#636 Defining Thyroid: Goiter
Scott Benner
Scott and Jenny Smith define thyroid terms.
In this Defining Thyroid episode, Scott and Jenny explain Goiter and talk supplements and nutirition.
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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner 0:00
Hello friends and welcome to episode 636 of the Juicebox Podcast.
Today I bring you the sixth installment of the defining thyroid series today Jenny Smith and I are going to talk about goiter, and supplementing, and some other stuff. So far in the defining thyroid series, we've tackled hypothyroidism, and Hashimotos thyroiditis, that's an episode 616. In Episode 619, we define pituitary and thyroid glands. In Episode 624, we defined P S H testing, and in Episode 628, we define T four and T three. In episode 632. We talked about auto immune, and today we're gonna be talking about goiter, supplementing and some other stuff. It's kind of a, I don't want to call today a free for all but today is sort of a building conversation. You'll well you'll see in a minute. While you're listening today, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan or becoming bold with insulin.
If you have type one diabetes, or are the caregiver of someone with type one, and are a US resident, please go to T one D exchange.org. Ford slash juicebox. And take the survey. This episode of The Juicebox Podcast is sponsored by Omni pod makers of the Omni pod dash, the Omni pod promise and the upcoming Omni pod five. Learn more about that Omni pod dash and see if you're eligible for a free 30 day trial at Omni pod.com forward slash juicebox. Today's episode is short. So at the end, I'll explain how you may be eligible for that free 30 days of the AMI pod dash. Alright, Jenny, we're gonna we're gonna do a quick All right, I'm already laughing ready? Goyder?
Jennifer Smith, CDE 2:25
I know it's such a funny word. Funny Little word. Really goitre. Like, couldn't. There are many medical terms that I think are hilarious. But definitely goiter is one of them. It is. It's funny.
Scott Benner 2:37
I don't know. I'm just I always wonder still. Why, you know, we didn't find out what Hashimotos first name was before they named it?
Jennifer Smith, CDE 2:46
Well, I think the thing about goiter, too, is the fact that like there's a visible part of Goyder, right? It's not just like the name. That's right. That's funny. Like there's a visible piece that on your body, you're like, ooh, that doesn't look normal. shouldn't really be there.
Scott Benner 3:01
Well, and some people can get them. I mean, they can look like real like lumps in your neck, right?
Jennifer Smith, CDE 3:07
Yes, yes, my mom. In fact, when I've seen pictures of my mom, I mean, they're the really old like fading types of pictures before she was diagnosed or within the process. She had a very visible I was on both sides of her neck, she had a very visible she had kind of like the protruding sort of like eyes. There were a lot of things that were very like, that's diagnostic there for her. But, but yes, goiter is essentially an alert and enlargement of the thyroid gland. If that all that we just said did, like, bring that up. That's what it is enlargement of the thyroid gland.
Scott Benner 3:46
goiter also called enlarged thyroid probably by a doctor who laughed every time he said goiter. You know, when it's um, gosh. Do you remember I'm really gonna date myself. There used to be this. People used to shop on TV. I don't know if that's the thing that everyone knows. But there were like infomercials or longer commercials that some guy would come on with a deep voice and tell you about the the heartbreak of psoriasis, you know, or something? Yes. And it's the word terror, which has nothing to do with anything we're talking about here but sticks in my head since I'm a child, because you know, the heartbreak of surprises you and he runs through these lists of other things you might see. And then he goes terror. And it's like stuck in my head. I don't know why I can't get rid of it. I don't even know what it means. That's really funny. So, goiter says abnormal enlargement of the butterfly shaped gland, below the Adam's apple, which is called the thyroid. Of course, a goiter commonly develops as a result of iodine deficiency or inflammation of the thyroid gland. Not all goiters cause symptoms symptoms that do occur might include swelling cough. Rarely, symptoms may include throat tightness or trouble breathing A small goiter that doesn't cause symptoms may not need treatment. In some cases, medication or surgery is needed. Doesn't have. So it's so funny because I'm actually learning something here today. So it shows me we're on the right track, Jenny. Yes. So goiter. I mean, not that I'm just repeating myself. But goiter is an enlarged thyroid. It's not a thing. It's not like a new thing that appears in your neck. It's, it's the enlarged,
Jennifer Smith, CDE 5:34
it's the thyroid and large and really reason. I mean, the reason is because your thyroid gets kind of signaled too much by the pituitary gland to bring out more thyroid hormone, right, I mean, that's the gist of it. And so that over stimulation can cause the thyroid to get larger. And to some people get large enough that you could visibly see that see the change,
Scott Benner 6:03
and the reason in the United States that you would kind of pretty much think thyroid hormone problem or nodules, when you see a goiter. But I guess Believe it or not, is because we have iodized salt in the United States.
