Memleketimizdeki Endemik Guvatr Vak’alarının Etiyopatogenezinde Rol Oynayan Guvatrojen Faktörler

Endemic goiter arises from two converging mechanisms: increased thyroid-stimulating hormone (TSH) secretion due to higher thyroid hormone demand and factors impairing thyroid hormone synthesis. In a series of 708 Turkish patients, regions with high goiter prevalence were mapped and goitrogenic elements investigated. Beyond classical iodine deficiency, goitrogenic plants (e.g., cabbage), excessive calcium intake, fluoride exposure, and subclinical vitamin A deficiency emerged as contributors to hormonogenesis failure. Demographic analysis highlighted peaks during puberty, pregnancy, and emotional stress, while congenital defects played a minor role. These findings underscore the multifactorial nature of endemic goiter in Turkey and suggest that legislation and public health measures must address goitrogenic dietary components alongside iodine prophylaxis.

This study analyzes 708 cases of simple endemic goiter seen at Ankara University Faculty of Medicine to identify factors driving its development. Two main mechanisms were examined: increased thyroid hormone demand during puberty, pregnancy, lactation and emotional stress, and inhibition of hormone synthesis by environmental and nutritional goitrogens. Key inhibitory factors included iodine deficiency, thyroid‐blocking plants (e.g., cabbage), vitamin A deficiency, excessive calcium intake and fluoride exposure. Regional epidemiology, age‐sex distribution and survey data revealed that non‐iodine goitrogenic factors play a substantial role alongside iodine insufficiency in our endemic areas.