The most common presentation of endemic goiter is

Answer is B (Diffuse Goiter) : 'Euthyroid state is generally the rule' - Robbins Endemic goiter :occurs in geographical areas where the soil, water and food supply contains only low levels of iodine. The lack of the iodine leads to decreased synthesis of thyroid hormones and a compensatory increase in TSH, which in turn leads to follicular cell hyperophy and hyperplasia and goitrous enlargement - Diffuse hyperplastic goitre. 'Euthyroid state is generally the rule' 'Rare patients are hypehyroid'