Nodular goiter, 5 common manifestations

Nodular goiter is very common in adolescent girls. Patients will experience symptoms such as difficulty breathing, facial edema, and discomfort in swallowing. Iodine deficiency is the main cause and it needs to be treated as soon as possible because sometimes nodular goiter will evolve into thyroid cancer.

1. The patient has a long-term history of simple goiter. The age of onset is generally over 30 years old. There are more women than men. The degree of thyroid enlargement varies and is often asymmetric. The number and size of nodules vary, generally there are multiple nodules, and in the early stages there may be only one nodule. The nodules are soft or slightly hard, smooth and non-tender. Sometimes the boundaries of the nodules are unclear, and the surface of the thyroid gland only feels irregular or lobed when touched. The disease progresses slowly and most patients are asymptomatic. Larger nodular goiters may cause compressive symptoms, including difficulty breathing, dysphagia, and hoarseness. Acute bleeding into a nodule may cause a sudden increase in size and pain; symptoms may subside within a few days, and an enlarged mass may decrease in size over a few weeks or longer.

2. When nodular goiter develops hyperthyroidism (Plummer's disease), the patient has symptoms such as fatigue, weight loss, palpitations, arrhythmia, heat intolerance, sweating, and irritability, but there is no local vascular murmur or tremor in the thyroid gland, exophthalmos is rare, and finger tremor is also rare. Symptoms in elderly patients are often atypical.

3. Whether the patient has a history of radiation exposure, oral medication history and family history, whether the patient comes from an area where goiter is endemic, etc. Generally, nodular goiter has a long history, with no compression symptoms and no symptoms of hyperthyroidism. Most patients do not care about it and come for medical examination only when they accidentally discover thyroid nodules.

4. If it is a hot nodule, also known as a toxic nodule, the patient is mostly over 40 to 50 years old, the nodule is of medium hardness, there are symptoms of hyperthyroidism, and even atrial fibrillation and other arrhythmias may occur. If there is bleeding, there may be pain and even fever. When the nodules are large, compression symptoms may occur, such as dysarthria, difficulty breathing, chest tightness, shortness of breath, and irritating cough.

5. For example, patients with nodular goiter from iodine-deficient areas may have low thyroid function, and clinically they may also experience slow heart rate, edema, rough skin, and anemia. A small number of patients may also develop cancer. Warm nodules are more common and can be treated with thyroid preparations, and the enlarged glands can be shrunk. Cold nodules are relatively rare. Patients with clinical hypothyroidism can be treated with thyroid preparations, but surgical treatment is often required.