 micrograms / liter. The iodine cycle continues as long as this
( 2011) .Kembalinya iodine to the ground very slowly and in small amounts
compared to when the release. This process will be repeated continuously so that the iodinedeficient soil will continue to decrease levels of yodium.

Here there is no natural and iodine deficiency correction will be settled. As a result, human and
animal populations in the area that is entirely dependent on food grown in the area would be a
deficiency of iodine. Seeing that it is very much in the Indonesian population who suffer from severe
iodine deficiency because they live in the system to make a living by farming in mountain areas or
valleys. Iodine deficiency will override the population in the area that is in the food no iodine
supplements or no diversification in diets with foods from other areas that are not iodine deficient.
Djokomoeljanto (2002), since the specific geological, this rare element has been eroded from the
land and carried out to sea. This element is carried by the wind and rain back to the mainland
through a cycle of sea-air-land. In general, drinking water is a source of iodine which is very limited.
Most of these elements are obtained through food. Plants obtain iodine from the soil in which the
plants grow, so the higher the soil iodine levels, the higher the iodine content of plants that live on
the land. Opinions Hetzel (1996) states that iodine occurs in the soil, contained in the oil and natural
gas. Water from the soil contains a lot of iodine. In general, the land that is not protected for a long
time a lot of release of iodine. Iodine is found on land and sea as the iodide is oxidized by sunlight
into iodine which can evaporate, so that each year more than 400,000 tons of iodine evaporates
from the sea surface. Iodine in the atmosphere back to the ground through the rain with a
concentration of 1: 8 to 8.5 ug / L