Toxic nodular goiter

• weight loss
• increased appetite
• nervousness
• restlessness
• heat intolerance
• increased sweating
• fatigue
• muscle cramps
• frequent bowel movements
• menstrual irregularities (in women)

Signs and Tests:
A physical examination reveals single or multiple nodules in the thyroid. There may be a rapid heart rate .

• Radioactive iodine uptake is elevated.
• A thyroid scan shows iodine uptake in nodules.
• Serum TSH is decreased.
• Serum T3 , T4 , T3 resin uptake are elevated.

Treatment:
Radioactive iodine or antithyroid agents are the treatments used for toxic nodular goiter.

Beta-blockers, such as Propranolol, can control some of the symptoms of hyperthyroidism until the thyroid hormone level in the body is under control.

Prognosis:
Since toxic nodular goiter is primarily a disease of the elderly, other chronic health problems may influence the outcome of this condition. The elderly person may be less able to tolerate the effect of hyperthyroidism on the heart.

Complications:
Cardiac complications include rapid heart rate , congestive heart failure , and atrial fibrillation .

Thyroid crisis or storm is an acute worsening or exaggeration of the symptoms of hyperthyroidism , which may occur with infection or stress . Fever , decreased mental alertness, and abdominal pain may occur and immediate hospitalization is indicated.

Call Your Healthcare Provider:
Call for an appointment with your health care provider if symptoms of this disorder occur. Follow the health care provider's recommendations for follow-up visits.


This picture shows an enlargement of the thyroid (goiter), which can be caused by lack of iodine in the diet, thyroid infection, or excessive thyroid function (hyperthyroidism). Since iodine has been added to table salt, the incidence of goiter has decreased.