Hyperthyroidism, also known as hyperthyreosis manifests when the thyroid glands are producing excessive amount of thyroid hormone.
Most of us experience a little bit of fatigue now and then, an occasional irregular period, mental fog and a loss of few kilos. But if you are experiencing these symptoms on a regular basis, with increasing severity, your thyroid gland may be the culprit.
Hyperthyroidism is a condition wherein too much of thyroid hormones are produced by over activity of thyroid glands. The thyroid gland is a small gland located at front of your neck, just below the Adam’s apple.
T4 (tetraiodothyronine) and T3 (triiodothyronine) are the two primary thyroid hormones. Hormone T3 is the more active hormone and has the greatest effect on the body than T4.
The main functions of thyroid hormones are to regulate metabolism, heart functions, breathing, reproductive functions, weight, nervous system and body temperature.
Pituitary gland located in brain regulates rate of thyroid hormone production. Pituitary by releasing hormone TSH stimulates thyroid gland to synthesize thyroid hormones.
During overproduction of thyroid hormones, production of TSH reduces as pituitary gland attempts to decrease excessive amount of circulating thyroid hormones (feedback effect).
Hyperthyroidism is more commonly seen in women, people above 60 years of age and those with other thyroid problems.
Symptoms of Hyperthyroidism
High levels of T3, T4 or both can lead to acceleration of metabolic rate – hypermetabolic state. In this state every function of your body tends to speed up.
However, patients with mild disease, patients older than 60 years and those with hyperthyroidism during pregnancy usually do not experience typical signs and symptoms.
Most people with hyperthyroidism may experience enlargement of thyroid gland, which is called goiter. Other symptoms include
- Brain: Nervousness, irritability, anxiety, inability to concentrate, fine tremors in hands and fingers.
- Bowel movement: Frequent and loose (diarrhea is uncommon).
- Eyes: Double vision, protrusion (graves’ disease).
- Hair: Fine, brittle and hair loss.
- Skin: Itching, thinning.
- Heart: Palpitations, irregular heart beat (arrhythmia) or rapid heartbeat (tachycardia-usually more than 100 beats/minute).
- Nails: Rapid growth.
- Muscle: weakness (usually thighs and upper arms).
- Sleeping disturbances.
- Menstrual cycle: Frequency reduces.
- Excessive sweating.
- Unexpected weight loss.
- Heat intolerance.
Causes of Hyperthyroidism
1 :: Graves’ disease: An autoimmune disease wherein body’s own immune cells create antibodies that stimulates thyroid gland to produce more hormones. It runs in families and generally affects women.
2 :: Thyroiditis: Inflammation of thyroid gland due to virus or immune system dysfunction
- Sub-acute: painful inflammation of thyroid gland.
- Postpartum: affects women after having a baby.
- Silent: overactive thyroid gland without pain.
3 :: Thyroid nodule: Lumps or nodules can grow in thyroid gland and can lead to gland’s hyperactivity.
- Single toxic nodule.
- Multinodular goiter.
4 :: Excessive iodine intake: Food, supplements and medications.
5 :: Benign tumors of thyroid gland.
6 :: Toxic adenoma and plummer disease.
Diagnosis of Hyperthyroidism
1 :: Physical examination: it is done to check symptoms including
- Weight loss.
- Eyes protrusion.
- Finger tremor.
- Rapid pulse rate.
- Elevated blood pressure.
- Thyroid gland enlargement.
2 :: Blood tests:
- Thyroid hormones (generally elevated).
- TSH (typically low).
- Thyroid-stimulating immunoglobin test (to check graves’ disease).
In case blood tests are abnormal, your doctor may advice for following tests:
3 :: Ultrasound thyroid: To check for nodules or lumps.
4 :: Radioactive iodine uptake test: To check for Iodine absorption.
5 :: Thyroid Scan: To check for thyroid over-activity.
6 :: CT scan or MRI: To check for pituitary tumor.
Treatment of Hyperthyroidism
Treatment depends on your age, severity of disease, overall health and cause of your hyperthyroidism.
1 :: Anti-thyroid drugs: Medications including methimazole, tapazole, can prevent over production of thyroid hormones.
2 :: Radioactive iodine: Iodine is quickly absorbed by overactive thyroid cells and lead to cell death. Any excess iodine is then eliminated from body in few days.
3 :: Surgery (thyroidectomy): To remove a part or whole of the gland. You may have to take thyroid hormones supplements for rest of your life.
4 :: Beta-blockers: For reducing heart rate.
5 :: Diet: Supplement your diet with calcium and sodium as these minerals can prevent hyperthyroidism. Consider taking vitamin D as untreated hyperthyroidism can weaken your bones. Add extra calories and protein to your diet if you experience weight loss or fatigue. Avoid foods containing too much iodine such as kelps.
6 :: Mind-body techniques: Yoga and meditation can manage stress and can get your body- especially thyroid gland- back in balance. by focusing on your breathing you can learn to manage stress, and more importantly, slow down.
7 :: Exercise: Exercise can help you feel better, increase energy level and improve your muscle and heart endurance. Weight bearing exercises are recommended for patients with Graves’ disease, as it may regulate bone density.
8 :: Relaxation techniques: Having positive outlook towards oneself or disease can help you, especially when coping with illness. Relationship between stress and Graves’ disease is well documented by studies. So learning relaxation techniques can help you achieve physical and mental well being.
Post treatment, you may need to undergo regular blood tests to check hormone levels.
Complications and risk factors governing Hyperthyroidism
Untreated Hyperthyroidism can lead to a number of complications, including:
1 :: Heart diseases: Atrial fibrillation (dangerous arrhythmia that can cause stroke) and heart failure.
2 :: Osteoporosis: Weak, brittle bones can result because of hyperthyroidism as it interferes with calcium absorption into bones.
3 :: Vision loss.
4 :: Skin issues: Untreated hyperthyroidism can result in graves’ dermopathy – red and swollen skin usually on shins and feet.
5 :: Miscarriage.
6 :: Impaired brain growth in children: High maternal thyroid levels can result in impaired brain development of the offspring.
7 :: Thyrotoxicosis crisis: sudden intensification of hyperthyroidism symptoms. Immediately seek doctor’s advice if you have symptoms including:
- Signs of delirium
- Rapid pulse
Keep in mind that thyroid disease is very common, and with good care, hyperthyroidism can be easily diagnosed and treated.