The Sixth Issue Summer 2017
    what's your situation?  > i have been diagnosed with hyperthyroidism > what is a toxic multinodular goiter? A toxic multinodular goiter is a disorder that may develop when there is enlargement of the thyroid gland caused by the growth of multiple thyroid nodules that produce and secrete excess amounts of thyroid hormone. In and of themselves, multinodular goiters are pretty common. generic viagra online By definition, the individual thyroid nodules present in a multinodular goiter are benign. generic viagra delivered to canada There is no risk that the follicular cells in these nodules will spread to invade other parts of the neck or the body. generic viagra au canada As the follicular cells in these nodules divide and expand, they gradually begin to escape from the normal control exerted by the pituitary gland. This process may continue until these follicular cells reach a point where they are considered to be autonomously functioning, producing and secreting thyroid hormone in an uncontrolled manner. If the amount of thyroid hormone collectively secreted by these follicular cells exceeds normal requirements, a patient may present with evidence of hyperthyroidism or subclinical hyperthyroidism. Toxic multinodular goiters account for about 5% of all cases of hyperthyroidism in the united states. kleine nils viagra youtube Most patients who present with toxic multinodular goiters tend to be older. viagra lilly once day How are toxic multinodular goiters diagnosed? Patients who are diagnosed with toxic multinodular goiters usually present to attention in one of two ways. generic viagra india 100 mg Some patients may present with enlargement of the thyroid gland caused by the growth of multiple thyroid nodules. generic viagra This enlargement may cause compressive symptoms that are first identified as problems with swallowing or breathing. viagra online canadian pharmacy no prescription Enlargement of the thyroid gland may also have been noted by observers, identified on physical examination, or discovered as an incidental finding on radiographic images of the neck. viagra lilly once day Subsequent thyroid function tests may confirm the presence of thyrotoxicosis, raising the suspicion that the thyroid nodules may represent a toxic multinodular goiter. viagra lilly once day Other patients may present with profiles of symptoms and thyroid function tests that are consistent with thyrotoxicosis. cheap generic viagra Subsequent physical examination may reveal the presence of multiple thyroid nodules that may represent a toxic multinodular goiter. In either case, further evaluation to establish a definitive diagnosis usually involves performing a thyr. The Fifth Issue Autumn 2016
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