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Thyroid effects: Response to ID is enlargement of the thyroid gland. Goiter may appear in preadolescence, and rates may reach 100% when ID is severe. Thyroid nodules occur when ID is severe. While the goiter in itself is harmless, the nodules can cause obstruction of the trachea or impair function of laryngeal nerves. Some increase in cancer rates is suspected to be associated with goiter cases.