Hyperthyroidism

What Is Hyperthyroidism?

The thyroid is a butterfly-shaped gland, which is present in the neck. This gland releases T3 (Triiodothyronine) and T4 (Tetraiodothyronine), which are hormones that regulate the metabolism in the body.

When the thyroid gland secretes too much of T3, T4, or both, it is called hyperthyroidism or overactive thyroid. Overproduction of these hormones affects many functions of the body. This condition can result from various causes and can lead to many symptoms. It affects women more commonly than men and is commonly seen in people who are 60 years or older.

What Are the Causes of Hyperthyroidism?

Many factors cause the thyroid gland to become overactive. Some of the common causes are:

• Graves’ Disease - It is an autoimmune condition and is responsible for more than 70 percent of hyperthyroidism cases. It is genetic and causes the eyes to protrude. Patients usually suffer from discomfort in the eyes and double vision.

• Nodular Thyroid Disease - This condition causes noncancerous lumps to develop in the thyroid gland. They make the thyroid gland overactive.

• Thyroiditis - A viral infection of the thyroid that results in inflammation is called thyroiditis.

• Increased Iodine Intake - The thyroid gland uses the iodine from the blood to produce thyroid hormones. Thus, increased intake of iodine makes the thyroid gland absorb too much iodine, which results in overproduction of thyroid hormones.

• Follicular Thyroid Cancer - The cancer cells start producing thyroid hormones in addition to the healthy cells.

• Medications - Medicines that contain high amounts of iodine can result in hyperthyroidism. Examples are Amiodarone, Lithium, etc.

• Taking Too Much Thyroid Hormone Medicine - If an individual is under treatment for hypothyroidism, it is crucial to check the hormone levels every year, as taking too much thyroid hormone medicine might result in hyperthyroidism.

What Are the Signs and Symptoms of Hyperthyroidism?

Mild hyperthyroidism usually does not cause any symptoms and goes unnoticed. The symptoms seen are different for different people. The most common symptoms include:

The thyroid gland enlarges, which causes swelling in the neck (goiter).

• Irritability.

• Mood swings.

• Restlessness.

• Lack of concentration.

• Tiredness.

• Difficulty sleeping.

• Breathing problems.

• Intolerance to heat.

• Excessive sweating.

• Frequent bowel movements.

• Urticaria.

• Heart palpitations.

• Fine and brittle hair.

• Menstrual periods are lighter or absent.

• Low libido (decreased sexual desire).

• Infertility.

• Hair loss occurs in patches (alopecia).

• Sudden weight loss.

• Tremors in palms and hands.

• Nails become loose.

• Thinning of the skin.

It also causes increased thirst and tiredness for diabetic patients and heart failure and arrhythmias in patients with heart problems.

What Are the Risk Factors for Hyperthyroidism?

Some of the factors that increase the risk of hyperthyroidism are:

• Females.

• Family history of the disease.

• Presence of any chronic illness like diabetes (type 1), vitamin B12 deficiency, and primary adrenal insufficiency.

What Are the Complications Associated with Hyperthyroidism?

This condition can result in a lot of complications like:

• Graves’ Ophthalmopathy - The eyes of people with hyperthyroidism become protruded, swollen, red, sensitive to light, and develop double vision. It can also result in blindness if left untreated.

• Osteoporosis - As high levels of thyroid hormones interfere with the absorption of calcium into the bones, it results in weak and brittle bones.

• Atrial Fibrillation - Hyperthyroidism can also lead to atrial fibrillation, where the heart beats rapidly, which increases the risk of a stroke and congestive cardiac failure.

• Graves’ Dermopathy - The skin becomes red and swollen. It usually affects the skin of the shins and feet.

• Thyrotoxicosis Crisis or Thyroid Storm - It is a medical emergency, which causes high fever, rapid heartbeat, jaundice, vomiting, diarrhea, dehydration, and delirium (a major change in thinking skills).

How Is Hyperthyroidism Diagnosed?

The doctor might suspect hyperthyroidism if the patient has some of the signs and symptoms as mentioned above. He or she will ask to swallow and will examine the thyroid gland for any swelling, bumpiness, or tenderness.

To confirm the diagnosis, the patient has to get the following blood tests done:

• T3 and T4 -If the blood reports show high levels of thyroxine (T3 and T4), it indicates hyperthyroidism.

• Thyroid-stimulating Hormone (TSH) - TSH is the hormone secreted from the pituitary gland, which signals the thyroid gland to release thyroxine. Low or absence of TSH indicates that the thyroid gland is overactive.

• Cholesterol and Triglycerides - Low levels of triglycerides and cholesterol indicate an elevated metabolic rate.

If one has hyperthyroidism, the doctor will suggest to take the following tests to know the cause:

• Thyroid Ultrasound - An ultrasound is done to measure the size of the gland, and to see the presence of any mass or cysts.

• Radioiodine Uptake Test and Thyroid Scan - Here, the amount of iodine absorbed by the thyroid gland is seen, after administering an oral dose of radioactive iodine. If the gland absorbs too much iodine, it indicates overproduction of thyroxine.

• CT or MRI Scans - These scans are used to diagnose a tumor of the pituitary gland, which might also cause this condition.

Is Hyperthyroidism Curable?

The following treatment options help manage symptoms and reduce the production of thyroid hormones.

• Beta-blockers - They help ease symptoms like tremors, rapid heartbeat, and heart palpitations. It is used until the hormone levels come back to normal.

• Antithyroid Medicines - Drugs like Methimazole and Propylthiouracil (PTU) stop the thyroid gland from producing too much T3 and T4. It usually takes about a year or more for the hormones to come back to normal.

• Radioactive Iodine - Radioactive iodine which when taken orally gets absorbed by the gland, which causes the gland to shrink.

• Thyroidectomy - Here, the thyroid gland is partially or completely removed. The disadvantage is that one has to take Levothyroxine for the rest of their life to supply sufficient amounts of thyroid hormones to the body.

Can Diet Improve Hyperthyroidism Symptoms?

Take supplements or food rich in vitamin D and calcium, as the patients are susceptible to developing osteoporosis. Reduce the intake of iodine, as it can worsen the symptoms. Even some multivitamins and cough syrup contain a lot of iodine.

What Are the Precautions to Be Taken to Avoid Complications of Hyperthyroidism?

To prevent Graves’ ophthalmopathy and dermopathy, some preventive measures that can be applied are:

• Avoid smoking.

• Prevent the patient's eyes from drying out by using lubricating gel or drops.

• Wear sunglasses when the patient goes out in the sun.

• Use pillows to keep the head elevated, as this will reduce swelling and relieve pressure on the eyes.

• For redness of the skin, try using creams containing Hydrocortisone.

Conclusion

Hyperthyroidism, also referred to as an overactive thyroid, is more prevalent among females. This condition arises from a variety of factors, with the predominant cause being Graves’ disease. Individuals affected with hyperthyroidism have a range of treatment options at their disposal to effective.