Multi-node goiter

• What is a multi-node goiter?
• A multi-node colloidal goiter is a tumor on the anterior surface of the neck, rounded or oval in shape. It is a consequence of the abnormal growth of the thyroid gland.

The thyroid gland produces a hormone called "thyroid hormone" Most thyroid nodes do not change the level of thyroid hormones in the body. But some nodes contribute to the production of a large number of thyroid hormones.  If the thyroid gland has a large number of nodes (multi-nodular goiter), this can cause clinical symptoms.

• What are the symptoms of multi-node goiter?

Most people with multi-nodular goiter do not have any symptoms. Changes in the thyroid gland can be found accidentally during an examination, ultrasound, which are performed during the diagnosis of another disease.  With the help of a blood test, it can be determined that the patient has too many thyroid hormones in the body and, therefore, this may be a sign of the presence of a multi-node goiter.   

Some patients with multi-nodular goiter feel or see swelling on the neck. In the presence of a large level of thyroid hormones in the body, the following symptoms are determined in patients:

• Feeling agitated or irritable;
• Feeling weak or tired;
• Weight loss;
• Tachycardia (feeling of rapid heartbeat);
• Frequent urination.

If the multi-node goiter presses on the neck and respiratory tract, this leads to:

• Difficulty breathing - especially during exercise or at night
• Wheezing
• Cough
• Feeling suffocated
• Difficulty swallowing

• What are the methods of examination for multi-node goiter? 

The attending physician will want to make sure that the multi-node goiter does not cause harm to the body.  You will need to take tests to find out what the nodule of thyroid hormones in the body is. Your doctor will also check for nodules in your thyroid gland to know what size they are and what treatment is best to use.

Among the mandatory methods of examination are usually used: blood test, ultrasound.

Additional survey methods include:

• Fine needle aspiration biopsy: Taking a small sample of tissue with a thin needle from one of the largest nodes, which is then examined under a microscope.  
• Thyroid scan (scintigraphy) - the patient is performed this study only if there is a large amount of thyroid hormones in the body. This is a study of the accumulation of radiopharmaceuticals (isotopes) by the thyroid gland, i.e. drugs that are analogs of iodine, but have the ability to emit gamma rays. The patient receives a radiopharmaceutical, after which a special device takes a picture of the thyroid gland. However, this research method is not safe for women who are pregnant or breastfeeding.

How to treat a multi-node goiter?

Many patients with multi-nodular goiter do not need treatment. If the nodes are small in size, your doctor can monitor them in dynamics in order to determine their increase in time and prescribe the necessary treatment.

A multi-node goiter needs treatment if:

• Leads to excessive production of thyroid hormones;
• Causes problems with breathing, swallowing, or disrupts other body functions;
• He is a cancer;
• It causes a cosmetic defect.

Treatment of multi-node goiter includes:

Taking antithyroid drugs.  If the test results show that your  the thyroid gland produces too many thyroid hormones, and doctors prescribe medications to reduce the level of hormones. These drugs control thyroid hormone levels while doctors use other treatments. But as a rule, the most effective method of treatment in this case is surgery.  

• Taking medications for symptomatic treatment.
• Surgical treatment – removal of the thyroid gland. Such operations should be performed by endocrine surgeons
• Therapy with radioactive iodine, which is contained in the solution and has a small amount of radiation. Radiation cures the problem by destroying most of the thyroid gland, resulting in less hormone production. Radioactive iodine is sometimes only used to treat nodes that produce too much thyroid hormone. But this is not a safe treatment for pregnant or breast-feeding women.
• Ethanol sclerotherapy, laser destruction, and radiofrequency ablation also destroy the node, but the long-term results of such minimally invasive treatment may be worse than after traditional surgery.

What should I do if I have a multi-node goiter and I want to get pregnant?

If you want to get pregnant, consult your doctor. Your doctor should make sure, before you get pregnant, that your thyroid gland does not produce too many thyroid hormones. Women who are pregnant should not be treated with radioactive iodine, as this can cause serious harm to the baby.

Diagnosis and treatment of thyroid diseases should take place with the participation of an endocrinologist and an endocrine surgeon in a specialized department.