Jennifer Smith, CDE 6:21
Yes, we do. As long as you truly get iodized salt,
Scott Benner 6:26
right. Yeah. Can you get it non right.
Jennifer Smith, CDE 6:28
But I mean, if you look, and it's interesting, since we started doing all of these about thyroid specifically, I've started paying attention to salt at the grocery store. I like the grocery store anyway, so. But I was noticing like at Costco specifically, there are big things of sea salt, specifically state on the label. This is not a valuable source of iodine in the diet. So does Himalayan sea salt. I mean, there are many salts that have now become this as the preferred to use that no longer have enough of it in it.
Scott Benner 7:10
Yep. And it's so so in a past episode, I think in the goitre episode, I talked about No, not in the greater episode in the autoimmune episode. This is the goiter episode I talked about. I talked about a new rheumatologist that that ardency she spent 10 minutes talking about iodine and how it's interesting, not in our diet anymore. You know, and and then she went into talking about, I think this kind of fits, she went into talking about even when you eat well, in a factory farming society, you're not eating as well as you think you are. And she used an example of she chose a very popular grocery store chain and said, they, some of their fruits, they they flash freeze, and they don't deliver them to you for months afterwards. And she's like, they have ways of delivering foods where they show up to you with not nearly as much nutritional quality and quality believe that they have because you're like, Ooh, I'm eating a piece of fruit or I'm eating a vegetable. She said but the they've been decimated for nutrition all the time. And she started talking about having to supplement things that you just even if you have a certain diet, you might not know you need to supplement and that that's what made me think of this, which is you know, we all use salt and things. So if you used iodized salt and you have a goiter, it's likely not because of iodine, it's likely because of thyroid, but in other places in the world or if you've gotten all Fifi and you're using sea salt which I say jokingly because I realized this we're talking I switched to pink salt like years ago years ago right? I absolutely don't use much of the other people might have still use the salt shaker but I I have a little salt
Jennifer Smith, CDE 9:04
pig you like that you like the pink salt.
Scott Benner 9:08
I like to take a little pinch and just like you know let it go over top of things and and now I'm realized that I better just shake this the shaker a little bit myself once in a while. Okay, glitters did not look pleasant in the photographs.
Unknown Speaker 9:22
No, they don't. Yeah.
Scott Benner 9:25
And your mother had one. My mother
Jennifer Smith, CDE 9:27
had one. Yes, a noticeable one again from pictures and whatnot from that time and then once her thyroid was well managed, and she actually had thyroid burnout and everything because she was hyperthyroid and now she actually takes the typical levothyroxine because she has hypothyroid because of everything wise
Scott Benner 9:51
I have to say when I when I just Googled for pictures of goiter when they come back with like no not drawings but like but actual therapy. Following photographs, a lot of them do look like they don't live in the United States. That's interesting. That is interesting. Yeah. And while they can get massive in some Yeah. Oh, that's horrible. Okay. All right. Fun times here on the podcast.
Jennifer Smith, CDE 10:14
Yes, exactly. From time.
Scott Benner 10:17
There's nothing else to add to this one, right?
Jennifer Smith, CDE 10:19
I don't think so. No, there's certainly things that I could add, but I don't think that they're as 13. I'll
Scott Benner 10:25
just read this last piece that I had here in larger the thyroid gland, when your thyroid is bombarded by signals from the pituitary in an effort to trigger the thyroid into making more hormones. The excessive stimulation may cause the thyroid gland to enlarge to the point where you have a bulge in your neck. So this seems like that means in the case of an actual thyroid issue, but not an iodine deficiency, correct? Exactly. All right. Well, let's never speak of this again. Seriously,
Jennifer Smith, CDE 10:57
unless somebody comments, just like I want to learn more about guider, and
Scott Benner 11:01
we'd be happy to talk about it. But my goodness, that is that is very unpleasant, we'd
Jennifer Smith, CDE 11:05
have to find a greater ologists, I think.
Scott Benner 11:09
I'll tell you what, if my life gets down to that, Jenny, I'm not, I can't do this anymore. That's fine. I'm trying to outline the fact that I think that if I don't get Arden straightened out, and everybody else doesn't just stay healthy for five minutes, I'm gonna like light my underwear on fire and start running around the streets much longer.
