Toxic Nodular Goiter – Causes, Symptoms, Diagnosis, And Treatment
What is a toxic nodular goiter?
Goiter is defined as an enlarged thyroid for any reason. If there is a nodule in the goiter, it is referred to as a nodular goiter. A nodule is an abnormal growth of tissue in the thyroid gland. If there are two or more nodules, it is called a multinodular goiter. Toxic nodular goiter refers to a multinodular goiter that causes hyperthyroidism. Hyperthyroidism refers to overactive thyroid producing excessive thyroid hormone. When this condition occurs, one or more nodules within the goiter produce too much thyroid hormone, resulting in the overactive thyroid (hyperthyroidism).
Toxic multinodular goiter mostly occurs in older adults, more so in women. This disorder is rare in children. It is the second most common cause of overactive thyroid (hyperthyroidism).
What causes toxic nodular goiter?
What causes toxic nodular goiter is not known to doctors most of the time. What is known is this condition starts from an existing simple goiter. Most people who develop toxic nodular goiter have had a goiter with nodules for many years.
Toxic nodular goiter is also caused by taking in a large amount of iodine through the mouth (orally) or intravenously (through a vein). The iodine is usually used as contrast for a CT scan or heart catheterization. Taking medicines that contain iodine, such as amiodarone, may also cause this disorder.
Risk factors include being female and over 55 years old.
What are the symptoms of toxic nodular goiter?
Symptoms of toxic nodular goiter are the same as those of an overactive thyroid gland (hyperthyroidism).
One or more of the following symptoms may occur with toxic nodular goiter:
- Heat intolerance
- Muscle cramps
- Increased appetite
- Frequent bowel movements
- Increased sweating
- Irregular menstrual period (in women)
- Weight loss
How is toxic nodular goiter diagnosed?
The doctor will perform a physical exam and review the symptoms. The physical examination may reveal one or more nodules in the thyroid. The exam may also show a rapid heart rate.
The doctor may order the following tests to diagnose toxic nodular goiter:
- Serum TSH (thyroid stimulating hormone)
- Serum thyroid hormone levels (T3, T4)
- Thyroid ultrasound
- Radioactive iodine uptake or thyroid uptake and scan
How is toxic nodular goiter treated?
Treatment of toxic nodular goiter depends on the size of the goiter and the symptoms. Treatments include watchful waiting, antithyroid medications, radioactive iodine, or surgery.
Your doctor may prescribe a beta-blocker, such as propranolol to control some of the symptoms of hyperthyroidism. Drugs that block or change how the thyroid gland uses iodine may also be prescribed. These drugs may be prescribed to control the overactive thyroid gland before surgery or radioiodine therapy or as a long-term treatment.
Your doctor may recommend radioactive iodine therapy to shrink the goiter and control hyperthyroidism. Radioactive iodine is given by mouth.
Your doctor may recommend surgery to partially or totally remove the thyroid. Surgery is generally recommended if the goiter is very large, if it is causing symptoms, or if thyroid cancer is present. Surgery is also an option if urgent treatment is needed due to severe symptoms, such as problems with breathing or swallowing.
This feature is for informational purposes only and is not intended to substitute the expert guidance of a doctor. We advise seeing a doctor if you have any health concerns.