Treatment of toxic multinodular goitre is preferably by radical partial thyroidectomy after administration of preoperative antithyroid medication to produce euthyroidism. There is still debate about the need for long-term postoperative T4 administration to prevent recurrence of the nodules. If the patient is elderly or unwell, radioiodine can be used, but larger doses (for example, double) are required than those employed in the treatment of toxic diffuse goitre.
