MANILA -- Maricel Galang, 43, has been battling goiter since she was a teenager. While the disease kept her from doing certain physical activities, it did not keep her from pursuing her passion -- singing in their church's worship team and caring for her family.

"Nalaman ko na mayroon ako nito noong 14 ako. Sa side ng nanay ko, ang pinsan ko mayroon ring ganitong problema. Lahi namin kumbaga (I learned I have this [goiter] when I was 14. On my mother's side, my cousin also has this problem. It's like it's in our blood)," she told the Philippine News Agency (PNA) Wednesday.

Galang shared that living with goiter is a big challenge because it makes her feel tired easily but she doesn't allow the disease to overcome her.

"Nawalan ako ng boses noong 14 to 18 years old ako, pero salamat sa Diyos at umayos ako. Nakakanta pa rin ako sa simbahan pero ang pinakamatagal na pagkanta ko ay isang oras na lang (I lost my voice when I was 14 to 18 years old but thank God that I recovered. I can still sing in the church but not longer than one hour)," she said.

World Health Organization (WHO) Philippines says goiter or iodine deficiency disease is characterized by a swelling in the neck due to the enlarged thyroid gland. (Photo courtesy of WHO K. Bagchi)
Galang is one of 200 million people around the world who suffer from goiter.
Goiter or iodine deficiency disorder (IDD) is the enlargement of the thyroid glands. People who acquire the disease have unusually big lumps on their necks.

Its symptoms include tight feeling in the throat, frequent coughing, hoarseness, difficulty swallowing, and difficulty breathing.
The Philippine Thyroid Diseases' latest study in 2012 showed that goiter has a prevalence rate of 10.12 percent among the adults.

Meanwhile, the 2013 National Nutrition Survey showed that about 5.8 million Filipinos were afflicted with thyroid disorders, such as goiter, thyroid malignancy, mental deficiency, physical deformities, congenital hypothyroidism, cretinism, and reproductive failure.

In a recent health forum, Dr. Clarito Cairo Jr., Department of Health (DOH) Thyroid Disorder Prevention and Control Program Manager, said thyroid disorders affect 8.53 percent of adults, with thyroid cancer being the eighth top cause of cancer cases for both sexes.

"Five out of every 1,000 people could suffer from goiter. Ang mga babae na edad 20 years old pataas ang mas prone sa sakit na iyan (Women aged 20 years old and above are more prone to that disease)," he said.

Apart from iodine deficiency, Cairo said goiter could be inherited or caused by hyperthyroidism or hypothyroidism.

Hyperthyroidism occurs when your thyroid gland is overactive in producing the hormone thyroxine. People with hyperthyroidism have accelerated metabolism, hence, they're underweight despite eating a lot. They also have palpitations, high body temperature and a tendency to get tired easily.

On the other hand, hypothyroidism happens when the thyroid gland does not actively produce thyroid hormones to keep the body running normally.

Galang's goiter was caused by hyperthyroidism.

"Kapag malamig ang panahon sa paligid, nahihirapan lang ako. Parang ako nanghihina, pero kapag nakakainom ako ng gamot ko na Tapdin, umaayos pakiramdam ko at nagkakaroon ako ng lakas ng loob kasi may (When the weather is cold, it is difficult for me. I feel weak, but when I take Tapdin, I feel better and I gain confidence because there is a) sense of protection because of the medicine," she said.

Tapdin is a drug used to treat hyperthyroidism.

Because she is scared that her children might acquire the disease, Galang said she goes through regular consultations to her doctors during pregnancy.

"Hindi ako umiinom ng goiter medications ko kapag nagbubuntis ako. Itinutuloy ko lang kapag nakapanganak na ako tapos kumakain ako ng seafoods gaya ng payo ng doktor ko (I don't take my goiter medications when I'm pregnant. I continue taking it once I give birth, then I eat seafood as per my doctor's advice)," she said.

Cairo said goiter and other thyroid gland disorders could lead to heart disease, infertility, mental health concerns, congenital hypothyroidism, mentally deficient babies, pre-term delivery and miscarriage, and even death among susceptible individuals.

"Para maiwasan ang goiter at ang hypothyrodism and hyperthyrodism, kumain ng pagkaing sagana sa iodine na nakukuha sa dagat, gumamit ng subok na brand ng iodized salt bilang panimpla sa pagkain (To avoid goiter, hypothyrodism and hyperthyrodism, eat iodine-rich food from the sea, and use a trusted brand of iodized salt as food seasoning)," he said.
Department of Health (DOH) Thyroid Disorder Prevention and Control Program Manager Dr. Clarito Cairo Jr. says DOH is pushing for the approval of a national policy on Thyroid Disorder Prevention and Control in line with the Universal Health Care program. (Photo courtesy of Philippine Information Agency Cordillera Administrative Region) 

However, the World Health Organization advised that people must consume less than 500 grams or one teaspoon of iodized salt a day to avoid health problems, which may be caused by too much salt in the body.

Meanwhile, Philippine Thyroid Association president Dr. Wenceslao Llauderes said information drives, such as health forums about the disease, also help in its prevention.

The DOH, together with its health partners from the public and private sectors, is continuously embarking on the information, education and communication activities about the IDD in communities.

Cairo added the National Salt Iodization Program aims to address the IDD issue in the country while the DOH is pushing for the approval of a national policy on Thyroid Disorder Prevention and Control in line with the Universal Health Care program. It will be a comprehensive health care program that covers prevention, screening, diagnosis, treatment and rehabilitation.

In the Philippines, the National Goiter Awareness Week is observed every fourth week of January and this year’s theme is “Goiter Sugpuin, Isip Patalinuhin, Iodized Salt Gamitin”. (PNA)