Goiter and TSH test

As a child in the 1930's I recall seeing many of my adult family relatives with neck swellings that I was told were goiters (enlargements-cellular proliferations- of the thyroid gland). Health authorities also told us that Manitobans live an area deficient in iodine and that its this deficiency of iodine that stimulates the thyroid gland to produce more thyroid tissue often resulting in a visible goiter.

With the knowledge that the thyroid gland is the only gland in the body that utilizes iodine to produce its hormone thyroxin (actually 2 hormones T3 and T4 ) iodine was added to our diets and the incidence of such goiters fell. I can also recall seeing large blocks of red colored salt containing iodine in the feeding bins and/or in pastures for our cattle to lick .

In the 1970's the role of TSH and the TSH test was developed. TSH is a hormone produced by the anterior pituitary gland located in the brain which works on the thyroid gland by a feed back system. Thus if the level on the circulating thyroxine hormones is low the pituitary releases more TSH stimuating the thyroid gland to produce more thyroxine , and reversely if the level of the thyroid hormones is elevated, less TSH is released by the pituitary gland and less thyroxin is produced. The literature does not indicate clearly whether TSH stimulates proliferation of thyroid cells

I also recall that as an intern in the 1960's surgical removal of enlarged thyroid glands was still being done for "goiters". The TSH test might have help to determine if such a surgical procedure was warranted. If such patients are indeed hypothyroid you may not want to remove an enlarged thyroid gland . I am not referring to cancerous nodules.

Currently patients with an elevated TSH are prescribed synthetic thyroxin medication- usually taken for life. Do we know the level of iodine in those patients we currently have on thyroxine supplements ? Is prescribing thyroxine supplements the right medication, especially if it has to be given for life? We might find that a pinch of KI powder, a little sea salt and/or some sea food in our diet might be all that we need when we find elevated TSH levels.

Because body organs begin to atrophy when patients are prescribed specific hormone supplements that these organs produce, for example testosterone and the testis, the use of such a prescription policy may have to be reassessed.