Iodine deficiency: Iodine deficiency can lead to compensatory hyperplasia of the thyroid gland, which is one of the main causes of endemic goiter, and iodized table salt can prevent goiter. An increase in the body’s need for thyroid hormones can cause relative iodine deficiency, such as during growth and development, pregnancy, lactation, cold, infection, trauma and mental stimulation, which can aggravate or induce goiter. Goiter-causing substances: Some substances containing thiourea goiter-causing substances, which can prevent the synthesis of thyroid hormones, cause goiter. The content of minerals such as calcium, magnesium and zinc in soil and drinking water is also relevant to the occurrence of goiter. Drugs such as potassium thiocyanide, potassium perchlorate, para-aminosalicylic acid, thiouracil, sulfonamides, pautazone, colchicine, etc., can prevent the synthesis and release of thyroxine, thus causing goiter. Hormone synthesis disorders: The causative factor of familial goiter lies in hereditary enzyme defects that cause hormone synthesis disorders, such as lack of peroxidase and deiodinase, which affect the synthesis of thyroxine, or lack of hydrolase, which makes it difficult to separate and release thyroid hormones from thyroglobulin into the blood, all of which can lead to goiter. High iodine: Excessive intake of iodine affects tyrosine iodination, the organic process of iodine is blocked, and the thyroid gland becomes compensatory enlarged. There are more causes of high iodine along the coast, which are related to the intake of more iodine-rich foods, such as: seafood, kelp, and iodized salt. Geographical influences, such as being in high mountains and loss of soil and water, seriously affect the health of the body and lead to the development of thyroid nodules. Thyroid nodules caused by this cause are usually accompanied by phlegm, which can lead to pharyngitis and other serious conditions. Dietary habits: For example, many people live in mountainous areas where there is a lack of iodine, resulting in a lack of iodine in food, and many people have this disease, also known as “endemic goiter. Social pressure is also increasing, which can easily lead to endocrine changes in the body. Patients have a history of neck x-ray exposure in early childhood, as x-rays can cause DNA changes.