Toxic Nodular Goitre

Overview

Toxic Nodular Goiter is where a thyroid gland contains hyperfunctioning thyroid nodules. There can be either a single hyperfunctioning nodule within a multinodular thyroid gland or there can be multiple areas of hyperfunction in a normal looking gland. This results in hyperthyroidism.

Signs and Symptoms

Swelling in the neck (goitre), Irregular or rapid heartbeat, Irritability, Increased sweating, Hand tremors, Anxiety or nervousness, Fine brittle hair, Muscle weakness, Diarrhea, Weight loss, Irregular menstrual period in women, Intolerant to heat, Obstructive symptoms such as difficulty swallowing, difficulty breathing, wheezing, Voice changes

Common Causes

Iodine deficiency

Risk Factors

Positive family history, Female gender, Age more than 40 years old, Previous goiter, elderly and endemic iodine deficiency, History of head and neck irradiation

Investigation Techniques

Thyroid function test including serum thyroid stimulating hormone (TSH) levels, Thyroid autoantibodies, Radioiodine uptake test, Ultrasound of thyroid gland, Full blood count, Fine Needle Aspiration Cytology

Treatment and Prevention

Antithyroid medications (Thioamides) and beta blockers, Radioactive iodine, Thyroidectomy, Avoidance of iodine rich foods