Treatment for Hyperthyroidism

Hyper meaning extra, hyperthyroidism is a disorder where thyroid hormones are produced in excess i.e. much more than required. Since more thyroid hormone is produced the body’s process speeds up leading to several symptoms.

Common Symptoms include:

• Rapid heart rate, palpitations, irregular heart rate
• Weight loss
• Excessive sweating
• Heat intolerance
• Increased bowel movements
• Tremors (usually fine shaking of hands and tongue)
• Anxiety, Nervousness, agitation.
• Fatigue, weakness
• Decreased concentration and irritability
• Irregular and scant menstrual flow
• Fine or brittle hair
• Wet, moist Thin skin
• Sleep disturbances
• Irregular heart rhythms and heart failure can occur (more so in older patients).

Causes

A variety of conditions can cause hyperthyroidism.

Graves’ disease, an autoimmune disorder, is the most common cause of hyperthyroidism. It releases antibodies that stimulate the thyroid to secrete too much hormone. Graves’ disease occurs more often in women than in men. It tends to run in families, which suggests a genetic link.

The occurrence of toxic nodular or multinodular goitre, which are lumps or nodules in the thyroid gland, causes the thyroid to produce excessive amounts of thyroid hormones causing hyperthyroidism.

Viral Thyroiditis-Inflammation of the thyroid gland resulting from a virus or a problem with the immune system may temporarily cause symptoms of hyperthyroidism. Furthermore, some people who consume too much iodine (either from foods or supplements) or who take medications containing iodine may cause the thyroid gland to overproduce thyroid hormones.

Some women may develop hyperthyroidism during pregnancy or in the first year after giving birth.

• Benign tumours of the thyroid or pituitary gland
• Large amounts of tetraiodothyronine taken through dietary supplements or medication.

Diagnosis

Hyperthyroidism occurs when the thyroid makes too much T4, T3, or both.

Do T3, T4, TSH or free T3, freT4, TSH for diagnosing thyrotoxicosis.

Diagnosis of overactive thyroid and early treatment of the underlying cause can relieve symptoms and prevent complications.

Complications:

In hyperthyroidism, since metabolism is on overdrive all the time it can affect the heart majorly along with other vital organs. The rapid pulse rate and circulatory issues created by hyperthyroidism can cause a collapse in the system. If remains untreated it can lead to serious complications.

Some possible heart-related complications of uncontrolled hyperthyroidism are:

• Atrial fibrillation and flutter-Arrhythmia (abnormally increased heartbeat)
• Increased size of the heart and congestive heart failure
• Sudden cardiac arrest
• Hypertension

Other Complications

• Brittle bones: Excess thyroid hormone disturbs the body’s ability to incorporate calcium into your bones, thereby affecting the strength of the bone. Untreated hyperthyroidism can also lead to weak, brittle bones (osteoporosis) increasing the risk of fractures at minor falls.

• Eye problems. People with Graves’ ophthalmopathy develop eye problems, including bulging, red or swollen eyes, sensitivity to light, and blurring or double vision. If this remains untreated, can lead to permanent vision loss.

• Red, swollen skin. People with Graves’ disease develop Graves’ dermopathy, which affects the skin, causing redness and swelling, often on the shins and feet.

• Thyrotoxic crisis: Excess thyroid hormone can lead to a condition called thyrotoxic crisis, leading to a fever, a rapid pulse and even delirium.

Treatment

Beta-Blockers: Some of the symptoms of hyperthyroidism such as tremor and palpitations are treated with Beta-blockers. These drugs only treat the symptom and do not have an effect on the thyroid itself.

Antithyroid Drugs: The goal of this form of drug therapy is to prevent the thyroid from producing hormones. two types of compounds are available. Neomerazole and PTU.

Radioactive Iodine Treatment: (only in event of non-response to Anti thyroid hormones and not as a routine)

By giving a radioactive form of iodine, the thyroid cells which absorb it will be damaged or killed. Radioiodine treatment does not require hospitalization. This form of therapy often takes one to two months before the thyroid cells are damaged. The majority of patients are cured with a single dose of radioactive iodine. The only common side effect of radioactive iodine treatment is under activity of the thyroid gland since radioactive iodine kills too many of the thyroid cells so that the remaining thyroid does not produce enough hormone, leading to hypothyroidism. This is treated by lifelong supplementation of thyroid hormone.

Surgical Removal of the Gland or Nodule- this option is reserved when medications or radioiodine doesn’t work or malignancy is suspected.

Surgery is not used as frequently and only as last resort. Although there are some Graves’ disease patients who will need to have surgical removal of their thyroid (cannot tolerate medicines for one reason or another, or who refuse radioactive iodine), other causes of hyperthyroidism are better suited for surgical treatment earlier in the disease.