Hyperthyroidism
Hyperthyroidism (overactive thyroid) occurs when your thyroid gland produces too much. Hyperthyroidism can speed up your body’s metabolism, causing unwanted weight loss and rapid or irregular heartbeats.
Although hyperthyroidism can be serious if ignored, most people respond well after being diagnosed and treated for hyperthyroidism.
Diagnosis of hyperthyroidism
The diagnosis is based on the combination of symptoms, Such as unexplained weight loss, irregular heartbeat, palpitations, nervousness, irritability, increased sweating, changes in the menstrual cycle, fatigue, muscle weakness and …. together with abnormalities in blood tests used to examine thyroid hormone levels. Thyroid function tests to diagnose hypothyroidism include the following:
Thyroid Stimulating Hormone (TSH)
Thyroxine (T4)
Triiodothyronine (T3)
To diagnose thyrotoxicosis, tests should show raised thyroid hormone levels in the blood (raised thyroxine and/or triiodothyronine) and low, undetectable thyroid stimulating hormone (a hormone released by the pituitary gland that stimulates the thyroid gland to release its hormones). Thyroid stimulating hormone becomes suppressed in this way due to the excessive thyroxine and triiodothyronine already circulating in the body. This is sensed by the pituitary gland, which inhibits it from producing any more thyroid stimulating hormone.
If the patient is suspected of having autoimmune hyperthyroidism (Graves’ disease), an additional blood test to check for thyroid autoantibodies is helpful.
Thyroid antibodies are essential. These antibodies include:
- Anti-thyroid peroxidase (TPO) antibody
- Thyroid Stimulating Antibody Antibody (TSab)
In patients with Graves’ disease, these two antibodies increase significantly.
Treatment for thyrotoxicosis will depend upon your age, the cause and severity of your illness, and other medical conditions you may have.There are three main methods of treatment for thyrotoxicosis:
Drug treatment
Two “antithyroid” drugs are available to treat hyperthyroidism. These drugs inhibit the thyroid gland’s production of thyroid hormone. Another class of drugs called beta adrenergic blocking agents can diminish some of the symptoms of thyrotoxicosis.
Radioactive iodine
Your doctor may choose to treat your condition by permanently damaging the cells in the thyroid that produce thyroid hormone. This can be accomplished with the use of radioactive iodine, which has been utilized as a treatment regimen since the 1940s. Radioactive iodine is a tasteless and odorless substance that is swallowed in capsule or liquid form. Once ingested, it is absorbed into the bloodstream and is taken up by the overactive thyroid cells. Over a period of several weeks your thyroid gland will shrink in size and blood levels of thyroid hormone and thyroid stimulating hormone (TSH) will return to normal.
Surgery
Your doctor may recommend that you have surgery to remove all or part of your thyroid gland. You may be a candidate for partial removal of your thyroid gland if one or more nodules on the gland are overactive. However, if many nodules are involved or if your entire thyroid gland is overactive, your doctor may suggest that most or all of it be removed. Surgery to remove part or all of your thyroid gland is done under a general anesthetic in the operating room. Once the majority of your gland is removed, you will need to take thyroid hormone replacement therapy every day to replace the hormone that is not being made naturally in your body.
Who is most at risk for hyperthyroidism?
- Women are 2 to 10 times more likely than men to develop hyperthyroidism
- have a family history of thyroid disease
- have other health problems, including
- pernicious anemia NIH external link, a condition caused by a vitamin B12 deficiency
- type 1 diabetes
- primary adrenal insufficiency, a hormonal disorder
- are older than age 60, especially if you are a woman
- were pregnant within the past 6 months
References
https://emedicine.medscape.com/article/121865-overview
https://www.yourhormones.info/endocrine-conditions/thyrotoxicosis/
https://www.niddk.nih.gov/health-information/endocrine-diseases/hyperthyroidism
