what is tmng

by Prof. Perry Sawayn PhD Published 3 years ago Updated 2 years ago

Toxic multinodular goiter (TMNG), also known as multinodular toxic goiter (MNTG), is an active multinodular goiter associated with hyperthyroidism. Toxic multinodular goiter. Other names. Toxic nodular goiter, Plummer's disease, multinodular toxic goiter, TMNG, MNTG. Most common causes of hyperthyroidism by age.

What does TMNG-IDM stand for?

The Trademark Next Generation ID Manual (TMNG-IDM or ID Manual) is a web-based application that provides users the ability to search for acceptable identifications of goods and services and information related thereto. To submit comments regarding your experience using TMNG-IDM, please contact [email protected]

What are the features of the main page of TMNG-IDM?

The Main Page of TMNG-IDM features a text box for searching, an Information icon with links to resources and related pages, and an Advanced Search icon. These Main Page features are addressed in greater detail below.

Where can I find TMG naturally?

In addition to taking a supplement, you can increase your intake of TMG naturally, as it’s found in many foods. Wheat, beets, quinoa, and seafood are particularly rich sources (24). Here’s the amount of TMG found in a 3.5-ounce (100-gram) serving of several foods (24, 25, 26):

How do I search the TMNG-IDM?

Search Box: The Search Box (or “text box”) located on the center of the Main Page below the Trademark Next Gen logo is used to enter Search Terms. See How to Conduct a Simple Search and How to Conduct an Advanced Search for additional information about searching the TMNG-IDM.

What are the symptoms of goiter?

The main symptoms of goiter include:A lump in the front of your neck, just below your Adam's apple.A feeling of tightness in your throat area.Hoarseness (scratchy voice).Neck vein swelling.Dizziness when you raise your arms above your head.

How is goiter caused?

The most common cause of goiters worldwide is a lack of iodine in the diet. In the United States, where the use of iodized salt is common, goiters are caused by conditions that change thyroid function or factors that affect thyroid growth.

How do you know if your thyroid is toxic?

The symptoms of a toxic thyroid nodule are a result of the high levels of thyroid hormones in the blood, increasing the rate at which the body is working. Similar to those of hyperthyroidism, these symptoms include: weight loss. diarrhoea.

Is Plummer's disease autoimmune?

Toxic nodular goiter does not cause the bulging eyes that can occur with Graves disease. Graves disease is an autoimmune disorder that leads to an overactive thyroid gland (hyperthyroidism).

What foods cause goiter?

Eating very large amounts of certain foods (soy, peanuts, or vegetables in the broccoli and cabbage family) Toxic nodular goiter, an enlarged thyroid gland that has a small growth or many growths called nodules, which produce too much thyroid hormone.

Can goiter be cured?

It is often harmless, though it can signal an underlying thyroid condition. Depending on its cause, a goiter may go away without treatment. Doctors may recommend treatments if there is an underlying thyroid disease, or if the goiter gets in the way of a person's daily life.

What is the main cause of thyroid problems?

Problems with the thyroid can be caused by: iodine deficiency. autoimmune diseases, in which the immune system attacks the thyroid, leading either to hyperthyroidism (caused by Graves' disease) or hypothyroidism (caused by Hashimoto's disease) inflammation (which may or may not cause pain), caused by a virus or ...

What happens if a thyroid nodule is left untreated?

Fluid-filled nodules (thyroid cysts): It is usually fine to leave cysts untreated, especially if they are causing no problems. Sometimes these can keep collecting more fluid and get bigger, causing difficulty swallowing, a choking sensation, or a feeling of pressure in your throat.

Can thyroid problems affect your breathing?

Too little thyroid hormone weakens the muscles you use to breathe and makes your lungs work less efficiently. As a result, you may feel short of breath or have trouble exercising. Hypothyroidism also makes it more likely to develop sleep apnea, which are pauses in breathing that happen while you sleep.

How do you get Plummer's disease?

It's the most common cause of hyperthyroidism. Hyperfunctioning thyroid nodules (toxic adenoma, toxic multinodular goiter or Plummer's disease). This form of hyperthyroidism occurs when one or more adenomas of your thyroid produce too much T4.

How is Plummer's disease treated?

Currently, the 2 major treatment modalities for Plummer's disease include surgery and RAI treatment. Thioamides such as propylthiouracil and methimazole are largely ineffective in the long-term, with 1 study reporting 95% relapse rate at 2 years.

