Multinodular goitre overview and its treatment

What is Multinodular goitre?

The thyroid gland present in your neck helps to make hormones that control many body functions. Multinodular goitre is a goitre with many lumps, or nodules, inside the gland. This is probably the most common problem with the thyroid gland. Too much thyroid hormone (T3/T4) is made by a toxic goitre. When your body makes too much of the hormone, this is called hyperthyroidism.

Most of the multinodular goitres do not show any symptoms. Most of the time, the cause is unknown. When you have a multinodular goitre, you have the risk of getting thyroid cancer. If you have symptoms of multinodular goitre, your doctor will probably also look for signs of thyroid cancer.

The best way to treat a multinodular goitre depends on:

• If you have hyperthyroidism 
• Size of the goitre
• If any of the lumps are cancerous or not..

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Symptoms of Multinodular goitre

A physical test or visual study is observed to confirm multinodular goitres. The multinodular goitre looks like a few big nodules inside of it. But there are a lot of small ones in there, too.

People can feel the nodules right next to their thyroid, which is in the neck below Adam’s apple in both men and women.

In cases that are more serious, symptoms could include:

• Coughing
• Feeling like your throat is going to close
• Voice changes, such as hoarseness
• Having trouble swallowing (dysphagia)
• You may have trouble breathing and make a high-pitched sound when you do.

There may be signs of hyperthyroidism in people who have a toxic multinodular goitre, but they may not know it and they may go through such signs like:

• Difficult to deal with the heat
• When at rest, the heart beats.
• Irritability
• Nervousness
• Difficult to fall asleep

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How multinodular goitre causes

When there is more thyroid gland tissue in the neck, this is called a goitre. It is how the body makes up for not making enough thyroid hormones, like thyroxine and triiodothyronine. Different things cause the two types of simple goitre.

A goitre can be caused by a number of things that affect how the thyroid functions or grows it including as:

1. Due to Iodine deficiency:

Iodine is needed for the production of thyroid hormones. If a person does not get enough iodine, hormone production decreases, and the pituitary gland gets a signal from the thyroid gland to produce more thyroid hormone. This more signal cause the thyroid to grow. 

2. The Hashimoto’s disease:

Hashimoto’s disease is an autoimmune disorder. This means that healthy tissues are attacked by the body’s immune system. When the thyroid gland is damaged and sore, it doesn’t make enough hormones (hypothyroidism). When the pituitary gland secretes a drop in hormone production and tells the thyroid to make more hormones, the thyroid becomes larger.

3. It may due to Graves’ disease:

Graves’ disease is also another autoimmune disorder that happens when the immune system makes a protein that begins to look like TSH (Thyroid-stimulating hormone). This unrequired protein makes the thyroid produce more hormones, which is called hyperthyroidism and can cause the thyroid to become larger.

4. Thyroid gland nodules:

A lump is called a nodule when thyroid cells grow in an uncontrolled way. A person could have one or more nodules (multinodular goitre). It’s not clear what causes nodules, but it could be a mix of things like genes, diet, lifestyle, and the environment. Most thyroid nodules are noncancerous (benign).

Read More: Hyperthyroidism diet: Foods to avoid and eat

5. Thyroid cancer:

Thyroid cancer is less common than other cancers and generally treatable. About 5% of people with thyroid nodules are found to have cancer (malignant).

Multinodular goitre treatment

Not everyone who has a multinodular goitre needs to be treated. It often depends on how well the thyroid works.

If the nodules aren’t making toxic thyroid hormones, a doctor will check their size, symptoms, and how they grow.

1. Radioiodine therapy:

One way to treat both toxic and non-toxic goitres is to use radioiodine therapy. In this therapy, medication helps to shrink the thyroid. In the case of toxic goitres, it also stops the production of too much thyroid hormone.

As soon as you get treatment, your goitre usually shrinks for 2 to 6 months. It may take up to a year. Also, studies have shown that in most cases, normal thyroid function stays or gets back to normal after treatment. Small goitres are better at the treatment of radioiodine therapy than larger ones.

2. Thyroid medicine:

If the goitre and its nodules aren’t too enlarged, then a doctor may recommend taking a thyroid hormone drug like levothyroxine (Synthroid).

3. Thyroidectomy:

This surgery is done to remove the thyroid gland. But,  with a new understanding of thyroid disease, it isn’t needed to remove.

If the goitre is putting pressure on damaged blood vessels, making it hard to breathe or swallow, or causing psychological pain, a doctor may recommend trying to remove the thyroid.

If a person isn’t getting recovered or treated by radioiodine therapy, a doctor may also suggest having their thyroid removed. This is especially the case if the multinodular goitre seems to be very big because radioiodine therapy doesn’t work as well on big goitres as it does on smaller ones.

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