Jennifer Smith, CDE 11:36
Everybody just needs to well, and what it actually goes along with something that I It sounds like you really found a quite good physician, because a lot of what she was telling you about the quality of food, I mean, it's the big reason that I take or spend the extra to buy non farm raised fish, okay, because the difference between farm raised salmon and actual wild salmon, there's a major difference. If you look at farm raised salmon, and you look at the package, you will see color added that color is added because they haven't been being fed the wide diet that they would eat in the wild to actually get the quality or megas that your body the benefit of eating salmon or tuna is for the omegas which in your daughter's case, the doctor was like, hey, you need more omegas right? Well, don't buy farm raised fish then because that's not going to help her anymore.
Scott Benner 12:38
I want to say too, she spent a lot of time showing us how to read labels on supplements, vitamins, and she said there are overwhelmingly more useless vitamins on the market, then, you know, she's like, and they're very good at marketing it to make it sound like they're good, but she's like there's nothing in them. It's just a it's just a waste of your money.
Jennifer Smith, CDE 12:59
So my original naturopath when I saw her years ago, um, she actually did the same thing. What supplements are you using? How are you using them, and she actually recommended very minimal list of quality, just multivitamins, and at that time I had needed to start taking like a prenatal vitamin, right in terms of preparation for getting pregnant. And she was like these are the ones and don't pick outside of those this list. These are quality they come actually the nutrients come from real food sources, not from synthetic something something she's like otherwise you paying for a bottle of what's actually getting peed out into the toilet.
Scott Benner 13:39
He also told me that the real popular vitamins that people know are good get knocked off online, so you have to be careful about even buying them from Amazon. And what else did she say? Oh yeah, anything that you can absorb to the lining of your mouth is preferable over swallowing it. So she gave Arden vitamin D drops instead of like sardines, one of those people that takes 50,000 I use a vitamin D a week, like once a week. And she's like No, she's like, just do these drops instead.
Jennifer Smith, CDE 14:07
Again, it goes back to the gut and absorption and they know very well that the gut and absorption and people who have type one is lacking. My my naturopath did the same thing. My vitamin D was 18 Yeah, the doctor had given me a supplement, huge dose like pills, supplements. And he was like, I don't know I started seeing a naturopath. She said you need to drop you need to put it under your tongue every single day, get things retested in eight weeks and come back and they were up already.
Scott Benner 14:38
You know, it's funny I'll add here before we end this one and move on to the next that if you would have found me before Arden had type one diabetes and before I knew anything about all this stuff, and had this conversation with me, I would have said oh I met a hippie lady today that was talking about vitamins and how they're not all the same and you know, you got to take vitamin D under Your tongue and I think she was high on the weed is what I would have thought, you know, they mean like, oh well, lovely cookie woman, you know, but now I know you're not cookie, and I'm not either. Thank you. So there's way more to this than, than most people would think, Oh, just just getting your supplements, right? It's not coming from your food. I mean, everybody, look when this is over today, take five minutes, close your eyes, be honest with yourself and think about what you've eaten this week. And tell me if there's food in any of it. Or if you're just keeping yourself alive and not nurturing yourself. You know, so I, I was on a road trip yesterday. I got up very early in the morning, I did not feel like eating, I drove a couple of 100 miles. I saw my son, I drove a couple of 100 miles back, I drank two bottles of water in the morning. I peed in a sketchy rest stop. I went to get my son. We went to lunch, where we went to a English pub, and I had fish and chips. So I had cod, probably not deep fried, but I stay away from the oil. So I picked all the breading off of it. And then I had fries and a little bit of ketchup. And then I got in a car and drove home and ate a peppermint patty, because that's what I could find it a rest stop. And then I got home and that is what I'd eaten that day. You know, and if you asked me, How do I eat? I'd probably say I'm fine. Because the day before I didn't eat well, but I didn't. I didn't on Sunday. And you really do have to start asking yourself, Am I I'm fueling myself and I'm not hungry, and I'm staying alive. But am I bringing in the nutrition that my body actually needs to maintain itself and to rebuild itself from problems? You know, and I think for most of us, I really I hate to say it, I'm not coming down on people. I think most of us, I don't think we do really?
Jennifer Smith, CDE 16:53
Right? Well, and I think if you ask many people who have enough resources and whatnot to actually have enough food in their life, it's quantity of food seems enough. So they would say yes, I'm well fed. Well, what's the quality? Not the quantity of what you're eating? Because quite honestly, here in our United States, we have enough quantity,
Scott Benner 17:19
right? It's almost hard to go hungry at this point. Yeah.
Jennifer Smith, CDE 17:23
So you know, and I mean, there are certainly people who do struggle for enough. But even them unfortunately, what they can have then access to doesn't have a quality piece to it. It's what they can have is what they can have, because this is what's affordable. And unfortunately, there's not much quality there.
