What is the treatment for multi nodular goitre?

Treatment for multinodular goitre depends on the size and nature of the goitre, associated symptoms, and underlying thyroid function. It ranges from conservative management to surgical intervention.

Conservative Management:

1. Observation: Small, non-toxic multinodular goitres that do not cause symptoms or cosmetic concerns can be observed periodically to monitor for any changes.

2. Thyroid Hormone Replacement Therapy: If the goitre is associated with hypothyroidism (underactive thyroid), thyroid hormone replacement medications, such as levothyroxine, are prescribed to restore normal thyroid hormone levels.

3. Suppressive Therapy: In some cases, thyroid hormone suppression therapy may be used to shrink the goitre's size and alleviate symptoms. This involves administering higher doses of thyroid hormone medication than required to achieve normal thyroid function.

Surgical Intervention:

Surgery is recommended when conservative management fails or in cases of:

1. Size and Compression: A large multinodular goitre causing compression of surrounding structures, such as the windpipe (trachea) or oesophagus, leading to breathing or swallowing difficulties.

2. Toxicity: If the goitre is causing hyperthyroidism (overactive thyroid), surgical removal of part or all of the thyroid gland may be necessary.

3. Nodules with Suspicious Features: If any nodules within the goitre show suspicious characteristics, such as rapid growth, irregular borders, or abnormal uptake on thyroid scans, surgery may be performed for diagnostic purposes and potential removal of cancerous nodules.

4. Cosmesis: In cases where the goitre's size or appearance causes significant cosmetic concerns, surgical removal may be an option based on individual preference.

The specific surgical procedure performed depends on the circumstances and may involve removal of the entire thyroid gland (total thyroidectomy), partial removal (subtotal thyroidectomy), or removal of individual nodules (lobectomy).

It is important to consult a healthcare professional, such as an endocrinologist or a surgeon, to determine the most appropriate treatment approach based on your specific situation and the characteristics of your multinodular goitre.