Why normal T4 in non-toxic multinodular goiter - USMLE Forums
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Old 08-14-2011
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Thyroid Why normal T4 in non-toxic multinodular goiter

E.g. in iodide deficiency:
plasma T4↓→TSH↑→thyroid hyperplasia (goiter). Eventually, possibly because of iodide repletion or a decreased requirement for thyroid hormone, thyroid gland enters a resting phase characterized by colloid storage and a colloid goiter. Marine believed that repetition of stimulation and resting phases of the cycle would eventually result in the formation of nontoxic multinodular goiter.

So in multinodular goiter, TSH may be normal. However, how to explain the normal T4 level?
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Old 08-14-2011
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if your TSH is normal, your T4 is expected to be normal....

furthermore, its non-toxic, no technically your t3 and t4 are meant to be in the normal range..

hope this answers your question.
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Endocrine-, Physiology-

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