Scott Benner 17:47
Yeah, no, I mean, if you are a person who's listening to this in the hopes of fine tuning your health, there's nothing in a Dorito that's going to help with that, I guess is the message. Even though I will say this of all the longtime foods from my childhood, the junk foods, Doritos has done the best job of keeping the experience of a Dorito the same as it was 20 years ago. Here's a short list of people who have not Fruity Pebbles, Apple Jacks, just using. There are some junk foods that people have just messed up over the years. For funny, Fruity Pebbles is my biggest disappointment. Jenny's like I don't know what a fruity Pebble is that? I'm not eating it.
Jennifer Smith, CDE 18:26
I don't Well, the funny thing is I do but we didn't have we didn't have those. I think I've had 30 pebbles, maybe once in my life. And it was just because my parents just didn't buy that kind of stuff. If we did have cereal, it was way way up camping. And it was like honey nut cheerios, right. I mean, that was like, and I mean, it still has sugar added to it. Obviously it's still you know what it is? But yeah, I think we just we didn't get that kind of stuff. I was actually talking to somebody the other day and I were talking about like kids and what they eat and whatever and it was like my children have never been enough Donald's
Unknown Speaker 19:05
like we can pass and Donald's and there is no Mama Mama Mama.
Jennifer Smith, CDE 19:11
They don't really I mean, my nine year old now obviously knows what it is but he would have no desire to stop there. Because we just don't that's not a regular thing for us to do.
Scott Benner 19:23
Yeah, in my house. It was soccer because Kelly did not did not want our children to play soccer we gave them no context for when they were growing up. I know I've told this story before but it I don't think to me that's interesting. We bears it bears repeating because you can you can impact how your children go up and what they think to do and what they think to don't do you know, food being the example but when my son was like two or three years old, we were stopped at a traffic light and there was a men's league and they were playing soccer. I'm talking about like hundreds of people spread out over five soccer fields. My son says, Mommy, what are they doing? And Kelly looks out the window and looks back and goes I have No idea and the light turned green. And we drove away. Because Kelly's sisters played soccer growing up, and Kelly hated going to soccer games. Ah, she's like I didn't, she didn't want to have a kid who played soccer. So we just didn't tell him what it was. And he just didn't, he never asked about it. And that that was it. And I, I'm dialing that back to your, you can, you can move your children in the right direction with a lot of different things. Even taking a supplement every day, you know, like just a multivitamin. You can make that part of their life to the point where they get older, they just, they just do it. You know, because not every older kid just you know, if you you realize when you're 20 years old, you need a a multivitamin or something. It's not going to be easy to get everyone to integrate that into their life. You know, most people are gonna have a hard time adding things as adults. So,
Jennifer Smith, CDE 20:52
right. I mean, even my five year old can go to the refrigerator and pick something like he'll often want and want to do it himself. An apple cut up with peanut butter. That's like his favorite thing ever. He can he make his own egg salad. I think it's pretty awesome. It's not pretty. And it certainly is kind of messy on the counter. But you know what? He can make his own eggs
Scott Benner 21:16
to do it. Well, that's, that's the, that's the takeaway from this one is you can make decisions about how you eat and how you get. There you go. Alright, Jen, do we have time for one more? Yeah, absolutely. If you're tired of injecting your insulin with a pen, or a syringe, or you have a pump with all kinds of crazy tubing attached to it, that you really don't like, this next bit is for you.
