What causes toxic multinodular goiter?

Toxic nodular goiter arises from a long-standing simple goiter and occurs most often in the elderly. Symptoms are those of hyperthyroidism, but the protruding eyeballs seen in Graves’ disease do not occur. Risk factors include being female and over 60 years old.

What are the signs and symptoms of toxic goiter?

Symptoms

• Fatigue.
• Frequent bowel movements.
• Heat intolerance.
• Increased appetite.
• Increased sweating.
• Irregular menstrual period (in women)
• Muscle cramps.
• Nervousness.

What are the symptoms of toxic multinodular goitre?

Symptoms of multinodular goiter If you have a toxic multinodular goiter, which makes too much thyroid hormone, you might have symptoms of hyperthyroidism. These include: sudden and unexplained weight loss. rapid heartbeat.

How do you treat a multinodular goiter?

Treatment

1. Radioiodine therapy. One treatment for both toxic and non-toxic goiters is radioiodine therapy.
2. Thyroid medication. If the goiter and its nodules are relatively small in size, a doctor may recommend taking a thyroid hormone medication, such as levothyroxine (Synthroid).
3. Thyroidectomy.

Should a multinodular goiter be removed?

Most patients need no treatment. Occasionally, surgery to remove all or most of the thyroid can be carried out, particularly if a multinodular goitre is large and the patient feels it is unsightly. However, removing a normally functioning gland can leave a patient requiring thyroxine for life.

Is toxic multinodular goiter an autoimmune disease?

Toxic multinodular goiter: a variant of autoimmune hyperthyroidism.

Is toxic multinodular goiter painful?

Less commonly, multinodular goitre can cause pain or discomfort from a rapid increase in size. This may be due to a sudden build-up of fluid or blood within a nodule or, very rarely, due to a tumour.

How is toxic multinodular goitre diagnosed?

Diagnostic investigations

1. free T4 (or total T4 with measure of binding)
2. total T3 with a measure of binding (or free T3)
3. I-123 thyroid scan and uptake.
4. Tc-99 pertechnetate scan.
5. thyroid ultrasound.
6. metabolic panel.
7. FBC.
8. thyroid peroxidase antibodies.

How do you treat a non toxic multinodular goiter?

The goiter, if significant in size, should be removed surgically. The currently available therapies include thyroidectomy, radioactive iodine therapy, and levothyroxine (L-thyroxine, or T4) therapy. Radioactive iodine therapy – Radioiodine therapy of nontoxic goiters is often performed in Europe.

What is the best treatment for multinodular toxic goiter?

Hyperthyroidism from toxic multinodular goiter and toxic adenoma is permanent and usually occurs in adults. After normalization of thyroid function with antithyroid medications, radioactive iodine ablation usually is recommended as the definitive therapy.