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Multinodular Goiter

A multinodular goiter is an irregular swelling of the thyroid gland that consists of multiple thyroid nodules (growths). In some cases, having too little iodine in the diet and some genetic factors can lead to multinodular goiters. There are two types of goiters, toxic multinodular goiters, which make too much thyroid hormone, and non-toxic multinodular goiters, which do not make too much thyroid hormone.


There are often no symptoms. When symptoms do occur, they may include:

  • Difficulty breathing or swallowing
  • Neck or throat pain
  • Toxic multinodular goiters may exhibit hyperthyroidism symptoms including:
    • Weight loss or difficulty gaining weight
    • Irregular or rapid heart beat
    • High blood pressure
    • Nervousness and trouble concentrating
    • Irritability
    • Bulging eyes
    • Diarrhea
    • Poor school performance
    • A lump in the neck


Multinodular goiter diagnosis will begin with a physical exam and review of your child’s full medical history. In addition, our physicians may use a variety of diagnostic tests including:

  • Blood tests to measure the thyroid-stimulating hormone (TSH) levels.
  • Ultrasound, a radiation-free imaging technique, which uses high-frequency soundwaves to capture images of your child’s thyroid gland.
  • Fine needle aspiration biopsy may be used to extract cells from the thyroid for further examination. 


At Texas Children’s Hospital, treatment plans are tailored to your child’s individual needs. Treatment for multinodular goiters may include:

  • Observation: If the goiter is not suspicious or causing difficulty with swallowing, your physician may simply monitor it through regularly scheduled appointments.
  • Surgery: A total thyroidectomy (removal of the entire thyroid gland) may be performed. These surgeries should be performed by high-volume surgical teams, such as our Thyroid Program Surgical Team, to achieve the best possible outcomes.
  • Medication: Your child will be treated with hormone medication to correct any irregularities caused by the goiter.