A 14-year-old girl noticed gradual neck enlargement during the past 8 months. On physical examination, her thyroid gland is diffusely enlarged. Her serum TSH level is normal. A dietary history is most likely to reveal that she has begun eating more of which of the following foods?
She has developed a sporadic goiter. Vegetables of the Brassicaceae family, including cabbage, turnips, and Brussels sprouts, contain glucosinolate, which can decompose to release thiocyanate, a by-product that interferes with thyroid hormone synthesis. Thus such substances are known as goitrogens. Young persons with increased demand for thyroid hormones are at increased risk. Fava beans contain oxidizing agents that incite hemolysis in persons with glucose-6-phosphate dehydrogenase (G6PD) deficiency. In addition, beans contain long-chain sugars that are indigestible with human intestinal enzymes, leaving them to be fermented by colonic bacteria that release gas (flatus). Fish have omega-3 fatty acids that protect against atherogenesis. Plantains are starchy, as anyone mistaking them for sweet bananas soon discovers; rare food allergy develops to them. Fungus growing on moldy rye produces ergot poisoning.
Cabbage
Fava beans
Fish
Plantains
Endocrine