Hyperthyroidism is a disease frequently found worldwide. The symptoms of this illness intensely affect the whole body, and there is a reason. Its particular way of manifestation is because of the hormonal basis of the disease.
The severity of the symptoms of hyperthyroidism would depend on many interacting factors, but yes, they can be very dangerous. By reading this article, you would obtain in-depth knowledge about this condition. Directly from a doctor with the most up to date information available, just keep reading through.
What is the thyroid?
The thyroid gland is a structure within the forefront of the throat that produces an essential molecule, a thyroid hormone. It is relatively small and has two lobes. The thyroid gland does not function alone; for thyroid hormone production, many factors take part in regulating the thyroid function. Despite small and its isolated location, this gland influences the whole body, as we will see further.
Two upper structures regulate the thyroid function from the skull; they are the pituitary gland and the hypothalamus, conforming an axis. First, the release of thyrotropin-releasing hormone (TRH) by the hypothalamus stimulates the pituitary gland to discharge the thyroid-stimulating hormone (TSH) that directly causes the thyroid gland to release thyroid hormones.
The thyroid function would end up on stable thyroid levels in the blood. However, a thyroid disorder would cause either an excess of thyroid hormone or a decrease in it. That is the aim of this article and the hypothyroidism one, to explain, when it raises or lowers, respectively.
The thyroid gland production of the thyroid hormone relies on many factors. The first one, as you saw, is the stimulation by other molecules from upper structures. Then, there is the iodine element; the thyroid gland needs it for producing hormones. It can be found in food as inorganic iodide, which can be absorbed and used by the body. The thyroid hormone has two major types, T4 (thyroxine) and T3, and both are produced in the gland. Nearly all of the thyroid gland production is T4, which is not active, and just 1% the active form, T3. However, the T4 transforms into T3 thanks to the liver and kidney; this active form of the hormone produces all the symptoms of hyperthyroidism.
What role plays the thyroid hormone in the body?
The thyroid hormones, as you just saw has two representatives, one that is inactive and mostly produced by the thyroid gland and the other, which is active and acquires its function capabilities by other organs like the liver and kidney, T4, and T3, respectively. For T3 to generate any effect on the body needs to join its receptor. Luckily, the receptor for this hormone is nearly in all the body, so when produced, it acts almost on every inch of body tissue.
The primary purpose of this hormone is to accelerate things, and I mean everything, including metabolism. T3 can rush things up, to generate energy, to speed up the heart, to burn fat, to stay alert. Mostly because this is some kind of chain reaction, the thyroid hormone does not do it all by itself. It triggers other hormones as the catecholamines thas produces the same effect. Nevertheless, remember that this is invariably a balance, the body is not always in acceleration, and it needs an adequate quantity of thyroid hormone to develop and maintain successfully. Therefore, when imbalanced, diseases arise.
What is hyperthyroidism?
Hyperthyroidism is a disease with a precise definition of an overactive thyroid gland that causes more production and circulation of the thyroid hormone. It creates a thyrotoxicosis state, which is the term for an increase in the blood levels of thyroid hormone; it does not have to do with the thyroid function, just blood thyroid hormone levels. Please, remember this because people tend to confuse or use these terms interchangeably.
This thyroid disorder showcase symptoms throughout the body, mostly subtle in the early stages, and sometimes alarming and very suggestive of hyperthyroidism with disease progression. However, the definitions of hyperthyroidism would mostly come from blood analysis, and it has various. For example, by measuring the blood levels of different hormones implicated in the thyroid loop, some conclusions could arise from what is happening to the thyroid gland, and the doctors give names to such situations.
The first situation is thyrotoxicosis, where there is a total suppression of TSH and an increase in the T3 and T4 levels. And there is subclinical hyperthyroidism, which often is a patient that does not have symptoms, but also in the blood exams only have a decrease in the TSH levels while T3 and T4 levels are normal. How is this possible? Well, as I said, between all of them, there is constant regulation. There are the upper structures that are supposed to stimulate the thyroid gland when thyroid hormones are low. However, in this situation thyroid gland is anomalously over-functioning and sending way more thyroid hormones to the blood than what the body needs. Therefore, the upper structures sense this high thyroid hormone levels as that they do not need to send more TSH to stimulate the thyroid gland because there is already too much of it.
What is the difference between hyperthyroidism and hypothyroidism?
Hyperthyroidism is a disease where the thyroid gland is over-functioning, while hypothyroidism has an underactive thyroid. The condition would manifest as precisely the opposite because when there is too much thyroid hormone, there would be an acceleration of all the body systems, and in the hypothyroidism would be inverse, a marked slow-moving of all the normal human body processes. For obtaining more knowledge about this thyroid problem, just click here.
So, what causes it?
Hyperthyroidism can exist because of several causes, some of them by increasing the thyroid gland activity and others without it. Yes, it is possible to have symptoms of hyperthyroidism without detecting an overactive thyroid that you must remember is the one that secretes the hormone. Let me show you.
