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Toxic multinodular goiter

The toxic nodular goiter is an enlargement of the thyroid gland , with appearance of many nodules inside .

Some of these nodules produce thyroid hormones in large quantities and others do not, but, as a whole, in this disease there is an increase in thyroid function, which results in an increase in the amount of thyroid hormones in the body, that is , a situation of hyperthyroidism .

Multinodular goiter is more frequent in women, and constitutes one of the most frequent causes of hyperthyroidism in elderly people, a period of life for which it is typical.

Causes of Toxic Multinodular Goiter

Sometimes, in geographic areas where there are many cases of goiter, toxic multinodular goiter is a disease that results from a simple goiter , which has appeared many years ago.

In this case, since there is a low production of thyroid hormones in the simple goiter, the thyroid gland increases its function to produce more (feedback mechanism), and the start-up of this mechanism for many years makes multiple appear in the gland. nodules, some of which are already functioning on their own, unresponsive to stimulation by TSH.

There are also non-toxic multinodular goiters , that is, they do not produce a situation of hyperthyroidism, but at a certain point they become toxic, and the cause of this is unknown.

In short, whether by one mechanism or another, the fact is that in toxic multinodular goiter there are, characteristically, many nodules of thyroid tissue that function autonomously , on their own, producing hormones in an uncontrolled way and escaping the control mechanisms that exist, under normal conditions, between the thyroid gland and the rest of the glands with which it is related.

It is this autonomy that is the main characteristic of this disease.

Symptoms of Toxic Multinodular Goiter

Symptoms derived from the increase in thyroid hormones and their action on the tissues.

General alterations

They cannot bear the heat and have excessive sweating, which is why they have hot and humid skin, with an increase in body temperature above normal.

Digestive system

Loss of weight and body fat, with increased appetite, diarrhea, and thirst. Weakness and lack of appetite may also predominate, although it is less frequent.
Nausea and vomiting

Cardiovascular system

Palpitations, rapid and arrhythmic pulse, angina, heart murmurs, increased blood pressure.

It is the predominant and most intense clinic in patients, and can cause heart failure and even serious heart rhythm disorders.

Nervous and muscular system

Muscle weakness and fatigue, hand tremors.

Psychiatric disorders

Irritability, nervousness, emotional instability, insomnia .


Itching, nail injuries, hair loss.

You may also be interested in:   Hashimoto’s Thyroiditis

An important, voluminous goiter appears, which is observed with the naked eye, and if we palpate it, we will detect a large number of nodules of different sizes and different hardness.

How is it diagnosed?

It is usually suspected by the symptoms of hyperthyroidism , especially by the manifestations in the heart, associated with the enlargement of the thyroid gland with palpable nodules, but not in all cases the gland is palpable (it can be located within the rib cage , behind the sternum) the symptoms are not so clear.

The diagnosis should be confirmed with a thyroid hormone test (increased thyroid hormones and decreased TSH) and a thyroid scintigraphy in which iodine uptake is observed in several foci distributed throughout the gland.

Treatment of toxic multinodular goiter

Radioactive iodine treatment is ideal for this disease .

With iodine, the nodules responsible for the uncontrolled hyperthyroidism in the patient’s body will be destroyed.

Large doses of radioactive iodine must be used, due to the lack of control in the functioning of the gland and the need for the treatment to be definitive and radical, when treating patients, mainly, elderly people.

However, before starting this definitive treatment, medications must be administered: antithyroid drugs that reduce the uncontrolled and increased production of thyroid hormones that the gland possesses.

By achieving, through these drugs, a decrease in the functioning of the thyroid to a normal state, a serious complication is avoided, which could occur when administering radioactive iodine: radiation thyroiditis. This complication would dramatically increase the symptoms of hyperthyroidism, due to the massive release of hormones, with serious consequences.

As in other diseases that cause hyperthyroidism, radioactive iodine can cause an excessive decrease in the function of the gland (hypothyroidism), in toxic multinodular goiter this complication is very rare.

How to avoid it?

This disease would be avoided, to a large extent, if a diagnosis and previous treatment of the main diseases that cause it were made after the years, which are simple goiter and multinodular goiter.

We must go to the doctor before any visible increase in the size of the anterior part of the neck, especially in older people who have lived or live in a geographical area where the goiter has been or is very frequent.

It is especially urgent that you consult with your doctor if, in addition to having a goiter, it begins, suddenly, with palpitations, with fatigue (especially when lying in bed), your ankles or abdomen swell, as they would be signs that the heart is not working well or is functioning beyond its means, due to excess.

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Hello Readers, I am Nikki Bella a Psychology student. I have always been concerned about human behavior and the mental processes that lead us to act and think the way we do. My collaboration as an editor in the psychology area of ​​Well Being Pole has allowed me to investigate further and expand my knowledge in the field of mental health; I have also acquired great knowledge about physical health and well-being, two fundamental bases that are directly related and are part of all mental health.

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