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Bama

Goiter question

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Bama

One of my wife's older nieces has developed a goiter. It's not really of any size yet but everyone has seen examples of over sized goiters which can later cause health issues.

Most goiters are caused by a lack of iodine in the diet. Getting more iodine in the diet can be problematic for the poor as the foods that can be helpful here are often too expensive or unavailable or simply unpalatable to local tastes.

An internet search suggests that a medicine called Levothroid can be helpful.Obtaining and taking meds can be problematic for our family members as they tend to be inconsistent in their actions. I have noted a oral med that can be taken that lasts for one year and an injection that lasts for 3 years. Since I'm paying for it my preference would be the oral or inject-able meds noted above.

Does anyone have any history with these treatment options ? Are there other options out there that I'm not aware of? Could a barrio clinic be helpful here?

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RangerUp
2 hours ago, Bama said:

Most goiters are caused by a lack of iodine in the diet. Getting more iodine in the diet can be problematic for the poor as the foods that can be helpful here are often too expensive or unavailable or simply unpalatable to local tastes.

Try the seaweed (guso) it's everywhere.

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Bama
37 minutes ago, RangerUp said:

Try the seaweed (guso) it's everywhere.

Guessing that seaweed would fall into the unpalatable category to them and the closest source would be 20K away.

Edited by Bama

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RangerUp
9 minutes ago, Bama said:

Guessing that seaweed would fall into the unpalatable category to them and the closest source would be 20K away.

It's sold in every market, big mountains of it.

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Jawny

Goiters are not exclusively caused by lack of iodine, though that is common here.  In fact, I recall that salt without iodine added is not supposed to be sold here. A simple blood test can provide a diagnosis of the cause of the goiter. Might cost a few hundred pesos plus a doctor fee ( or free if at public health office). 

 

https://pia.gov.ph/news/articles/1016509

https://www.livingincebuforums.com/topic/41820-non-iodized-salt/

Edited by Jawny
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Woolf

Use more salt  in the food

All salt I have seen in the shops  has added iodine

Edited by Woolf
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lamoe

Lato -Tata feeds me this stuff usually once a week - either in soup, salad, or raw

Put some banana catsup on it :tease:

https://www.philstar.com/business/agriculture/2016/07/03/1598848/lato-nutritious-grapes-sea
 

Quote

 

http://122.53.86.125/Seminar Series/30th/canton.pdf

The canton noodles with “Guso” contains 11% protein and 112 µg iodine/100 g, while canton noodles with “Lato” contains 12% protein and 356 µg iodine/100 g. Consumption of about 30 g of noodles with “Guso” and with “Lato” will provide 22% and 71% of the RENI for iodine of a 30-49 year-old adult.

 

 

image.png.b3af3ca2db0866a579a7d85d39f57038.pngimage.png.2d425c6f1e9f64d9092f473ca57d7258.png

 

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Bama
1 hour ago, RangerUp said:

It's sold in every market, big mountains of it

You might want to look around a bit more before throwing this out there.

Some people don't live anywhere near even modest sized cities that would carry mountains of anything. The farming community that my wife lived in is 20K from a very small market which certainly doesn't have seaweed----often only a modest selection of fish, and a poor offering of vegetables all of which have been brought in from elsewhere with a considerable price markup.

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Woolf

 

Mayo Clinic Q and A: Sea salt and sufficient iodine intake

https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-sea-salt-and-sufficient-iodine-intake/

 

I looked at a bag of sea salt at a fooda store  it stated  iodine added

Edited by Woolf

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RangerUp
1 hour ago, Bama said:

 The farming community that my wife lived in is 20K from a very small market which certainly doesn't have seaweed----often only a modest selection of fish,

If they sell fish it would be very strange if they didn't sell guso...and they sell fish everywhere

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Don.
1 hour ago, Bama said:

You might want to look around a bit more before throwing this out there.

Some people don't live anywhere near even modest sized cities that would carry mountains of anything. The farming community that my wife lived in is 20K from a very small market which certainly doesn't have seaweed----often only a modest selection of fish, and a poor offering of vegetables all of which have been brought in from elsewhere with a considerable price markup.

