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Condition leads to dysfunction of thyroid hormone production, but has treatment

Halanna Halila image in Unsplash

Hyperthyroidism is the excessive production of hormones produced by the thyroid gland, responsible for maintaining the function of important organs such as the heart, brain, liver and kidneys.

Also called "overactive thyroid", the disease is more common among women aged 20 to 40 years, but can affect anyone, even newborns - the so-called congenital hyperthyroidism.

What causes

The most common cause of hyperthyroidism in adults is Graves' disease - the immune system attacks and damages the thyroid, causing it to enlarge, stimulating the gland to produce excess T3 and T4 hormones. It is a chronic (long-term) disease and occurs more often in people who have relatives with a history of thyroid problems.

Other possible (much less common) causes of hyperthyroidism include:

• Thyroid nodules: Tumors in the thyroid gland, which can secrete excess thyroid hormone.
• Subacute thyroiditis: A painful inflammation of the thyroid typically caused by a virus.
• Lymphocytic thyroiditis: A non-painful inflammation caused by infiltration of lymphocytes (a type of white cell in the immune system) into the thyroid.
• Postpartum thyroiditis: thyroiditis that develops soon after the end of pregnancy

Symptoms

Early in the disease or in its milder form, symptoms are not easily recognizable. Sometimes there may be a feeling of discomfort and weakness. However, hyperthyroidism is potentially serious and can be fatal.

In more developed cases the symptoms of hyperthyroidism are:

• Acceleration of heartbeats (more than 100 per minute);
• Irregularity in heart rhythm, especially in patients over 60 years of age;
• Nervousness, anxiety and irritation;
• Shaking and sweating hands;
• Loss of appetite;
• Hot temperature intolerance;
• Sweating;
• Hair loss and/or scalp weakness;
• Fast growth of the nails, with a tendency for them to peel;
• Weakness in muscles, especially in the arms and thighs;
• Loose bowels;
• Weight loss;
• Irregular menstruation;
• Increased probability of miscarriage;
• Stare;
• Eye protrusion (bulging), with or without double vision (in Graves' disease patients);
• Accelerated loss of calcium from bones, with increased risk of osteoporosis and fractures.

Diagnosis

To diagnose hyperthyroidism, physical and blood tests are performed. The disease is confirmed when T4 and T3 levels are higher than normal and the TSH level is lower than the reference.

To determine the type of hyperthyroidism, a radioactive iodine uptake test is ordered to measure how much iodine is absorbed by the thyroid. There may also be a request for images of the thyroid in order to verify its size and possible presence of nodules.

Treatment

The treatment of hyperthyroidism depends on each case. Age, type of hyperthyroidism, allergy to medication (used to treat hyperthyroidism), disease severity and pre-existing conditions are the main factors that determine which treatment will be appropriate.

The drugs used will basically stop the thyroid from using iodine, which will reduce the levels of thyroid hormones circulating in the blood. This is because iodine is essential for the synthesis of T3 and T4 and, in its absence, the thyroid will not be able to produce them in excess, generating the necessary reduction in hormone production.

Another way of treating hyperthyroidism is through the use of radioactive iodine. This treatment cures the condition, but it usually completely destroys the thyroid, making the person need to take thyroid hormones for the rest of their lives.

Surgical removal of the thyroid is another permanent solution, but it poses a risk of damage to the parathyroid glands (which control calcium levels in the body) and the laryngeal nerves (vocal cords). This type of treatment is only recommended when medications or radioactive iodine therapy are not appropriate.

In the treatment of hyperthyroidism, beta-blocking drugs can also be used. These medications (such as atenolol) do not lower thyroid hormone levels, but they can control severe symptoms such as a fast heart rate, tremors, and anxiety.

If you have ever been treated for hyperthyroidism or are being treated, remember to see your doctor regularly so that the condition is monitored. Thyroid hormone levels need to be normal and your bones must be getting enough calcium to keep your bones strong.

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