In accordance with Proclamation No. 1188 by President Gloria Macapagal-Arroyo declaring every fourth week of January as Goiter Awareness Week, the Philippine Society of Endocrinology and Metabolism (PSEM) recently held a press conference entitled "PSEM and the Public: Working together to fight goiter".

FIGHT GOITER!  Standing firm on their advocacy campaign are (from left) doctors Josephine Carlos-Raboca, Rosa Allyn Sy, Leilani Mercado- Asis, and Gabriel Jasul, Jr..

Gracing the event were, PSEM president Dr. Rosa Allyn Sy, PSEM vice-president Dr. Josephine Carlos-Raboca, PSEM director and committee on advocacy chairman Dr. Gabriel Jasul, Jr., and PSEM director Dr. Leilani Mercado-Asis.

"Goiter or the enlargement of the thyroid gland is considered prevalent in the Philippines. It is common and is still a formidable disease that affects women under reproductive age and school children aged seven years old onwards," says Dr. Jasul.

He continues, "This disease in thyroid glands is classified as an endemic, meaning present or continuously in a community, or sporadic goiter. Its primary symptoms are thyroid enlargement, breathing difficulties, swallowing difficulties from compression of the esophagus, and neck vein distention and dizziness when the arms are raised above the head. Thyroid gland is a butterfly-shaped organ in front of the neck that plays a major role in regulating the body’s metabolism."

"The manifestation of goiter can be diagnosed in two types, as caused by either Hypothyroidism or Hyperthyroidism. Hypothyroidism often result from the failure or inability of the thyroid gland to produce adequate amounts of thyroid hormones while Hyperthyroidism is the result of an over-active thyroid gland with consequent excess or too much secretion of thyroid hormones," he tells.

Based on the studies on urinary iodine levels conducted by the Department of Health, most goiter cases are found in the mountainous provinces and other remote areas of the country, where children and pregnant women are mostly affected.

"Pregnant women and children are prone to goiter because they are in the stage of hormonal changes. Iodine deficiency during pregnancy results in decreased maternal and neonatal thyroid hormone secretion. Adequate amount of thyroid hormone is crucial for brain development in the first and second trimester of pregnancy, however, there are two types, so we need to identify first what is the cause of the goiter before treating," says Dr. Jasul.

In his report, Dr. Jasul stressed that some inland residents may have goiter because of insufficient iodine intake in their diet aside from eating a lot of goitrogenic foods, which are found in cabbage, soybeans, peanuts, peaches, strawberries, spinach, and radishes. Other people living in remote areas are discovered to have goiter because of iron deficiency due to poverty.

"The use of iodized table salt prevents Hypothyroidism, while limiting goitrogenic foods and drugs prevents Hyperthyroidism. We don’t say that you should not eat goitrogenic foods especially vegetables. Goitrogenic foods help thyroid hormones to function normally, but to achieve this purpose, the thyroid hormones must be present in the body in correct amount ― not too little and not too much," he states.

The most common cause of goiter in the country is iron deficiency, but this condition is curable by mass food-supplementation with iodine.

"The government is still addressing the situation by an intensive information drive about the benefits of iodized salt and performing health related programs. The best way to avoid goiter is to eat lot of sea foods, milk and dairy products, bread, and fruits," Dr. Jasul advises.