The Omni pod tubeless insulin pump does not have any tubing. That's why they call it tubeless. I know you're thinking that's not possible. But it is Omni pod doesn't have tubing. Other insulin pumps have a controller with a cartridge, connected the tubing that kind of you know, goes all over the place to an infusion set. And then that's how you get your insulin through that long tube. But with Ali pod, there is no tubing, no tubing to get caught on door handles. And nothing to disconnect when you're bathing or swimming. Because the Omni pod is, you know, it's happy in the water. You can go in the bathtub, in the shower in the local lake. You can go wherever you want wearing your Omni pod tubeless insulin pump. That's pretty important because then you don't lose your insulin during those times. How many of you have disconnected for a shower only to forget to reconnect to your tubed insulin pump? When do you find out an hour or two later when your blood sugar's sky high? Because you haven't had any insulin for a while. Why? Because you had to disconnect for a shower. That shouldn't be the way and with Omni pod it isn't. Now if this all sounds magical or different to you, and you're not sure what to do, I understand that, but you may be eligible for a free 30 day trial of the Omni pod dash. Now go to Omni pod.com forward slash juicebox to find out. If you're eligible, Omni pod, we'll send you a free 30 day supply. You can check it out and see what you think. And even if you decide to stick with what you're doing after the trial, you still got our free 30 days. How often you get a free month of anything. So the Omni pod dash is tubeless it's waterproof, you can shower with it, or you know swimming the pool. Right the pool the pool. Are you thinking about summer I just made me think about summer. It's not here yet kids slipped through this cold a little longer anyway. swim in the pool. Don't get your tubing caught anything, don't have any tubing to be sneaking through your clothing. It's all pretty great. And no multiple daily injections. With the Omni pod, you just pull out the PDM that's the personal diabetes manager's little handheld device kind of looks like a cell phone. And you you just say I'm gonna have 12 carbs, he talks a little thing 12 carbs and says I think you should have this much insulin, you know, based on your settings and you go okay, push a button and boom, boom, here comes the insulin. No injections. I love it. Now you might be thinking, Alright, Scott, I want it on the pod but I've been hearing about this Omni pod five, and I'm just gonna wait for that. Hmm, I would say in a normal circumstance, I understand. But with the Omni pod promise, you don't have to do that. Here's what the Omni pod promise says. You get the Omni pod dash today. And you start using it and you love it. And then I don't know, a month from now two months from now whenever Omni pod five is available for you and covered by your insurance. You just move up to the Omni pod five. That's the Omni pod promise. The Omni pod promise says you can go to new technology that Omni pod has, when it's available to you and covered by your insurance. That's it, you want to change, you can change. That's a pretty good promise on the pod.com forward slash juice box, you might as well go poke around on the website and figure it out a little bit. See if you're up for it. Check to see if you know you're eligible for that free trial and get started today. Omni pod.com forward slash juice box. There are links in the show notes of your podcast player and at Juicebox Podcast comm to Omnipod and all of the sponsors
if you're wondering what signs and symptoms to look for in hypothyroidism, hyperthyroidism, Graves' disease, and Hashimotos, I'm going to list them all for you right now. If you already know what they are. Well then thanks so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. But if you're waiting for the signs and symptoms they're gonna happen like right now. symptoms of hypothyroidism Farey the Mayo Clinic list of possible symptoms such as fatigue, increased sensitivity to cold constipation, dry skin, weight gain, puffy face, hoarseness, muscle weakness, elevated blood cholesterol level, muscle aches, tenderness and stiffness, pain stiffness or swelling in your joints heavier than normal or irregular menstrual periods. thinning hair slow heart rate depression impaired memory enlarged thyroid gland, which could be known as a goiter. If you're looking for this in infants, you might also look for a large protruding tongue difficulty breathing, hoarse, crying, an umbilical hernia, or yellowing of the skin and whites of the eyes. As the disease progresses in infants, you may also notice constipation, poor muscle tone and excessive sleepiness. In teens, you may notice poor growth resulting in short stature, delayed development of permanent teeth, delayed puberty were poor mental development. Let's move on to hyperthyroidism. Still on the Mayo Clinic's website, they say of course, that hyperthyroidism can mimic other health problems. We've been talking about this through all these episodes, you know that unintentional weight loss even when your appetite and food intake stay the same? We're increase, rapid heartbeat, irregular heartbeat, pounding of your heart, increased appetite, nervousness, anxiety, and irritability. Tremors, usually a fine trembling in your hands or fingers, sweating changes in menstrual patterns, increase sensitivity he changes in bowel patterns, especially more frequent bowel movements, and enlarged thyroid gland of course called a goiter, which may appear a swelling at the base of your neck, fatigue, muscle weakness, difficulty sleeping, skin thinning, fine embrittle hair. For Graves disease, you're looking for dry eyes, red or swollen eyes, excessive tearing or discomfort in one or both eyes, light sensitivity, blurred or double vision, inflammation or reduced eyes movement, protruding eyeballs just quickly Hashimotos disease which as we know is an autoimmune version of hypothyroidism. Hashimotos disease progresses slowly over the years you may not notice signs or symptoms of the disease eventually the decline in thyroid hormone production can result in a the following. There going to be a lot of duplicates here from hypothyroidism, fatigue and sluggishness, increased sensitivity to cold increase sleepiness, dry skin, constipation, muscle weakness, muscle aches, tenderness and stiffness, joint pain and stiffness, irregular or excessive menstrual bleeding, depression, problems with memory or concentration, swelling of the thyroid, the goiter of puffy face, brittle nails, hair loss, enlargement of the tongue. I'd like to just finish by saying that if you have any of these, please see a doctor get a simple blood test and get yourself some answers. Don't forget a TSH over two is enough reason to be concerned. Treat your symptoms, not the lab values. Thanks again for listening. I'll be back very soon with another episode of The Juicebox Podcast.
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