Hyperthyroidism

Hyperthyroidism is a condition in which the thyroid gland produces an excessive amount of thyroid hormone. The thyroid gland, a small butterfly-shaped gland located at the front of the neck, produces thyroid hormones that regulate how the body utilizes energy. Hyperthyroidism speeds up your body’s metabolism, which causes unexpected weight loss and a fast or irregular heartbeat. There are various ways to treat hyperthyroidism, and most people respond well once it is detected and treated.

Hyperthyroidism can be caused by a variety of conditions, including: 

• Graves’ disease: An autoimmune condition in which your immune system attacks your thyroid, causing it to produce excessive amounts of the hormone. 
• Thyroiditis, or inflammation of Thyroid: The stored thyroid hormone is leaked out of the thyroid gland in this condition. 
• Thyroid nodules are abnormal growths on the thyroid gland that are usually benign (not cancer) but may become overactive, producing an excessive thyroid hormone. Thyroid nodules are more common in those over the age of 50. 
• Consuming too much iodine: Some medicines, cough syrups, seaweed, seaweed-based supplements, and common salt include iodine. If you consume too many of these, your thyroid will produce too much thyroid hormone.

The symptoms of hyperthyroidism include:

• Weight loss 
• Anxiety and irritability
• Palpitations
• Bulging eyes
• Increased appetite
• Mood swings
• Irregular heartbeat
• Goiter (enlarged thyroid gland)
• Heat intolerance
• Diarrhea
• Hand tremors
• Trouble sleeping
• Irregular periods
• Muscle weakness

The risk factors of hyperthyroidism include:

• A family history of thyroid disease. 
• Female sex. 
• It occurs two to ten times more often in women.
• More common in people over the age of 60 years.
• Have you been pregnant or given birth in the last six months
• Undergone thyroid surgery or  suffering from a thyroid condition such as goiter
• Have pernicious anemia, a condition in which the body cannot produce enough healthy red blood cells due to a lack of vitamin B12.
• Suffering from type 1 diabetes or hormonal issue called primary adrenal insufficiency
• Consuming too much iodine by eating a lot of iodine-rich foods or taking iodine-containing drugs or supplements.

If you have symptoms or signs of hyperthyroidism, your doctor will probably ask you if you have a family history of the condition and order one or more of the following tests:

• Physical examination: Includes checking blood pressure, heart rate, examining bulging of the eyes, observing thyroid gland for enlargement (goiter).
• Thyroid tests: To measure the thyroid hormone (T3, T4, and TSH) levels.
• Thyroid Stimulating Immunoglobulin Test (TSI): 
• Radioactive Iodine Uptake test: The amount of iodine absorption by the thyroid gland help determine the disease condition. Image scan pattern iodine uptake will be useful in the diagnosis.
• Ultrasound: High-frequency sound waves used to image the thyroid gland helps to identify enlargement.
• Thyroid scan: It is to see where the radioactive iodine travels in your thyroid gland.

• Grave’s Disease
• Thyroiditis
• Exogenous and ectopic hyperthyroidism
• Hashitoxicosis
• Toxic adenoma 
• Toxic multi nodular goiter

If hyperthyroidism isn't treated, it can lead to a variety of serious health issues, such as:

• Blood clots
• Strokes
• Heart failure and other heart disorders
• Graves' ophthalmopathy (eye disease) causes double vision, light sensitivity, and eye pain; however, it may also cause eyesight loss in some cases.
• Bone thinning and osteoporosis: Untreated hyperthyroidism may cause bones to become weak and brittle. 
• Fertility issues in Women
• Pregnancy complications such as high blood pressure, premature birth, low birth weight, and miscarriage.

Medicines, radioiodine therapy, and thyroid surgery are all options for treating hyperthyroidism. The treatment goals are to stop the production of thyroid hormones and block the hormones’ effect on the body. 

• Radioactive iodine therapy: This treatment involves taking radioactive iodine (radioiodine) via the mouth. The thyroid accepts radioiodine into the thyroid cells because it needs iodine to generate hormones, and the radiation eventually kills the hyperactive thyroid cells. If you already have moderate to severe vision problems, radioiodine therapy may increase your risk of ophthalmopathy and is not advised. Tenderness in the neck and a short increase in thyroid hormones are possible adverse effects. Radioiodine therapy is likewise not recommended for treating hyperthyroidism in pregnant or lactating women since it causes thyroid function to decrease.
• Anti-thyroid medications: Antithyroid medications cause your thyroid gland to produce less thyroid hormone. You will most likely need to take the medications for one to two years. You may need to take the medications for several years in some circumstances. This is the most basic treatment, although it is rarely a long-term solution.
• Surgery: Thyroidectomy or partial thyroidectomy, which involves removing all or part of your thyroid, is another option for treating hyperthyroidism. Following the surgery, you'll most likely require treatment to restore normal thyroid hormone levels in your body.

The medications for hyperthyroidism include:

 Methimazole and Propylthiouracil: Propylthiouracil increases the likelihood of liver damage.  Methimazole is the primary choice when doctors prescribe medication.  During the first trimester of pregnancy, however, propylthiouracil is favored over methimazole since methimazole has a small chance of producing congenital abnormalities. After the first trimester, pregnant women will usually resume taking methimazole. Anti-thyroid medications can be administered as supplementary to radioiodine therapy before or after it. Rashes, joint discomfort, liver failure, and a decline in white blood cells are all possible side effects of both drugs.

Beta-blockers: These drugs don't prevent thyroid hormones from being produced, but they do block their effect on the body and may. They may relieve irregular heartbeats, anxiety, tremors, irritability, muscle weakness, heat intolerance, sweating, and diarrhea relatively quickly. They include Propranolol, Atenolol, Metoprolol, Nadolol. 

Beta-blockers aren't often prescribed for people with asthma because the drugs may trigger an asthma attack. These drugs may also complicate the management of diabetes.

If you have hyperthyroidism, make your mental and physical well-being a priority:

Eating well and exercising can improve some symptoms during treatment and help you feel better in general. For example, because your thyroid controls your metabolism, you may tend to gain weight when hyperthyroidism is corrected. Brittle bones also can occur with hyperthyroidism, and weight-bearing exercises may help to maintain bone density.

Reducing stress may be helpful, as stress may trigger or worsen hyperthyroidism. Partner with your doctor to develop a plan that involves including good nutrition, exercise, and relaxation in your daily routine.

The prognosis for hyperthyroidism is pretty good, considering that various effective treatments for the disease are available and can stop the adverse effects of hyperthyroidism. However, lifelong treatment to maintain a normal level of thyroid hormones is often required to remain healthy.

Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on May 21, 2023.

References

Hyperthyroidism (Overactive Thyroid) - NIDDK (nih.gov)

https://www.niddk.nih.gov/health-information/endocrine-diseases/hyperthyroidism#:~:text=Hyperthyroidism%2C%20also%20called%20overactive%20thyroid,the%20front%20of%20your%20neck.

Hyperthyroidism - Symptoms and causes - Mayo Clinic

https://www.mayoclinic.org/diseases-conditions/hyperthyroidism/symptoms-causes/syc-20373659