What is the Difference Between Toxic and Nontoxic Goiter

The key difference between toxic and nontoxic goiter is that toxic goiter causes thyroid gland enlargement with a disturbance in the thyroid function, while nontoxic goiter causes thyroid gland enlargement with no disturbance in the thyroid function.

Goiter involves the enlargement of the thyroid gland by nodules (nodular) or as a whole gland (diffuse). Nodule goiter is the most common type of thyroid lesion in the surgical pathology practice. Goiter may also involve multiple nodule formation in the thyroid gland. Based on thyroid function, goiter is mainly divided into two forms: toxic and nontoxic goiter.

CONTENTS

1. Overview and Key Difference
2. What is Toxic Goiter
3. What is Nontoxic Goiter
4. Similarities – Toxic and Nontoxic Goiter
5. Toxic vs Nontoxic Goiter in Tabular Form
6. Summary – Toxic vs Nontoxic Goiter

What is Toxic Goiter?

Toxic goiter is a type of goiter that causes thyroid gland enlargement with a disturbance in thyroid function. In this condition, the thyroid gland contains areas that have increased in size. In toxic nodular goiter, there is also nodule formation, and one or more of these nodules produce too much thyroid hormone. Toxic nodular goiter is called Plummer’s disease, while toxic diffuse goiter is called Graves disease.

Normally, a toxic goiter arises from a pre-existing simple goiter. The causes of this condition may include taking iodine through the vein or mouth, taking medications that contain iodine, moving from a country with iodine deficiency to a country with a lot of iodine in the diet, or having autoimmune conditions. The symptoms of this condition may include fatigue, frequent bowel movements, heart intolerance, increased appetite, increased sweating, irregular menstruation in women, muscle cramps, restlessness, erectile dysfunction or reduced libido, and weight loss.

Moreover, toxic goiter can be diagnosed through physical examination, serum thyroid hormone levels (T3 and T4), serum TSH (thyroid-stimulating hormone), thyroid uptake and scan (radioactive iodine uptake), and thyroid ultrasound. Furthermore, treatment options for thyroid goiter may include beta blockers to control the symptoms of hyperthyroidism, radioiodine therapy, thyroid replacement therapy, or surgery to remove the thyroid.

What is Nontoxic Goiter?

Nontoxic goiter is a type of goiter that causes thyroid gland enlargement with no disturbance in the thyroid function. Nontoxic goiter can also be divided into diffuse and nodular forms. This condition is more common in women and people over age 40. It is also more common in underdeveloped countries. In nontoxic goiter, the thyroid gland often works normally, so it often does not have symptoms unless the thyroid gland grows too big. In rare cases, symptoms may include swelling of the neck, problems with breathing, coughing, wheezing, swallowing problems, a feeling of pressure on the neck, and a hoarse voice. Moreover, some possible causes of nontoxic goiter may include a family history of goiters, iodine deficiency, and regular use of medicines such as lithium, propylthiouracil, phenylbutazone, and aminoglutethimide.

Nontoxic goiter is diagnosed through physical examination, blood tests, biopsies of a nodule, ultrasound, thyroid scan, Barium swallow, and X-ray. Nontoxic goiter usually grows very slowly; hence, no treatment is needed. However, if goiter starts to grow fast, treatment options may include hormone suppression therapy (to stop TSH hormone), radioactive iodine, and surgery (thyroidectomy).

What are the Similarities Between Toxic and Nontoxic Goiter?

• Toxic and nontoxic goiter are two forms of goiter based on thyroid function.
• Thyroid gland enlargement is present in both goiter forms.
• Both forms further divide as diffuse and nodular.
• They are more common in females.
• Both forms can be diagnosed through physical examination and imaging tests.
• They are normally treated through surgeries.

What is the Difference Between Toxic and Nontoxic Goiter?

Toxic goiter is a type of goiter that causes thyroid gland enlargement with a disturbance in the thyroid function, while nontoxic goiter is a type of goiter that causes thyroid gland enlargement with no disturbance in the thyroid function. Thus, this is the key difference between toxic and nontoxic goiter. Furthermore, toxic goiter is more common in people over age 60, while nontoxic goiter is more common in people over age 40.

The below infographic presents the differences between toxic and nontoxic goiter in tabular form for side-by-side comparison.

Summary – Toxic vs Nontoxic Goiter

Toxic and nontoxic goiter are two forms of goiter based on thyroid function. Thyroid gland enlargement is present in both toxic and nontoxic goiter forms. However, toxic goiter is a type of goiter that causes thyroid gland enlargement with a disturbance in the thyroid function, while nontoxic goiter is a type of goiter that causes thyroid gland enlargement with no disturbance in the thyroid function. So, this is the key difference between toxic and nontoxic goiter.

Reference:

1. “Toxic Goiter.” An Overview | ScienceDirect Topics.
2. “Nontoxic Goiter.”  Statpearls – NCBI Bookshelf.

Image Courtesy:

1. “Graves disease – alt — high mag” By Librepath – Own work (CC BY-SA 3.0) via Commons Wikimedia
2. “Diagram showing before and after a total thyroidectomy CRUK 106” By Cancer Research UK – Original email from CRUK (CC BY-SA 4.0) via Commons Wikimedia