El bocio es el agrandamiento del tiroides, glándula ubicada en la parte delantera del cuello y secretora de las hormonas tiroideas.
Las hormonas T4 y T3, segregadas por el tiroides, son absolutamente necesarias para el buen funcionamiento metabólico y del organismo en general. Sin embargo, la existencia de bocio no implica necesariamente que la glándula funcione mal y puede convivir con unas hormonas tiroideas normales.
En otros casos el bocio puede ir acompañado de hipotiroidismo (hormonas tiroideas bajas) o hipertiroidismo (elevadas). Según sus características el bocio puede ser difuso, determinado por un aumento global y regular de la glándula, o nodular, provocando un agrandamiento focal de la glándula y dando lugar al desarrollo de uno o varios nódulos.
¿Cuáles son los síntomas del bocio?
-La característica principal y en ocasiones único síntoma es la hinchazón o bulto en la parte anterior del cuello.
-Pero si el crecimiento del tiroides es importante, puede afectar a otras estructuras vecinas como la tráquea o el esófago y provocar ronquera, afonía, dificultad para deglutir o para respirar.
-Si la función tiroidea se ve comprometida aparecerán otras manifestaciones: aceleración del pulso, sudoración, nerviosismo, cansancio, o pérdida de peso si existe hipertiroidismo o intolerancia al frío, cansancio, piel seca, caída del cabello, voz ronca o lentitud mental (en pacientes con hipotiroidismo).
Diagnóstico en 3 claves
- El diagnóstico se puede establecer simplemente con la inspección o palpación del cuello.
- Se puede recurrir a la ecografía que establecerá si el bocio es difuso o nodular y, en este caso, si es susceptible de malignidad y necesita ser estudiado.
- Será necesario conocer cómo funciona el tiroides a través de un análisis de sangre que determine las hormonas tiroideas.
¿Cómo se trata?
El tratamiento depende de la causa del bocio, sus síntomas y el tamaño de este. Si el bocio es pequeño y la tiroides funciona con normalidad, únicamente requerirá revisiones periódicas.
Tanto el tiroides hipoactivo como el hiperactivo se tratan con medicamentos. Este último además puede requerir de la administración de yodo radioactivo o de una tiroidectomía, intervención que consiste en la extracción de toda o una parte de la glándula. La cirugía puede recomendarse también en el caso de un bocio grande que causa problemas respiratorios o de deglución, nódulos o cáncer de la tiroides.
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