In conclusion, endemic goiter is preventable and is a public health problem worldwide, affecting 13% of the world's population. Iodination is cost-effective, and although it results in a transient increase in hyperthyroidism, overall the benefits greatly outweigh the risks. Significant progress has been achieved in a global effort in eliminating IDD in the last decade, with 68% of the 5 billion people living in countries with IDD having access to iodized salt. The global rates of goiter, mental retardation, and cretinism are falling.
For established goiters, treatment with thyroid hormone is helpful in some patients in stabilizing or decreasing goiter size. Thyroidectomy becomes indicated for mechanical and cosmetic reasons or because of possible or documented malignancy.
The author is grateful to Mrs. Pat Soong for providing technical assistance in the preparation of the chapter and Ms. Veronica Chan for typing the manuscript.
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