What are the symptoms of a Toxic Multinodular Goitre?

The clinical features of a patient with a toxic multinodular goitre are the same as a patient with Graves' disease, except without the extrathyroidal (i.e. the eye) manifestations. These are:

  • Irritability
  • Weight loss 90% cases, weight gain 10%
  • Heat intolerance
  • Sweating
  • Fast or irregular heart rate
  • Vomiting or diarrhoea
  • Irregular periods and infertility
  • A fine tremor with possible muscle weakness (unable to climb stairs)
  • Heart failure in the elderly
  • Fever
  • In children: behavioural disorders
  • A nodular goitre is readily palpable.