ABSTRACT
The aetiology of benign pathological goitre can be broadly split into environmental and genetic factors, although these rarely exist in isolation and a thorough understanding of each is therefore essential. Although multiple genes have been identified that predispose to goitre formation, the majority of cases will be polygenic and heavily influenced by the environmental factors. These factors, inherent and exogenous all feed into the pathogenic model for goitre formation. Iodine deficiency is the biggest contributor to goitre. Tobacco smoking is another major risk factor for goitre development and is most marked in iodine deficient populations. Selenium, like iodine, is necessary for thyroid hormone synthesis although to a much smaller degree. While intuitively it may be thought that the oral contraceptive pill (OCP) would be a risk factor for goitre development, the converse appears to be true. Further understanding of the interplay between the metabolic syndrome and goitre formation, especially in view of the worldwide rise in obesity.
