Plummer's disease or toxic nodular goiter is a disorder when the thyroid gland nodules are overactive, causing the body to produce too much thyroid hormone.
Plummer's disease will cause an increase in thyroid hormone levels (hyperthyroidism). This condition occurs mainly in the elderly and people who are deficient in iodine. The appearance of symptoms of hyperthyroidism in Plummer's disease will occur when the size of the thyroid gland enlarges to 2.5 cm.
Symptoms of Plummer's Disease
Symptoms of Plummer's disease can be similar to other symptoms of hyperthyroidism. These symptoms include:
- Losing weight
- Increased appetite
- Heart palpitations (palpitations)
- Feeling anxious or restless
- Fatigue
- Shaking (tremors), generally in the hands
- Excessive sweating
- Increased sensitivity to heat
- Muscle cramp
- Irregular menstruation (in women)
When to go to the doctor
Check with your doctor if you experience any of the symptoms mentioned above. If you have been diagnosed with Plummer's disease, it is also necessary to have regular check-ups with your doctor.
In addition, you are also advised to immediately consult a doctor if there is swelling in the neck especially accompanied by other symptoms, such as difficulty breathing or swallowing, difficulty speaking, hoarseness, neck feels full, and feels like something is stuck in the throat.
Causes of Plummer's Disease
The exact cause of Plummer's disease is not known. However, there are several factors that can increase the risk of Plummer's disease, namely:
- Having an iodine deficiency
- Over 50 years old
- Have a family history of enlarged thyroid nodules
- Have a history of radiation to the head and neck
Plummer's disease usually begins with an enlarged thyroid gland nodule over many years. The growth of these nodules will cause excessive thyroid hormone production (hyperthyroidism).
Diagnosis of Plummer's Disease
To diagnose Plummer's disease, the doctor will take a history or ask questions about the symptoms experienced, the patient's medical and medication history, and family history of the disease. Then, the doctor will perform a physical examination.
To confirm the diagnosis, the doctor will also perform supporting examinations, such as:
- Thyroid hormone test, to determine thyroid hormone levels of triiodothyronine (T3), thyroxine (T4), and TSH (thyroid stimulating hormone) in the blood.
- Radioactive iodine level test, to measure the level of radioactive iodine absorbed by the thyroid gland over a certain period of time.
- Thyroid ultrasound, to detect a lump or tumor on the thyroid gland in the neck.
Plummer's Disease Treatment
There are several treatment methods that can be used to treat Plummer's disease, namely:
Radioactive iodine therapy
Radioactive iodine therapy is performed to reduce the size of the thyroid nodule. Radioactive iodine is given by mouth, which is then absorbed into the thyroid tissue and destroys the overactive thyroid tissue.
Beta-blocking drugs (beta-blockers)
Beta blockers (beta-blockers), such as propranolol, can be used to help relieve symptoms of hyperthyroidism. This drug can be used until the thyroid hormone levels in the body return to normal.
Antithyroid drugs
This medicine will reduce the production of thyroid hormone. Antithyroid drugs can be used long-term for patients who cannot undergo other treatment methods. Examples of antithyroid drugs that can be used to treat Plummer's disease are methimazole and PTU (propylthiouracil).
Thyroid removal surgery
Thyroid removal surgery is performed if the size of the thyroid gland is too large and compresses the surrounding organs.
Complications of Plummer's Disease
Increased thyroid hormone levels in Plummer's disease can cause several complications, including:
- Heart failure
- Atrial fibrillation
- Osteoporosis
- Thyroid crisis
Prevention of Plummer's Disease
Because the cause of Plummer's disease is not known with certainty, there is no special prevention that can be done. However, as much as possible get enough iodine and do regular checkups if there is a history of enlarged thyroid nodules in your family. Early detection and treatment can prevent complications.
