Doctors caution residents of South Rift to be wary of goitre

For 15 years, Richard Serem suffered in silence as he tried in vain to treat goitre using herbal medicine.

The 65-year-old experienced pain and persistent coughing, which was also accompanied by fatigue.

“Walking a distance of 100 metres would leave me breathless,” he says.

But today, Serem is enjoying a new lease of life after undergoing thyroid surgery.

“I can walk around my farm without any pain or difficulty in breathing,” he says.

Dr Philip Blasto, a general surgeon at the AIC Litein Mission Hospital, explains that goitre, Greek for neck, is caused by enlarged thyroid gland.

The surgeon say treats at least 20 to 30 goiter patients weekly. "We operate on 12 to 16 goiter patients in a month."

Since 2016 when they started keeping records, the hospital has handled 400 cases.

Dr Betty Langat, the Kericho County Director of Medical Services, says a national study carried out in 1984 indicated that goitre prevalence was highest in Kericho at 55 per cent, followed by Kiambu at 21 per cent and Nairobi 20 per cent. No case was observed in Mombasa.

Dr Blasto cautions that many people with goitre in South Rift could be unaware since they don't have pain or suffer any discomfort.

"Some patients present themself for treatment after 10 to 15 years since they noted the swelling," he says

He says not everyone with goitre requires surgery.

The are three categories of the disease. Some goitre occurs when the thyroid gland produces a few hormones, and requires replacement.

"The second category is the thyroid disease which occurs due to the thyroid gland producing many hormones. The patients require medication to suppress the hormone production," he says.

The patients with such "toxic" disease have prominent eyes, high heart rate and sometimes suffer high blood pressure.

"Though they eat, they lose weight. Women have a problem with their menses and have difficulty in bearing children," says Dr Blasto.

Most patients suffer enlarged thyroid with a normal hormonal profile. The enlargement, he says, maybe in one side of the thyroid or both lobes. The enlargement can be mild, moderate or severe.

"The patients who require surgery are the ones who have enlarged thyroid but produce normal hormones. We have to determine either to remove one side or both sides depending on which side is enlarged," he says.

The bigger the thyroid the longer time it takes to surgically remove. "It can two to three hours to remove a thyroid especially if it has affected both sides of the gland."

Dr Blasto notes that the disease affects all ages, with the hospital having treated teenagers with high hormonal production termed medically as toxic.

Prevention measures

But how can it be prevented.

The surgeon says iodized salt can help.

Dr Langat adds that vegetables such as cabbage, kale and rapeseed contain glucosinolates, compounds that compete with iodine for uptake in the thyroid gland.

Thyroid hormone regulates the rate at which the body uses calories (energy). This affects weight loss or weight gain.

"A major function of the thyroid hormone is in regulating cell growth. Also, the metabolism of proteins, carbohydrates, and lipids during early stages depends on thyroid hormone," says Dr Langat.

Dr Blasto says anyone can conduct thyroid self-examination by taking a glass of water before a mirror. "If you see a large swelling that comes up with swallowing water it could be an indicator of thyroid disease and requires further examination."

Patients have to be tested to determine the category of thyroid disease they are suffering from.