Hyperthyroidism

What is hyperthyroidism?

Hyperthyroidism occurs if the body is making too much of the thyroid hormone. The disorder:

  • Affects women five to 10 times more often than men
  • May not present with recognizable symptoms

Symptoms will typically vary in severity between different patients. The level of discomfort can range from being uncomfortable to being disabling or potentially life-threatening if ignored. Talk to your healthcare provider immediately if you start to notice any unexplained symptoms.

What causes hyperthyroidism?

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There are a number of conditions that can result in hyperthyroidism, which is why vigilance and regular doctor’s appointments are crucial. Common hyperthyroidism causes include:

  • Graves’ disease: It is an autoimmune disorder, characterized by the swelling of muscles and other tissues around the eyes. It results in thyroid enlargement and hyperthyroidism. Graves’ disease can cause eye prominence, discomfort, and/or double vision.
  • Postpartum thyroiditis: Hyperthyroidism from this condition typically lasts one to two months and occurs in 5 to 10% of women within several months of giving birth. After a possible several months of hyperthyroidism, most women will recover and once again have normal thyroid function.
  • Silent thyroiditis: It is similar to postpartum thyroiditis, but it is not related to pregnancy. Patients with silent thyroiditis do not experience a painful thyroid gland.
  • Subacute thyroiditis: Viral infections can cause the condition, which leads to painful thyroid gland enlargement and inflammation. The condition will often naturally resolve itself by the thyroid self-healing over a period of several months.
  • Toxic multinodular goiter: Multiple nodules in the thyroid, producing excessive thyroid hormone, are often diagnosed in patients over the age of 50. The condition can affect a person’s heart rhythm.
  • Toxic nodule: The condition is when a single nodule or lump produces more thyroid hormone than the body needs in the thyroid.
  • Excessive iodine ingestion: Kelp tablets, cough medicines, heart medications, and x-ray dyes can lead to hyperthyroidism in patients with thyroid nodules.
  • Overmedication with thyroid hormone: Receiving excessive thyroxine replacement treatment can result in the development of hyperthyroidism in patients. Make sure that your physician evaluates your thyroid hormone dosage at least once per year. Do not give yourself any extra doses.

Always speak with your doctor about possible side effects to specific medications or treatments.

What are common symptoms of hyperthyroidism?

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Symptoms that are related to hyperthyroidism can look like those of other conditions. Make sure that you discuss any concerns or unexplained symptoms with your healthcare provider. Keeping track of when they first occur can help result in the best treatment plan.

Some or many of the symptoms that a patient may experience are:

  • Fast heart rate (over 100 beats per minute)
  • Anxiety, irritability, becoming argumentative
  • Unexplained weight loss
  • Tremors in hands
  • Hair loss
  • Muscle weakness (particularly in upper arms and thighs)
  • Smooth skin
  • Loose and frequent bowel movements
  • Increased perspiration
  • Intolerance of warm temperatures
  • Change in menstrual pattern
  • Greater risk of miscarriages
  • Increased tendency of fingernails separating from the nail bed
  • Eye protrusion (with or without double vision)
  • Prominent “stare” with eyes
  • Irregular heart rhythm (common in patients over 60)
  • Accelerated loss of calcium from bones

How is hyperthyroidism diagnosed?

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Diagnosing hyperthyroidism in patients will generally require a primary healthcare provider to work with a specialist. Your doctor will likely refer you to an endocrinologist who specializes in treating hormone-related conditions.

Your doctor will start out by going through your medical history and running a physical exam that checks a patient for:

  • Finger and hand tremors
  • Overactive reflexes
  • Rapid or irregular pulse
  • Changes to the eyes
  • Warm and/or moist skin
  • A larger-than-usual, bumpy or tender thyroid gland

 

More in-depth tests, including blood tests, help to determine hyperthyroidism. These are:

  • TSH (thyroid-stimulating hormone or thyrotropin) test
  • Estimates of free thyroxine (T4) and free triiodothyronine (T3)
  • TSI (thyroid-stimulating immunoglobulin or TRAb (thyrotropin receptor antibodies)
  • Radioactive iodine uptake (RAIU)

 

Blood tests that reveal hyperthyroidism may lead to your healthcare provider suggesting that you undergo one of two tests to determine why your thyroid is overactive.

