Toxic multinodular goiter
What is Toxic Multinodular Goiter?
Toxic multinodular goiter (TMNG) is an enlargement of the thyroid gland due to the presence of numerous functional thyroid nodules that overproduce thyroid hormones. It is a common endocrinological disorder, typically caused by nodular enlargement of the thyroid gland, and is usually the result of chronic thyroid stimulation by thyrotropin. It typically affects individuals over the age of 60 and is more common in females than males.
Signs and Symptoms
The most common symptoms of TMNG include neck fullness or discomfort, difficulty swallowing, and hoarseness. Other signs and symptoms may include:
- Weight loss
- Increased appetite
- Nervousness and anxiety
- Rapid heart rate
- Irregular menstrual periods
- Hair loss
- Palpitations
- Tremors
- Sweating
Diagnosis
TMNG is typically diagnosed using a combination of physical examination, imaging tests, and laboratory tests. The physical examination may reveal a swelling in the neck, enlarged thyroid, and thyromegaly. Imaging tests such as ultrasound and CT scan can be used to visualize the size of the thyroid gland and evaluate the presence of multiple nodules. Laboratory tests can be used to measure thyroid hormone levels and thyroid-stimulating hormone (TSH) levels, as well as to evaluate antibody levels.
Treatment
Treatment of TMNG usually involves the use of antithyroid medications to reduce thyroid hormone production, surgery to remove the enlarged gland, or radioactive iodine therapy to selectively destroy the functioning nodules. The goal of treatment is to reduce and normalize thyroid hormone levels, thus preventing any associated symptoms or complications. Surgery should only be considered when other treatments have failed or when there is a suspicion of malignancy.