Toxic Nodular Goiters in the USA:Usually Imported from Iodine Deficient Countries
Most toxic nodular goiters are found in iodine defecient countries. When a patient with a goiter moves to USA they are exposed to higher iodine intake. This excess iodine feeds into the autonomous areas in the goiter and brings out the toxic nodule. We see this in patients coming from our neighbor Mexico who have a simple goiter with silent autonomy and get fill blown toxic nodular goiter in a few years of arrival.