Toxic Adenoma history and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Patients with toxic adenomas typically present with signs and symptoms of hyperthyroidism. Common symptoms include fatigue, unintentional weight loss, heat intolerance, diaphoresis, palpitations, anxiety, and nervousness. Specific areas of focus when obtaining a history from the patient of toxic adenoma include the possibility of recent iodide exposure in any form that can provoke transient thyrotoxicosis in a pre-existing toxic nodule such as medication (e.g., amiodarone), radiocontrast dye, dietary supplements.

Specific areas of focus when obtaining a history from the patient of toxic adenoma include:^[1]

• Possibility of recent iodide exposure—in the form of (can provoke transient thyrotoxicosis in a pre-existing toxic nodule)
  • Medication (e.g., amiodarone)
  • Radiocontrast dye
  • Dietary supplements

Patients with toxic adenomas typically present with signs and symptoms of thyrotoxicosis. Common symptoms of toxic adenoma include:^{[1][2][3][4][5][6]}

• Fatigue
• Unintentional weight loss
• Heat intolerance
• Diaphoresis
• Tremor
• Palpitations
• Diarrhea
• Anxiety
• Nervousness
• Irritability
• Difficulty with mental concentration
• Hair loss
• Women may experience^[7]
  • Oligomenorrhea
  • Amenorrhea
• Men may complain of
  • Decrease in libido
  • Erectile dysfunction
  • Gynecomastia

Rarely patients with a toxic adenoma may experience symptoms due to mass effect of adenoma itself.

• Neck discomfort
• Mild dysphagia
• Odynophagia

• Tachycardia
• Systolic hypertension
• Hyperactive or fatigued demeanor
• Staring gaze and lag
• Brisk carotid upstrokes
• Hyperdynamic point of maximal impulse
• Systolic flow murmur
• Proximal muscle weakness
• Fine hand tremor
• Velvety or oily skin