Babies who cry may simply be hungry, uncomfortable, or ill. Less than 10% of babies who would meet the definition of colic based on the amount they cry have an identifiable underlying disease.Cause for concern include: an elevated temperature, a history of breathing problems or a child who is not appropriately gaining weight.Indications that further investigations may be needed include:
Vomiting (vomit that is green or yellow, bloody or occurring more than five times a day)
Change in stool (constipation or diarrhea, especially with blood or mucous)
Abnormal temperature (a rectal temperature less than 97.0 °F (36.1 °C) or over 100.4 °F (38.0 °C)
Irritability (crying all day with few calm periods in between)
Lethargy (excess sleepiness, lack of smiles or interested gaze, weak sucking lasting over six hours)
Poor weight gain (gaining less than  15 grams a day)Problems to consider when the above are present include:
Infections (e.g. ear infection, urine infection, meningitis, appendicitis)
Intestinal pain (e.g. food allergy, acid reflux, constipation, intestinal blockage)
Trouble breathing (e.g. from a cold, excessive dust, congenital nasal blockage, oversized tongue)
Increased brain pressure (e.g. hematoma, hydrocephalus)
Skin pain  (e.g. a loose diaper pin, irritated rash, a hair wrapped around a toe)
Mouth pain (e.g. yeast infection)
Kidney pain  (e.g. blockage of the urinary system)
Eye pain (e.g. scratched cornea, glaucoma)
Overdose  (e.g. excessive Vitamin D, excessive sodium)
Others (e.g. migraine headache, heart failure, hyperthyroidism)Persistently fussy babies with poor weight gain, vomiting more than five times a day, or other significant feeding problems should be evaluated for other illnesses (e.g. urinary infection, intestinal obstruction, acid reflux).
Toxic multinodular goiter (TMNG), also known as multinodular toxic goiter (MNTG), is an active multinodular goiter associated with hyperthyroidism. It is a common cause of hyperthyroidism in which there is excess production of thyroid hormones from functionally autonomous thyroid nodules, which do not require stimulation from thyroid stimulating hormone (TSH).Toxic multinodular goiter is the second most common cause of hyperthyroidism (after Graves disease) in the developed world, whereas iodine deficiency is the most common cause of hypothyroidism in developing-world countries where the population is iodine-deficient. (Decreased iodine leads to decreased thyroid hormone.) However, iodine deficiency can cause goiter (thyroid enlargement); within a goitre, nodules can develop. Risk factors for toxic multinodular goiter include individuals over 60 years of age and being female. Signs and symptoms
Symptoms of toxic multinodular goitre are similar to that of hyperthyroidism, including:
heat intolerance
muscle weakness/wasting
hyperactivity
fatigue
tremor
irritability
weight loss
osteoporosis
increased appetite
non-painful goitre (swelling of the thyroid gland)
tachycardia (high heart rate - above 100 beats per minute at rest in adults)
tracheal compression
exophthalmos

Causes
Sequence of events:
Iodine deficiency leading to decreased T4 production. Induction of thyroid cell hyperplasia due to low levels of T4. This accounts for the multinodular goitre appearance. Increased replication predisposes to a risk of mutation in the TSH receptor. If the mutated TSH receptor is constitutively active, it would then become toxic and produces excess T3/T4 leading to hyperthyroidism. Diagnosis
Treatments
Toxic multinodular goiter can be treated with antithyroid medications such as propylthiouracil or methimazole, radioactive iodine, or with surgery. Another treatment option is injection of ethanol into the nodules.