Hyperthyroidism is a term meaning a person’s bodily metabolism is abnormally sped up due to the T3 and/or T4 thyroid hormone levels increasing too high in the body. Symptoms vary in severity among individuals, according to how advanced hyperthyroidism has become at the time of diagnosis.
Major Causes of Hyperthyroidism
Most cases of hyperthyroidism are caused by Graves’ disease, the autoimmune disease of the thyroid gland in which auto-antibodies sent from the immune system cause stimulation of excessive amounts of thyroid hormone production. Graves’ patients experience thyroid gland inflammation and enlargement to varied degrees, referred to as “toxic diffuse goiters”. Thyroid autoimmunity is a “primary” cause of an overactive thyroid gland.
Another primary cause of an overactive thyroid gland would include “hot nodules”, which are tumorous-growths in the gland that absorb iodine in the body and begin producing thyroid hormone just as normal thyroid tissue does.
Less common “secondary” causes of hyperthyroidism include excessive intake of iodine which can also act as a trigger for primary thyroid autoimmunity. Temporary types, of thyroiditis occurring in pregnant women or following giving birth or as a result of viral illnesses that settle in the thyroid gland, will cause a short-term phase of hyperthyroidism. Treated hypothyroid patients can become hyperthyroid from taking too high a dose of thyroid hormone replacement, sometimes referred to as “dose induced thyrotoxicity”.
Hyperthyroid Symptoms
The symptoms of a sped up metabolism from hyperthyroidism include, nervousness and anxiety, tremor (especially in the hands), rapid pulse and breathing, hypertension, diarrhea, oily skin and hair, increased sweating, increased hunger and thirst, changes in menstrual cycle and sex drive, goiter and rapid weight loss. Patients with Graves’ disease may also experience symptoms of muscle weakness and wasting referred to as “myopathy”. They may also develop an inflammatory condition affecting the eyes called “Graves’ Ophthalmopathy” or “Thyroid Eye Disease”.
Diagnosis
Blood tests of thyroid hormone levels and/or the TSH level can help to diagnose hyperthyroidism. Thyroid hormones (T4 and T3) will elevate to levels above normal values, while TSH (pituitary hormone) will decrease to levels below normal values. When testing is conducted to determine the cause of hyperthyroidism, blood tests for thyroid antibodies may be ordered to confirm or rule out Graves’ disease as the cause.
A Radioactive Iodine Uptake Test (RAIU) might also be performed to determine if the thyroid gland is absorbing high levels of iodine which can indicate that it is overactive. If only a certain area of the gland is absorbing high levels of iodine, this can point to hot nodules and an additional Radioactive Iodine Scan (radiology camera) might also be performed at the same time or separately to further evaluate nodules in the gland.
Treatment
In some cases of hyperthyroidism, the administering of anti-thyroid drugs designed to slow thyroid hormone production will be the initial treatment and possible the only one needed. Beta-blocker medications that moderate the activity of adrenaline in the body can help to alleviate symptoms and may be combined with anti-thyroid drugs.
Surgical procedures are required in some cases of hot nodules, to remove them or part of the thyroid gland if multi-nodules are present (several). Thyroid removal surgery called “thyroidectomy” may also be needed in cases of Graves’ disease that cannot be controlled by drug therapies or the gland may be ablated (destroyed) through administering radioactive iodine in a large enough to dose to kill-out the entire gland. Afterward, patients whose thyroid glands are ablated or removed will require thyroid hormone replacement to treat resulting hypothyroidism, as a lifelong treatment.
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