Hyperthyroidism

General Illness Information

Common Name:
Hyperthyroidism

Medical Term: Hyperthyroidism

Description: Excessive levels of thyroid hormone  – usually due to over-activity of the thyroid gland.  This hormone regulates all body functions, and therefore over-production of thyroid hormone will have widespread effect in the body.

Types of hyperthyroidism include:

  • Graves’ disease (GD) – the most common form – an autoimmune disease;
  • Toxic multinodular goiter – occurs late in life. Nodules are insidious and almost never malignant;
  • Toxic uninodular goiter – solitary nodule with autonomous function. Almost always benign;
  • Other causes are rare and include pituitary tumors, trophoblastic tumors, and iodine-induced hyperthyroidism, especially from the cardiac drug amiodarone.

Causes:

  • Graves’ disease – autoimmune disease;
  • Toxic multinodular goiter – iodine deprivation followed by iodine replacement;
  • Toxic uninodular goiter – unknown.

Prevention:

Not known.

Signs & Symptoms

  • Nervousness;
  • Increased sweating;
  • Heat intolerance;
  • Palpitations;
  • Shortness of breath;
  • Fatigue and weakness;
  • Weight loss;
  • Increased appetite;
  • Exophthalmos (protruding eyes);
  • Goiter;
  • Tremor;
  • Warm and moist skin;
  • Emotional changes;
  • Hair loss.

Risk Factors

  • Positive family history;
  • Female sex;
  • Other autoimmune disorders;
  • Iodide repletion after iodide deprivation.

Diagnosis & Treatment

Diagnostic work-up includes complete history and physical examination, blood tests to check level of thyroid hormones and other associated hormone levels and sometimes radioactive iodine (I131) uptake studies (i.e. measuring thyroid activity by doing a thyroid test).

General Measures:

  • Appropriate treatment will depend on the size of the goiter, the causes, your age, and a variety of other factors;
  • Rarely, subtotal thyroidectomy is required.

Medications:

Antithyroid drugs, therapeutic radioiodine, beta blockers for tachycardia and tremor.

Activity:

No restrictions.

Diet:

No restrictions. Maintain adequate caloric intake, because of the high metabolism caused by excess thyroid.

Possible Complications:

  • Hypoparathyroidism, recurrent laryngeal nerve damage, and hypothyroidism with subtotal thyroidectomy;
  • Development of hypothyroidism after radioiodine treatment;
  • Visual loss or diplopia due to severe ophthalmopathy;
  • Localized pretibial myxedema at any time;
  • Cardiac failure in the elderly with underlying heart disease;
  • Muscle wasting; proximal muscle weakness.

Prognosis

Good, with proper diagnosis and treatment.

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