Hyperthyroidism just reflects an increase in thyroid gland activity. It is defined by a radioactive iodine test that we will see further in the diagnosis section. And I said that you needed to remember there is thyrotoxicosis in which although there is no necessarily any increased thyroid gland activity. Indeed there is a raise in the thyroid hormone levels, which in the end are the ones causing the symptoms of hyperthyroidism.
Thyrotoxicosis with hyperthyroidism causes includes Graves’ disease, TSH secreting pituitary adenoma, trophoblastic tumors, self-governing thyroid function (solitary adenoma; multinodular goiter; familial non-autoimmune hyperthyroidism). And there is thyrotoxicosis without hyperthyroidism such as autoimmune disease destruction of the thyroid gland, viral infection (De Quervain thyroiditis), toxic drug effects, bacterial or fungal infection, radiation, and obtaining thyroid hormone from external to the body sources (excess of thyroid hormone administration for example among others.)
All the causes of thyrotoxicosis without hyperthyroidism are mostly due to direct harm of the thyroid gland that causes the release of the thyroid hormone that was stored, or the person unnoticed or not, starts obtaining thyroid hormone from an external source. In the end, no direct thyroid gland activity causes these diseases.
What are the most common causes of hyperthyroidism?
For the thyrotoxic with hyperthyroidism group, the most common cause of hyperthyroidism is Graves’ disease. This is a puzzling condition, an autoimmune disease, where genetics plays a significant role, but it cannot explain all the cases; other risk factors for having it are phycological distress, smoking, and female sex. In this disease, the body starts producing proteins that first had to protect us from foreign microbes. Still, they start recognizing and stimulates the same receptor TSH uses to increase thyroid gland activity.
People that do not obtain sufficient iodine (it mostly is on sea salt) cause chronic damage in the gland. The organ changes into bigger for producing the same number of thyroid hormones; it would become an enlarged thyroid gland (a goiter). The receptors change, and proteins within the cells are also hurt. The result is a permanent change of how the gland functions; it would require medical management. Nevertheless, it is important to point out that goiters can appear in everyone, at any time of life, and if people have risk factors for it, even more.
Some common thyroid problems could develop from this lack of iodine situation as toxic multinodular goiter and toxic adenoma. Iodine sufficient areas are places where the food must contain a specific amount of iodine, which is fundamental for thyroid gland function. In situations where there is adequate iodine on a diet, Graves’ disease accounts for 80% of the cases. In contrast, in places of insufficient iodine, multinodular goiter and toxic adenoma explain 50% of the cases.
Thyrotoxicosis without hyperthyroidism is less common and usually transient. However, it accounts for a non-despicable portion of the cases, approximately a fifth of them, only by subacute thyroiditis.
What are the risk factors for hyperthyroidism?
It would depend on the disease; for example, graves’ disease occurs mostly in people aging twenty to forty years. Toxic multinodular goiter and toxic adenoma in places where there is insufficient iodine consumption. Also, specifically, these two diseases tend to appear in older people, beyond fifty years. All of the thyroid disorders are way more common in the female than in the male population.
Furthermore, genetics plays a significant role too, so having a history of a family with thyroid disorders also accounts for a risk factor. In the female population, times in life where hormones play an essential role as pregnancy and menopause are a risk factor. Then, there are certain medications for heart or psychiatric conditions, amiodarone, and lithium, respectively. They enhance the possibility of having thyroid disease. Patients with a diagnosis of autoimmune disease are also at risk. Finally, radiation exposure of the neck or chest area in any way increases the chances.
What are the signs and symptoms of hyperthyroidism?
Hyperthyroidism condition affects a wide range of body’s spheres, through thyrotoxicosis. The symptoms subtly vary from the younger to the older patients with the disease, as the former present more with neurologic symptoms, as anxiety, and the latter, cardiovascular conditions as shortness of breath. However, they both can have any of the symptoms that I am going to tell you.
Typical symptoms are palpitations, nervousness, breathing rapidly, anxiety, disturbed sleep, heat intolerance, sweating, and a thirst increase. Because of the anxiety, patients can often have shortness of breath and diarrhea. Then, there are particular symptoms of the underlying cause. It is typical to find in Graves’ disease, for example, the graves’ ophthalmopathy, which is an affection of the eyes with symptoms as swelling, redness, bulging eyes, or even double vision. Nevertheless, this expression of the disease is not always present, although when it does, it is characteristical.
Now, the signs, which are the ones the doctor will seek for diagnosing the disease. The doctor can find an increase in the heart rate, high systolic blood pressure, warm skin, hand tremor, muscle weakness, weight loss, and less blood discharge while menstruating. All these signs could exist to a major or lesser extent, and they do not precisely correlate with the thyroid hormone levels.
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What are the possible complications of hyperthyroidism?