  • Radioiodine scan and uptake test
  • Thyroid ultrasound

How is hyperthyroidism treated?

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The method that a doctor uses to treat your hyperthyroidism will depend on the severity of your condition and any relevant pre-existing, personal medical history. Treatment options include:

  • Anti-thyroid medications: Propylthiouracil (PTU) and methimazole (Tapazole) are the common drug treatments for hyperthyroidism. Your doctor may recommend you taking methimazole, because PTU can cause fatal liver damage in rare cases.
  • Radioactive iodine treatment: Treating hyperthyroidism linked to the overproduction of the thyroid hormone typically involves taking oral radioactive iodine. Results are typically seen after three to six months of treatment.
  • Surgical removal of the thyroid: It is rare that a doctor will recommend removing most of the thyroid gland. Surgery may be the preferred option for a pregnant woman who has severe, uncontrolled hyperthyroidism. These patients cannot safely take radioiodine.
  • Beta blockers: The temporary treatment will help to control hyperthyroidism symptoms in your body until other therapies take full effect. It may be the only practical option when hyperthyroidism is caused by thyroiditis or excessive ingestion of iodine.
  • Iodine drops: These are prescribed for severe cases of hyperthyroidism. They are also prescribed before you undergo surgery to address Graves’ disease.

Are there hyperthyroidism risk factors?

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There are certain risk factors associated with the development of hyperthyroidism.

  • A family history of thyroid disease (like Graves’ disease)
  • A personal history of chronic illnesses (like pernicious anemia and primary adrenal insufficiency)
  • A recent pregnancy

Speak with your healthcare provider about your history if you have any concerns. You may also consider seeking a full medical examination before a pregnancy so you are aware of underlying medical conditions.

What are complications of hyperthyroidism?

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There are a variety of complications that can arise from hyperthyroidism, including:

  • Heart problems (atrial fibrillation and congestive heart failure)
  • Brittle bones (osteoporosis)
  • Vision problems (thyroid eye disease)
  • Vision loss (if vision problems are left untreated)
  • Discolored, swollen skin (Graves’ dermopathy)
  • Thyrotoxic crisis (thyroid storm)

 

Individuals who experience a thyrotoxic crisis must seek immediate emergency medical care. The symptoms can become life-threatening and often include:

  • Fever
  • Fast heartbeat
  • Nausea and/or vomiting
  • Diarrehea
  • Dehydration
  • Confusion and/or delirium

What are lifestyle and home remedies for hyperthyroidism?

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Taking certain steps in your daily life to minimize the chances of developing hyperthyroidism is possible. Reducing iodine in your diet can significantly improve your symptoms. Try to avoid:

  • Kelp
  • Dulse
  • Other types of seaweed
  • Certain cough syrups and multivitamins

 

Individuals who are suffering from Graves’ disease can relieve their eye or skin symptoms by:

  • Not smoking
  • Lubricating the eyes (eye drops, cool compress, lubricating gel)
  • Wearing sunglasses (to protect against sun and wind)
  • Elevating your head while asleep (to relieve eye pressure)
  • Using over-the-counter creams for swollen skin (on the shins and feet)

What is the outlook for hyperthyroidism?

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A hyperthyroidism diagnosis may feel overwhelming and upsetting, but getting prompt medical care can result in thorough and effective treatment. Other ways that patients can cope with the condition while their body heals include:

  • Getting regular exercise to improve muscle tone and energy levels
  • Learning relaxation techniques to help maintain a positive outlook

 

Stress can be a risk factor for many conditions and diseases, including Graves’ disease. Your doctor will be able to direct you toward additional resources and possibly literature so that you can resume a healthy and unrestricted lifestyle.

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