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.