Is it you, or a family member that is resistant to advice ?

Sometimes when a family member is asking for advice, they really don't want advice, they just want you to send money to take care of the "problem".

 

If the niece really does have a problem, then she probably needs blood tests to choose the correct treatment.

 

I've been taking levothyroxine for years, and she really does need  blood tests for diagnosis, dosage, and follow up verification of efficacy. 

Edited by Don.

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Bama
34 minutes ago, Don. said:

Is it you, or a family member that is resistant to advice ?

Sometimes when a family member is asking for advice, they really don't want advice, they just want you to send money to take care of the "problem".

What advise have I been resistant to exactly? No, I don't have a goiter if that's what you are suggesting.

I have stated repeatedly that seaweed is not available in the farming community that the niece lives in or anywhere else within 20K. I'm pretty sure that the niece isn't in this conversation as she has no internet access.

I'm well aware of the advise/money dynamic here in the PI. You should have been able to see that in my first post that I'm willing to pay for treatment and came here looking for ideas. Instead a extended discussion about seaweed availability breaks out.

She has been tested before and of course let treatment lapse.I was hopeful that someone knew of the 1 year oral meds or the 3 year injectable meds treatment,if available and would comment on it. Do it once and forget it for 1-3 years. 

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Paddy

I have coped with hyperthyroidism for the last 20 years. The meds I have used in that time can also be used to treat goiter (propylthyrioucil, tapazole). Thyroxine supplements are for hypothyroidism and can also treat goiter. Best to do a simple blood test first - at least TSH (=0 - hyper, >normal = hypo). 

The specialists I have been treated by have never suggested a magic fire and forget injection for my condition but that doesn’t mean to say it doesn’t exist for the opposite condition.

However, I do have experience of such a thing for a completely different condition. The pills, while effective, had mind changing side effects. The specialist suggested an injection - good for about 6 months. I was discouraged from taking more than 2 of those injections because 1. The specialist wouldn’t do a third and 2. He refused with a severe look of “worry” on his face and also sucking of teeth.

Another thing the thyroid specialists have said is that there is no cure for a thyroid condition, it has to heal itself. The drugs are used to control the situation in the meantime.

The niece needs educating about diet and consistency with medications if she ever wants to be free of the goiter (or doesn’t want to suffer the potential nasty complications of one). 

I realize it may not be realistic or possible in her area, but she really should be under the care of a specialist (or at least a doctor) while being treated with any meds - especially any “fancy” ones.

Sorry for the long post. 

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Bama
3 hours ago, Paddy said:

Sorry for the long post. 

No, thank you for injecting something constructive to the conversion.

Niece is off to the doctor today seeking tests/treatment as required.We gave her a list of questions to ask the doctor about possible treatments such as oral or injectable medicines,etc if available. Typically when the locals finally meet the doctor they clam up and leave with more questions than when they got there. Maybe the list will help.

4 hours ago, Paddy said:

The niece needs educating about diet and consistency with medications if she ever wants to be free of the goiter (or doesn’t want to suffer the potential nasty complications of one). 

She seems to understand the diet situation but I can see little of what she can do about it.Rice is always available but most everything else is purchased from motorcycle vendors or out of a sara sara store.The locals could grow veggies but most are too lazy to keep at it. Once their "garden" satisfies a 4Ps requirement it is allowed to go seed and is quickly forgotten. Poking around a bit I'm starting to suspect that a lot of the salt that is being sold isn't iodized.Was told that in the T Town markets that you can buy iodized or not iodized salt with the former costing more money. If you are buying it for resale in a sara sara store would guess that the cheaper variety would be the favored option.Will look into further.

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Paddy
18 hours ago, Bama said:

Typically when the locals finally meet the doctor they clam up and leave with more questions than when they got there. Maybe the list will help.

Yes, but will she write down the answers 😄

I’m glad she’s off to the doc at least. 

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