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How can multi nodular toxic goitre be treated?

Prof Dinesh Dhanwal
Prof of Medicine and Head of Endocrinology,
Maulana Azad Medical College,
New Delhi

Q: I am a 27 years old woman diagnosed with multinodular toxic goitre with T3 - 3.5 ng/ml and T4 – 42 ug/dl and TSH - 0.1 mIU/L. The doctor advised me to take Neomercazole, Inderal, vitamin B complex and Cacitate and also suggested surgical removal as radioactive therapy cannot be done because I am unmarried. Is it necessary to remove the gland? Will it cause any problem in the future if it is not removed? Can it be removed without leaving any external mark? Please advise.

A:I hope the diagnosis is confirmed with thyroid uptake studies. If so, then there are three options:

  1. Medical treatment, which you are already taking but it needs to continue for almost lifetime so not a good option.
  2. Surgical removal, which is ok but surgery is major and gives a thin scar.
  3. Radioiodine therapy is fine for you despite the fact you are unmarried. There is large data available, especially from USA, which suggests that this form of therapy is safe.