Hyperthyroidism – Causes, Symptoms, Diagnosis, and Treatments

What is Hyperthyroidism? 

Overproduction of thyroid hormone by the thyroid gland results in Hyperthyroidism. This condition is commonly referred to as overactive thyroid. This can cause diarrhoea, trouble breathing, and fatigue.

The thyroid gland is a little butterfly-shaped gland at the front of your neck. It produces triiodothyronine (T3) and thyroxine (T4), two major hormones that regulate how your cells use energy.

The thyroid gland is important in many of your body's processes, including:

• Maintaining your body temperature
• Keeping your heart rate under control
• Balancing your metabolism

When your thyroid produces too much T3, T4 or both, it causes your body's processes to speed up, producing discomfort.

Parathyroid hormone is another vital hormone produced by your thyroid, which helps maintain the optimal calcium level in your blood.

Causes of Hyperthyroidism  

There are various reasons for Hyperthyroidism.

• Graves' disease
• Overactive thyroid nodules
• Thyroiditis (inflammation of the thyroid gland)
• Excessive iodine intake
• Excessive thyroid hormone medication
• A noncancerous tumour of the pituitary gland

Graves' disease

Graves' disease, the most common cause of Hyperthyroidism, is an autoimmune condition. In this disorder, the immune system attacks the thyroid, causing it to produce an excess of thyroid hormone.

Overactive thyroid nodules

Overactive thyroid nodules, or lumps in your thyroid, are frequent and typically not malignant.

However, one or more nodules may become overactive and release excessive thyroid hormones. Overactive nodules are common in older adults.

Thyroiditis

Thyroiditis is an inflammatory condition that can affect the thyroid gland. In some cases of thyroiditis, thyroid hormones can leak out of your thyroid gland and into your circulation. And as a result, you may experience Hyperthyroidism symptoms.

The types of thyroiditis are:

• Subacute thyroiditis – Patient presents with severely inflamed and swollen thyroid
• Postpartum thyroiditis – A condition that can occur after a woman gives birth
• Painless thyroiditis – This is comparable to postpartum thyroiditis but does not develop during pregnancy. According to experts, painless thyroiditis is most likely an autoimmune illness.

Excessive iodine intake

Iodine is used by your thyroid gland to produce thyroid hormones. Iodine consumption has an impact on how much thyroid hormone your thyroid produces. In certain people, consuming large amounts of iodine may cause the thyroid to overproduce thyroid hormone.

Several cough syrups and medications, particularly some cardiac medications, may be high in iodine. Iodine is abundant in seaweed and seaweed-based supplements.

Excessive thyroid hormone medication

Some hypothyroid patients may take too much thyroid hormone medication. If you are taking thyroid medication, make an appointment with your doctor at least once a year to have your thyroid hormone levels examined.

If your doctor determines that your thyroid hormone level is too high, you may need to modify your dose.

Other medications may interact with thyroid hormonal treatment and raise hormone levels. If you use thyroid hormone medication, see your doctor before starting any new medications.

A noncancerous tumour 

A noncancerous growth of the pituitary gland, situated near the base of the brain, can induce Hyperthyroidism in rare situations.

Symptoms of Hyperthyroidism

If symptoms appear, they might impact the entire body and various physiological processes. Excess thyroid hormones increase metabolism, which accounts for the majority of symptoms.

These symptoms vary from person to person and might include,

• Weight reduction despite increased appetite
•  Fast or irregular heartbeat
• Agitation, irritability, sleeping difficulties and fatigue
•  Trembling hands and muscular weakness
•  Sweating or difficulty with heat tolerance
• Frequent bowel movements
• Infertility and a lack of sexual desire
• Itchy skin with hives or urticaria
• Loose nails
• Menstruation issues, particularly lighter or absent periods
• Alopecia or patchy hair loss

Treatments for Hyperthyroidism  

Some medications address Hyperthyroidism symptoms, such as heart issues, while others address thyroid hormone production.

Beta-blockers

Beta-blockers cannot treat Hyperthyroidism, but they can alleviate symptoms while waiting for other therapies to take action. However, this might take a few weeks or months.

Antithyroid drugs

Antithyroid drugs prevent the thyroid gland from releasing excessive amounts of thyroid hormone. Methimazole is a frequent drug that physicians suggest.

During the first trimester of pregnancy, a doctor might prescribe propylthiouracil rather than methimazole since methimazole may harm the foetus. Pregnant women may be able to transition to methimazole later in their pregnancy.

According to the American Thyroid Association, when treated with antithyroid medicines for 12–18 months, around 20–30% of persons with Graves' disease experience symptom remission.

Medication side effects might include:

• Allergic reactions
• Lesser white blood cells, increasing the risk of infection and, in rare situations, liver failure

Radioactive iodine

Radioactive iodine penetrates and kills active thyroid cells; the impact is localised, and there are no overall effects. The radiation dosage in radioiodine is very low and not dangerous.

Radioiodine therapy, on the other hand, is not recommended for pregnant or nursing women, and women should wait atleast 6–12 months following therapy to conceive.

Surgery

If no other therapies are available, surgery might be used to remove part or all of the thyroid gland. Pregnant women, individuals who cannot tolerate alternative medicines, and cancer patients may benefit from a surgical approach.

Diagnosis tests for Hyperthyroidism

When making a diagnosis of Hyperthyroidism a doctor will examine you physically, record your personal and family medical history, and order tests. Symptoms, clinical signs and lab testing are often used to diagnose Hyperthyroidism.

