Symptoms
It is difficult to recognise the first symptoms of goitre because they are of a very short duration. They usually appear as emotional upsets and can pass almost unnoticed. These spells of emotional upsets gradually increase in duration, when other symptoms also appear. These include loss of power of concentration, depression and weeping. The patient appears to be very easily irritated. The approach of a nervous breakdown is often suspended.
The thyroid gland may swell but this has no relation to the severity of the ailment because many serious cases have practically no visible swelling. There is always a rapid though regular heart beat and any undue excitement increases this to a quick pulsation which may even be conveyed to the thyroid gland. There is, in most cases, a tremor of the hands and a feeling of extreme tiredness, together with a lack of power to make any real muscular effort. The eyes may incline to protrude although this does not appear in all patients.
A most alarming symptoms of goitre is the loss of weight which no treatment seems to check, and this can persist till the patient feels extremely weak. All the symptoms appear very gradually and that is why so many women do not complain until the trouble has reached serious proportions.
Whenever goitre occurs, it must not be assumed that it is sudden flaring up because disease is not an abrupt derangement of a healthy system nor a sign that there has been a gradual loss of health. In practically every instance a bowel is clogged and there has been a slow poisoning of the entire system over a period of years.

Causes
Deficiency of iodine in the diet is the most common cause of goitre. The thyroid gland makes use of organic iodine in its secretion and a diet deficient in organic iodine is a predisposing factor towards the appearance of this disease incertain cases, especially if other physical and emotional disturbances are present.
People living near the sea rarely contract goitre, because all sea foods are rich in organic iodine. It should, however, be concluded from this that fish and other sea foods are essential to the diet to avoid goitre, or that people who eat plenty of fish are necessarily immune from this disease. IN fact, organic iodine is present in practically all foods which come from the earth as well as from the sea. Goitre gradually affects those who habitually live on denatured, that is cooked and refined foods, and not those who eat much of their food in the raw or uncooked state.

Treatment
The only real treatment for goitre is cleaning of the system and adopting of a rational dietary thereafter, combined with adequate rest and relaxation. To begin with, juices of fruits such as orange, apple, pineapple and grapes may be taken every two or three hours from 8 a.m. to 8 p.m. for five days. The bowels should be cleansed daily with lukewarm water.
After the juice fast, the patient may spend a further three days on fruits and milk, taking three meals a day of juicy fruits, such as apple, pineapple, grapes, papaya , with a glass of milk, at five hourly intervals. Thereafter, a balanced diet on the following line may be adopted.

Breakfast : Fresh acid foods such as apples, grapefruit, oranges, pears, grapes, a glass of whole milk and a handful of raw nuts.

Mid-morning : A glass of fruit or vegetable juice to which a table- spoon of yeast has been added.

Lunch : Steamed vegetables, whole wheat chappatis and a glass of buttermilk.

Mid-afternoon : A glass of milk or fruit juice.

Dinner : Vegetable soup, a large bowl of salad of raw vegetables in season such as lettuce, tomato, cabbage, carrot, turnips and celery, sprouts such as alfalfa seeds and mung beans and home made cottage cheese or nuts.

Before retiring : Milk or fruit juice.

The patient should take plenty of rest and spend a day in bed every week for the first two months of the treatment. More and more exercise should be taken after the symptoms subside. The appetite of the thyroid patient is usually very large and the weight reduction cannot be prevented for some time. This is because until the heart beat slows down and the tremors stop, there will be incomplete assimilation of the food. But as soon as the balance is restored, weight will slowly increase. To held the absorption of food, a narrow waist compress and, later , a neck compress should be worn for five nights a week.
As weight increases, the almost constant hunger will gradually disappear ; on no account should any stimulants be administered to create an appetite.
Certain foods and fluids are extremely injurious to the goitre patients and this should be avoided by them. These include white flour products, white sugar, flesh foods, fried or greasy foods, preserves, condiments, tea, coffee and alcohol. No drugs should be taken as they cause irritation in the tissues. Iodine is undoubtedly most helpful in many cases. But it should be introduced in organic form. All foods containing iodine should be taken liberally. These are asparagus, cabbage, carrots, garlic, onion, oats, pineapple, whole rice, tomatoes, watercress, and strawberries.
Great care must be taken never to allow the body to become exhausted and any irritation likely to cause emotional upset should be avoided. The cure of goitre is not a speed one and there is often a recurrence of symptoms but these should gradually become less pronounced. Strict adherence to a suitable diet is essential for complete cure.
Half the daily intake of food should consist of fresh fruits and vegetables and the starch elements should be confined to whole wheat products and potatoes. Potatoes are the most valuable form of starch. They should preferably be taken in their jackets. The protein foods should be confined to eggs, cheese, peas, beans , lentils and nuts. Milk and all flesh proteins must be avoided. The diet outlines here should be strictly adhered to for a year, and the compresses on the neck and the waist applied for five consecutive nights in a week for two months and discontinued for one month.
Water treatments should be taken to increase skin elimination. Application of a sponge to the entire body before retiring and a cold sponge on rising will be very helpful. It is most important that the bowels are kept working efficiently to avoid danger of a toxic condition of the blood arising from that source.
All efforts should be made to prevent emotional stress. There may be a light recurrence of this extremely nervous complaint for some time, but the attacks will become less severe and of shorter duration as the treatment progresses. And above all, there must be no lessening of the woman’s efforts to help herself because success can only be attained by assiduous effort.

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