Multinodular Goiter
Multinodular Goiter
Its scientific name may sound complicated, perhaps even a little alarming, but multinodular goiter is one of the most common disorders of the thyroid gland. This is usually a benign medical condition that should not cause any concern when the thyroid is functioning normally.
What is the Multinodular Goiter;
A goiter is nothing more than an enlarged thyroid. It can be simple when only enlargement is observed or multinodular when there are simultaneously multiple nodules scattered throughout the gland. Most thyroid nodules are benign, while cancerous nodules are rarer.
Toxic or Non-Toxic Multinodular Goiter
Multinodular goiter can be:
- To produce an excessive amount of thyroid hormones, causing hyperthyroidism.
- When thyroxine levels are normal.
Toxic Multinodular Goiter
Non-Toxic Multinodular Goiter
Multinodular Goiter & Causes
The causes of multinodular goiter are not completely clear. For example, a simple diffuse goitre can develop into a multinodular goiter over time.
Risk factors that seem to favor the development of goiter are:
- Iodine deficiency in the diet.
- Family history of nodular goiter.
- The age.
- The sex.
Multinodular Goiter & Symptoms
Multinodular goiter does not always present symptoms, while it is not rare that it is found accidentally during an examination for a different reason.
Many times it is visible as a lump at the base of the neck, while other times it shows symptoms of either an underactive thyroid gland, such as:
- Weight loss
- Hand tremors
- Palpitations
- Sleep disorders
- Heat intolerance
- Stress
or an underactive thyroid gland, such as:
- Weight gain
- Dry skin
- Constipation
- Intolerance to cold
- Bad mood
Also when the multinodular goiter is large it can cause:
- Difficulty swallowing or breathing.
- Hoarseness in voice.
- Feeling of pressure or "lump" in the throat.
Diagnosis
The diagnosis of multinodular goiter begins with a physical examination performed by the doctor and taking a detailed medical and family history. He will also order laboratory tests to determine if the thyroid is functioning properly.
Also thyroid ultrasound, one of the best tests for the thyroid, will give important information about the size of the gland and the characteristics of the nodules, while when the doctor suspects malignancy he can ask for a fine needle aspiration biopsy, which gives specific information and has particular diagnostic utility, as it has significantly reduced the number of thyroidectomies.
Treatment
In the treatment of multinodular goiter the surgeon will consider factors such as:
- The functionality of the gland
- The size of multinodular goiter
- Its growth rate
- The chances of malignancy
- The aesthetic image
Treatment of a multinodular goiter may include:
- Regular monitoring when there is no problem with thyroid function.
- Drug treatment in the case of an overactive or underactive thyroid.
- Surgery of part or all of the thyroid when there is a possibility of malignancy, in some cases of toxic goiter, when it creates problems in adjacent structures and creates a cosmetic problem.