The interaction between many factors mostly determines the possibility of having several complications. The list of factors includes the patient’s age and sex, having other conditions, disease duration, the specific cause for hyperthyroidism (ones are more severe than others), and of course, untreated hyperthyroidism.
For example, older patients, with more than sixty years, tend to have mild symptoms but to develop cardiovascular complications. They are three times more likely to have atrial fibrillation, which is a very life-threatening condition; it is an important cause of embolic stroke and congestive heart failure in them. Also, the studies show that patients with hyperthyroidism are more likely to die by cardiovascular causes than other healthy old patients.
Another serious complication is thyrotoxic periodic paralysis. Because of the hormonal changes exists an abrupt flow of potassium to the inner portion of muscle cells. It causes both muscle paralysis and low serum potassium. Also, the lower levels of potassium are in association with cardiac arrhythmias, and they can prompt death.
More complications could exist, although less severe such as osteoporosis, changes in the reproduction system, men could develop boobs (gynecomastia), and women can experience menstrual irregularities, and the list could continue.
Do you have a thyroid storm?
Thyroid storm is an unusual but deathly complication that could exist because of hyperthyroidism. It occurs in patients with an inadequate or no medical control at all, that are exposed to stressful events as can be an infection, surgery, or significant trauma.
The symptoms of this condition are overwhelming, it is the most prominent expression of what the thyroid hormones can do to the body. The patient will have a high fever, nausea, vomiting, accelerated heart rate, severe agitation, and can start to lose consciousness. This complication is the primary reason why patients should receive therapy.
Can hyperthyroidism be a thyroid cancer symptom?
Thyroid cancer has its own and worrying symptoms. If you are having any of these, you should consult a doctor right away: swelling in the neck, voice changes, trouble swallowing, trouble breathing, or chronic cough. Yet, a relationship between having a hyperthyroidism diagnosis and a further risk of developing thyroid cancer is evident in some studies. The thyroid cancer mean rate of appearance for patients with hyperthyroidism that underwent surgery was found to be about eight percent. However, this is just one study, albeit important further, and more specific information would come through.
What tests are used for the diagnosis of hyperthyroidism?
Firstly, a thyroid function screening test with a blood sample. It will measure thyroid hormone levels, T3 and T4, and TSH levels. From the three of them, the most reliable marker is the decrease of the TSH. This test would allow the doctor to identify thyrotoxicosis.
Secondly, a scintigraphy or thyroid radioactive iodine uptake test (a select thyroid scan) utilization is mandatory unless a Graves’ disease is evident by just looking at the patient. This test would determine the hyperfunction or not, and if it is hyperfunctioning, in which areas of the thyroid gland it is. It also helps to define which thyroid nodule needs more study by your doctor due to possible cancer. The next step for the patients with that possibility would consist of taking a sample of the thyroid tissue with a needle.
Thirdly, for the most common cause of this condition, Graves’ disease, there are blood tests that measure the levels of the protein which source it. Their names are autoantibodies, and the most specific for defining this disease is the anti-TPO antibody. This one is elevated only in Graves’ thyrotoxicosis because there others that, although they can help, could also have an elevation in people without any thyroid condition, as TSI and anti-TG. However, none of them are useful for screening otherwise healthy people because they all can yield positively at some point without graves’ disease. Therefore, their utilization is only in highly probable patients.
It is also a suggestion the utilization of thyroid echography or thyroid scan for the assessment of the thyroid gland, with the advantage of not having any side effects as the thyroid radioactive iodine uptake test does.
What is the treatment for hyperthyroidism?
Mainly there are three kinds of treatment, antithyroid drug, radioactive iodine therapy, and thyroid surgery. The utilization of each one of them would depend, let me explain it to you.
For Graves’ disease, all three types of treatment are useful. On the other hand, for toxic adenoma and toxic multinodular goiter should be used, the two latter. Antithyroid medication rarely accomplishes remission in these two diseases.
Antithyroid medicine (methimazole and propylthiouracil) function is simple. It will block the production of thyroid hormones. However, they do not have an impact on patients with a low response in the thyroid radioactive iodine uptake test, or the two diseases aforementioned. Also, this type of medication could have severe adverse effects.
Radioiodine treatment is a widespread therapy in the United States, mostly for Graves’ disease. This therapy is efficient and harmless and could even have higher cure rates than antithyroid medicine. The radioactive iodine is taken as a pill or in liquid form just once. Most of the time, this therapy will cause the patient hypothyroidism, although most of the experts consider it a tremendous success.
Thyroid surgery is reserved for special occasions due to the enormous achievement of the other two therapy options. The lists of possibilities include severe hyperthyroidism in children, a pregnant woman that does not want or can use antithyroid treatment, patients with very large goiters, patients needing a fast normalization of thyroid hormone levels, and the ones refractory to treatment.
I have symptoms of hyperthyroidism; what should I do?
I did this hyperthyroidism symptoms checker. This tool will serve you to acknowledge if your symptoms are indeed due to hyperthyroidism. It would only take a few minutes, and it is free.