Goitre related to hypermetabolism, (increased metabolism), excessive thyroid hormone, an increase in oxygen consumption, metabolic changes in protein metabolism, immunologic stimulation of diffuse goitre, and ocular changes (exophthalmos). Hypothyroid individuals may have weight gain despite poor appetite, cold intolerance, constipation and lethargy. However, these symptoms are often non-specific and make diagnosis difficult. A goitre may be classified either as nodular or diffuse. Nodular goitres are either of one nodule (uninodular) or of multiple nodules (multinodular). Worldwide, the most common cause for goitre is iodine deficiency, usually seen in countries that do not use iodized salt. Selenium deficiency is also considered a
Pseudo-goitre Pseudo-goitre Pseudo-goitre is the apparent fullness of the front part of the neck. It may be mistakenly diagnosed as thyroid enlargement. The cause for pseudogoitre can be fat tissue of the neck, cervical lordosis, cervical masses (such as cervical lymphadenopathy, branchial cleft cyst, pharyngeal diverticulum) or high lying thyroid or trachea. Pseudogoitre due to cervical lordosis (swan shaped-neck) is called Modigliani syndrome after the artist Amedeo Modigliani, who was famous for painting women with exaggerated curved neck. Pseudogoitre can be distinguished from other disease conditions of the neck by physical examination. Normal thyroid moves up with swallowing, and any structure