Thyroid Disorders  Hyperthyroidism
Overview and Causes
Hyperthyroidism occurs when the thyroid makes too much thyroid hormone. There are several types of hyperthyroidism, each associated with a different cause. Graves' disease (also known as diffuse toxic goiter) is the most common. Other causes of hyperthyroidism include toxic multinodular goiter, thyroid adenoma, and thyroiditis. Other rare causes include consuming too much dietary iodine, overactive metastatic cancer, or rare diseases of the ovary or testicles that can cause the thyroid to be over-stimulated.
Symptoms
There are several symptoms associated with hyperthyroidism. These include:
- Nervousness and irritability
- Increased resting heart rate
- High blood pressure
- Heat intolerance and increased sweating
- Tremor
- Weight loss or alterations in appetite
- Frequent bowel movements
- Sudden paralysis
- Thyroid enlargement (lump in the neck)
- Thick redness on the front of legs (Pretibial myxedema), presents with Graves' Disease
- Thin, delicate skin and irregular fingernail and hair growth
- Menstrual disturbance (decreased flow)
- Impaired fertility
- Mental disturbances
- Sleep disturbances (including insomnia)
Diagnosis
A complete medical history and physical exam should be performed by a physician with particular attention to weight and blood pressure, pulse rate and rhythm, thyroid gland size, reflexes, eyes (to check for exophthalmos or ophthalmopathy), skin changes, and lymph nodes. Often, other screening tests are performed to test Thyroid Stimulating Hormone (TSH) blood level, thyroid hormone levels, thyroid antibodies, radioactive iodine uptake, and/or a thyroid scan.
Treatment
Treatment can differ amongst patients depending on the cause of the hyperthyroidism. Thyroiditis often does not require specific treatment because this type of hyperthyroidism usually resolves itself within a few weeks to months. For treating other forms of hyperthyroidism, antithyroid drugs may be prescribed to stop the production and release of thyroid hormones or to block thyroid hormone activity through the body. Radioactive iodine is the treatment of choice for Graves’ disease, although most people become hypothyroid after radioactive iodine therapy.
In the past, surgery to remove the thyroid was a common treatment for Graves' disease, but it is rarely performed today. If surgery is elected for a patient with a toxic nodule, the surgeon removed the part of the thyroid that is dysfunctional, allowing the remaining thyroid to function normally. If the entire thyroid is over productive, as in Graves’ disease, the surgeon must remove most or all of the gland. Candidates for surgery may include pregnant hyperthyroid patients who cannot take antithyroid drugs, patients who do not want to use radioactive iodine, children, and patients with very large or multinodular goiters.
 |
