Toxic goiter is the swelling of the thyroid gland that is associated with a disbalance in thyroid hormones. Nontoxic goiter is the swelling of the thyroid gland with no disbalance in the thyroid hormones.

What is a toxic goiter?

Definition:

Toxic goiter is the swelling of the thyroid gland that is associated with a disbalance in thyroid hormones. 

Types:

Two types of toxic goiter are toxic nodular goiter or Plummer’s disease which has nodules secreting excess thyroid and toxic diffuse goiter or Grave’s disease. 

Causes:

Causes of toxic goiter include iodine intake either through the mouth or intravenously, taking medicines with iodine as a component, iodine deficiency, and underlying autoimmune etiology.

Symptoms:

The symptoms of toxic goiter are tachycardia, diarrhea, increased sweating, fatigue, weight loss despite increased appetite, tremors, irregular menstrual cycle, and reduced libido. 

Diagnosis:

The diagnosis of toxic goiter is made through physical examination, thyroid ultrasound, thyroid scan, and thyroid hormonal tests such as T3, T4, and serum TSH (thyroid stimulating hormone). 

Treatment:

Toxic goiter is treated with antithyroid drugs or thyroxine depending on the type of goiter, beta blockers to control palpitations, radioiodine therapy, and sometimes surgery that is a total or partial thyroidectomy. 

What is a nontoxic goiter?

Definition:

Nontoxic goiter is the swelling of the thyroid gland with no disbalance in the thyroid hormones.

Causes:

A few causes of nontoxic goiter are a positive family history of goiter, frequent use of medicines like lithium, propylthiouracil, and phenylbutazone, and dietary iodine deficiency.

Symptoms:

Nontoxic goiter is usually asymptomatic in the early stages until it gets really big. Rarely, a big nontoxic goiter will present with symptoms like swollen neck, difficulty in breathing, and swallowing, frequent coughing, hoarseness of voice, and a feeling of pressure on the neck.

Diagnosis:

Nontoxic goiter is diagnosed after physical examination, thyroid hormone tests, thyroid ultrasound, fine needle aspiration of the nodules, and thyroid scan. 

Treatment: 

A slow growing nontoxic goiter does not need treatment. A large goiter may need to be treated with biopsies of a nodule hormone suppression therapy, radioactive iodine, or thyroidectomy.

Difference between Toxic and Nontoxic goiter

Definition:

Toxic goiter is the swelling of the thyroid gland that is associated with a disbalance in thyroid hormones. Nontoxic goiter is the swelling of the thyroid gland with no disbalance in the thyroid hormones.

Causes:

Causes of toxic goiter include iodine intake either through the mouth or intravenously, taking medicines with iodine as a component, iodine deficiency, and underlying autoimmune etiology. A few causes of nontoxic goiter are a positive family history of goiter, frequent use of medicines like lithium, propylthiouracil, and phenylbutazone, and dietary iodine deficiency.

Symptoms:

The symptoms of toxic goiter are tachycardia, diarrhea, increased sweating, fatigue, weight loss despite increased appetite, tremors, irregular menstrual cycle, and reduced libido. Nontoxic goiter is usually asymptomatic in the early stages until it gets big. Rarely, a big nontoxic goiter will present with symptoms like swollen neck, difficulty in breathing, and swallowing, frequent coughing, hoarseness of voice, and a feeling of pressure on the neck.

Diagnosis:

The diagnosis of toxic goiter is made through physical examination, thyroid ultrasound, thyroid scan, and thyroid hormonal tests such as T3, T4, and serum TSH (thyroid stimulating hormone). Nontoxic goiter is diagnosed after physical examination, thyroid hormone tests, thyroid ultrasound, fine needle aspiration of the nodules, and thyroid scan. 

Treatment:

Toxic goiter is treated with antithyroid drugs or thyroxine depending on the type of goiter, beta blockers to control palpitations, radioiodine therapy, and sometimes surgery that is a total or partial thyroidectomy. A slow growing nontoxic goiter does not need treatment. A large goiter may need to be treated with biopsies of a nodule hormone suppression therapy, radioactive iodine, or thyroidectomy.

Table of differences between Toxic and Nontoxic goiter

FAQs

Can nontoxic goiter become toxic?

Yes.

What is the most common cause of nontoxic goiter?

Iodine deficiency.

Is toxic goiter the same as simple goiter?

A simple goiter is a diffusely enlarged thyroid gland. Toxic goiter releases too much thyroid gland therefore it can be a simple goiter as well.

What foods should you not eat with a nontoxic goiter?

Broccoli, cauliflower, and cabbage.

What triggers toxic goiter?

An ongoing infection can trigger a toxic goiter 

Is nontoxic goiter cancerous?

No.

How do you shrink a nontoxic goiter?

Through radioactive iodine therapy or thyroxine use.

At what size should a goiter be removed?

Greater than 4cm nodules should be removed.

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