The diagnosis tests are:

1. T4, free T4, and T3 tests

 These tests determine the amount of thyroid hormones (T4 and T3) in your blood.

2. TSH (thyroid-stimulating hormone) test

TSH is a pituitary gland hormone that increases thyroid gland hormone production. When your thyroid hormone levels are high, your pituitary gland responds by producing less TSH.

TSH levels that are excessively low might be an early symptom of Hyperthyroidism.

3. Thyroid scan (radioactive iodine uptake scan)

By analysing the amount of iodine your thyroid "takes up" from your bloodstream, this scan helps your doctor to determine whether your thyroid is hyperactive.

Your doctor will provide a little pill or liquid dose of iodine. Then you'll lie down on a table while an advanced and powerful camera photographs your thyroid.

A thyroid scan can identify whether the disease affects the entire gland or just a specific location.

4. Thyroid ultrasound

Ultrasounds may determine the size of the thyroid gland as a whole and any tumours on or in it (such as nodules). Doctors can also use ultrasounds to evaluate whether a tumour is solid or cystic.

5. MRI or CT scans

A pituitary tumour can be detected via a CT scan or an MRI.While some of these tests can be prescribed by general care physicians, it is recommended to consult an endocrinologist. Endocrinologists are experts in the treatment and management of hormone-related health issues.

Risk factors of Hyperthyroidism

The following are the primary risk factors for Hyperthyroidism

Sex

Females are far more likely than males to have Hyperthyroidism. Experts believe it has something to do with hormones.

 Pregnancy

Pregnancy can induce Hyperthyroidism in certain people, leading to difficulties for both the mother and the foetus.

 Age

As you age, your risk of Hyperthyroidism rises, especially around the age of 60.

 Genetics

A family history of Hyperthyroidism is typically associated with an increased risk of getting the illness.

 Iodine poisoning

Certain drugs and foods may have an excessive amount of iodine.

 Having another medical condition

Pernicious anaemia, Type 1 diabetes, and primary adrenal insufficiency patients are at an increased risk of getting Hyperthyroidism.

You can reduce the risk factors for Hyperthyroidism by changing your lifestyle. This involves eating a well-balanced diet, supplementing with nutritional supplements as needed, and obtaining enough physical exercise during the week.

You can create a strategy with specific goals to better your health.

Smoking has been shown to raise your risk of Graves' disease. Large-scale Norwegian research published by JAMA in 2007 indicated that smokers had greater thyroid hormone levels than nonsmokers. Women who currently smoked had about double the incidence of Hyperthyroidism as women who had never smoked.

Complications of Hyperthyroidism

Hyperthyroidism can lead to several serious complications, particularly if left untreated.

1. Eye

According to the American Thyroid Association, people can have eye problems (known as Graves' ophthalmopathy), which can produce gritty, red eyes or protrusion owing to swelling behind the eyeballs.

Double vision can occur in extreme situations.

2. Bone

Osteoporosis is associated with Hyperthyroidism, which causes bone weakness, making a person more prone to fracturing bones with simple bumps or falls.

3. Heart

There is a big chance of developing atrial fibrillation with Hyperthyroidism, especially in elderly adults. Atrial fibrillation is a frequent cardiac arrhythmia that can result in serious complications such as stroke or heart failure.

4. Pregnancy

While moderate-to-severe hyperthyroidism in a mother can cause problems, mild hyperthyroidism during pregnancy often poses no danger to the mother or her unborn child.

According to the American Thyroid Association, unmanaged or untreated Hyperthyroidism in the mother during pregnancy is linked to small gestational age babies, premature delivery, stillbirth, and congenital abnormalities.

Preeclampsia and, in rare cases, thyroid storm, are possible consequences of untreated Hyperthyroidism for the mother.

5. Thyroid storm

A thyroid storm is an uncommon but possibly fatal illness that develops in people with uncontrolled Hyperthyroidism.

A stressful event, such as surgery, loss, trauma, or disease, may cause a thyroid storm, according to the National Library of Medicine of the United States MedlinePlus.

A thyroid storm is characterised by exaggerated hyperthyroidism symptoms, such as a rapid heart rate, high temperature, diarrhoea, agitation, delirium, and/or diminished awareness.

When should you see a doctor?

Consult your doctor if you have,

• Unexplained weight loss,
• A rapid heartbeat
• Unusual perspiration
• Other signs and symptoms of Hyperthyroidism, such as neck swelling.

Because many signs and symptoms of Hyperthyroidism might be connected with various diseases, you must detail the changes you've noticed.

If you've undergone treatment for Hyperthyroidism or are currently being treated, see your doctor frequently so that they can check your health.

Conclusion 

Your thyroid may start producing too much thyroid hormones for a variety of reasons.

Hyperthyroidism can be caused by

• A genetic predisposition to thyroid diseases such as Graves' disease,
• Having an excessive iodine intake, or
• Even being pregnant.

Eating healthily, exercising and quitting smoking can all help lower your risk.

Symptoms, blood testing and imaging are used to diagnose Hyperthyroidism. Medication, radioiodine therapy, and, if required, surgery to remove all or part of the thyroid gland are the primary treatments.

The cause determines the long-term prognosis of Hyperthyroidism. Without treatment, most illnesses, including Graves' disease, will progress and can be fatal.

The good news is that Hyperthyroidism is fairly curable, and many people who have it can recover completely.

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