What is the difference between Graves disease and Plummer's disease?

Unlike Graves disease, Plummer disease seldom causes bulging of the eyes (exophthalmos). Swelling of the thyroid gland may obstruct breathing or swallowing, requiring surgery to remove the excess tissue; the cardiac symptoms may result in congestive heart failure.

Are you sure the patient has toxic thyroid nodules?

The signs and symptoms of toxic multinodular goiter (TMNG) or toxic adenoma (TA) depend on the patient’s age.

What else could the patient have?

The main differential diagnosis is Graves’ disease. This should be differentiated from the TMNG and TA by the presence of ophthalmopathy or serum thyroid receptor blocking antibodies (TRAb) and anti-peroxidase (TPO) antibodies, and rarely, pretibial myxedema. Scintigraphy will show a diffuse thyroid uptake of 123 I in Graves’ disease.

Key laboratory and imaging tests

Low/suppressed serum TSH concentrations with elevated serum total and free T3 and T4 levels. However, dependent on the autonomous cell mass, T3 toxicosis or subclinical thyrotoxicosis may be found.

Other tests that may prove helpful diagnostically

Cardiac evaluation: Echocardiogram, electrocardiogram, and Holter monitoring may be necessary, especially for older patients, due to the risk of asymptomatic atrial fibrillation.

How should I decide between the possible definitive treatment options?

Preferred in the elderly; patients with significant comorbidities; patients with prior surgery or scarring in the anterior neck; patients with a small goiter; and those with lack of access to a high-volume thyroid surgeon

When should I switch my treatment choice?

In patients with severe or refractory hyperthyroidism, thyroid surgery should be considered. In patients with mild hyperthyroidism following 131 I administration, the use of methimazole may be considered until the full effect of the radioiodine is achieved.

Additional references

Baek, JH, Lee, JH, Valcavi, R, Pacella, CM, Rhim, H. “Thermal ablation for benign thyroid nodules: radiofrequency and laser”. Korean J Radiol. vol. 12. 2011. pp. 525-540.

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What is the main page of TMNG?

What is TMNG-IDM?

What browser is TMNG-IDM?

The TMNG-IDM is best viewed in the Google® Chrome® browser version 57 or higher, but is also accessible in Windows® Internet Explorer® Version 11 and higher. Display resolution settings above 900px are recommended for optimal viewing of the search window and results table.

Why is TMG called TMG?

It was originally known as betaine because it was first discovered in sugar beets. However, TMG is one of the many betaines that have since been identified [ 1 ]. Scientists are investigating whether TMG can protect cells from stress and act as a source of methyl groups [ 1 ].

What is TMG in the body?

TMG is also known as betaine, glycine betaine, lycine, and oxyneurine. People consume TMG normally in their diet, though supplements are also available. TMG is also produced by the body from choline [ 2 ]. TMG supplements, commonly referred to as betaine anhydrous, have not been approved by the FDA for medical use.

Is TMG an osmoprotectant?

Is an Osmoprotectant. Researchers call TMG an osmolyte/osmoprotectant, which means that it keeps cells hydrated and increases stress resilience. In lab settings, it can stabilize proteins and membranes when environmental conditions are bad, such as drought, low temperatures, and high salt levels [ 8 ].

Does TMG donate methyl groups?

In the body, TMG can donate one of its methyl groups to homocysteine. Methyl groups are three hydrogen atoms bonded to carbon. This turns homocysteine back into methionine, which theoretically prevents homocysteine levels from getting too high [ 4 ].

Is TMG safe for medical use?

TMG supplements, commonly referred to as betaine anhydrous, have not been approved by the FDA for medical use. Supplements generally lack solid clinical research. Regulations set manufacturing standards for them but don’t guarantee that they’re safe or effective. Speak with your doctor before supplementing.

Does TMG help with skin irritation?

In 21 healthy subjects, TMG relieved the skin irritating effects caused by detergents and decreased allergic responses [ 29 ]. TMG’s osmolyte properties increased skin hydration and improved skin barrier. Also, by acting as a methyl donor, it protected the cells from detergent attacks [ 29 ].

Does TMG help with oxidative stress?

Additionally, by donating a methyl group, scientists think TMG may help produce S-adenosylmethionine and protect against oxidative stress with its antioxidant effects [ 6, 7 ]. TMG is a methyl donor: it helps add methyl group to compunds.