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Hyperthyroidism or Overactive Thyroid

by | May 26, 2022 | Info | 0 comments

Hyperthyroidism Overview

Hyperthyroidism, or overactive thyroid, occurs when the thyroid gland produces too much hormone. This can have effects throughout the body, including diarrhea, difficulty breathing, and fatigue.

The thyroid is a butterfly-shaped gland in the neck. The hormones it produces and releases into the bloodstream control the body’s growth and metabolism.

Around 1 in 100 people over the age of 12 years in the United States have hyperthyroidism. It is most likely to occur in individuals over 60 years.

Hyperthyroidism is separate from hypothyroidism, or underactive thyroid. “Hyper” means there is too much thyroid hormone in the system, while “hypo” means there is not enough.

Without treatment, hyperthyroidism can lead to severe complications. However, medication can normally control it by reducing thyroid hormone production.

This article provides an overview of hyperthyroidism, including its causes, symptoms, diagnosis, complications, and treatments.


Signs and Symptoms of Hyperthyroidism

Hyperthyroidism occurs when the thyroid gland produces too much thyroxine and triiodothyronine, two types of hormones.

If symptoms arise, they can affect the whole body and many body functions. Excessive thyroid hormones cause an increase in metabolism, which accounts for most symptoms.

These symptoms vary between patients and can include the following:

  • A faster heartbeat, sometimes with palpitations
  • Alopecia, or patchy hair loss
  • Changes in menstrual patterns
  • Difficulty sleeping
  • Diarrhea
  • Difficulty breathing
  • Fine, brittle hair
  • Fatigue and difficulty sleeping 
  • Frequent bowel movements and urination
  • A goiter, a swelling in the neck due to an enlarged thyroid gland
  • Hyperactivity
  • Increased appetite
  • Infertility and a loss of interest in sex
  • itchy skin with raised, itchy swellings, called hives or urticaria 
  • Muscle weakness
  • Menstrual problems, especially lighter periods or absence of periods
  • Nervousness, irritability, mood swings, and reduced concentration
  • Nails becoming loose 
  • Trembling hands and shakiness
  • Oversensitivity to heat, excessive sweating, and warm, damp skin
  • Redness on the palms of hands
  • Sudden weight loss

 

Causes of Hyperthyroidism

There are various possible causes of hyperthyroidism, Normally, your thyroid releases the right number of hormones, but sometimes it produces too much T4.

This may occur for a number of reasons, including the following:


Grave’s Disease

Grave’s Disease is an autoimmune condition and the most common cause of hyperthyroidism, accounting for over 70% of cases.

It is unclear what triggers Graves’ disease, but it often runs in families, suggesting a genetic basis.

Hyperthyroidism is most common in patients aged between 30 to 50 years and is seven to eight times more likely in females compared with males.

The condition can affect the eyes, causing protracted eyelids, bulging eyes, double vision, and swelling around the eyes.

Nodular Thyroid Disease

Thyroid nodules are lumps that develop in the thyroid gland. It is unclear why they occur.

These lumps may contain abnormal thyroid tissue, but they are usually benign or noncancerous. They affect the regular function of the thyroid, causing overactive thyroid.

The thyroid may become enlarged, and while people usually do not experience pain, they may be able to feel the nodules with their fingertips.

Excessive Iodine Intake

The thyroid gland removes iodine from the blood. Iodine comes from certain foods, such as seafood, bread, and salt. The thyroid gland uses the iodine to produce thyroid hormones.

Taking additional iodine in supplements can cause the thyroid gland to produce too many of the hormones.

Patients who take thyroid hormones as medication should follow up regularly with their doctor to make sure they are taking the right doses.


Medications

Some medications that treat heart problems contain a large amount of iodine, which may trigger changes in thyroid function. One drug that can affect thyroid function in this way is amiodarone, a drug doctors use to treat an irregular heartbeat.

Thyroiditis

Thyroiditis, an Inflammation of the thyroid, often results from a viral infection. Symptoms include:

  • Bosy aches
  • Fatigue
  • Sore throat 
  • Neck pain
  • Painful swallowing

Hyperthyroidism vs Hypothyroidism

Hyperthyroidism occurs when the thyroid is overactive and produces too many hormones. By contrast, hypothyroidism develops when the thyroid does not produce enough hormones.

The two conditions share some common causes, such as thyroiditis, iodine intake, certain autoimmune disorders, or taking certain medications. However, hypothyroidism may also result from:

Symptoms of hypothyroidism can vary and are not specific to the thyroid. Some common symptoms that differ from hyperthyroidism include:

  • Constipation
  •  Dry skin
  • Feeling cold quickly
  • Forgetfulness
  • Reduced mood
  • Tiring more easily

Diagnosing hypothyroidism often involves a physical examination, a complete family history, blood tests, and hormone tests. If a person receives a diagnosis, treatment will aim to manage the thyroid with thyroxine replacement.


Risk Factors of Hyperthyroidism

Risk factors for hyperthyroidism, include:

  • A family history, particularly of Grave’s disease
  • Female sex
  • A personal history of certain chronic illnesses, such as type 1 diabetes, pernicious anemia and primary adrenal insufficiency

 

Complications of Hyperthyroidism

Hyperthyroidism can lead to a number of other complications:

  • Heart Problems: Some of the most serious complications of hyperthyroidism involve the heart. These include a rapid heart rate, a heart rhythm disorder called atrial fibrillation that increases your risk of stroke, and congestive heart failure. Which is a condition in which the heart can’t circulate enough blood to meet the body’s needs.
  • Brittle Bones: Untreated hyperthyroidism can also lead to weak, brittle bones (osteoporosis). The strength of your bones depends, in part, on the amount of calcium and other minerals they contain. Too much thyroid hormone interferes with your body’s ability to incorporate calcium into your bones.
  • Eye Problems: Patients with Graves’ ophthalmopathy develop eye problems, including bulging, red or swollen eyes, sensitivity to light, and blurring or double vision. Untreated, severe eye problems can lead to vision loss.
  • Red, swollen skin: In rare cases, people with Graves’ disease develop Graves’ dermopathy. This affects the skin, causing redness and swelling, often on the shins and feet.
  • Thyrotoxic Crisis: Hyperthyroidism also places you at risk of thyrotoxic crisis, which is a sudden intensification of your symptoms, leading to a fever, a rapid pulse and even delirium. 

Treatment of Hyperthyroidism

Several treatments for hyperthyroidism exist. The best approach for a patient depends on their age, physical condition, the underlying cause of the hyperthyroidism, personal preference and the severity of your disorder.

Following are some of the available treatments:

  • Radioactive Iodine: Taken by mouth, radioactive iodine is absorbed by your thyroid gland, where it causes the gland to shrink. Symptoms usually subside within several months. Excess radioactive iodine disappears from the body in weeks to months.This treatment may cause thyroid activity to slow enough to be considered underactive (hypothyroidism), and you may eventually need to take medication every day to replace thyroxine.
  • Anti-thyroid Medications: These medications gradually reduce symptoms of hyperthyroidism by preventing the thyroid gland from producing excess amounts of hormones. They include methimazole (Tapazole) and propylithiouracil. Symptoms usually begin to improve within several weeks to months, but treatment with anti-thyroid medications typically continues at least a year and often longer.For some patients, this clears up the problem permanently, but other patients may experience a relapse. Both drugs can cause serious liver damage, sometimes leading to death. Because propylthiouracil has caused far more cases of liver damage, it generally should be used only when you can’t tolerate methimazole.A small number of patients who are allergic to these drugs may develop skin rashes, hives, fever or joint pain. They also can make you more susceptible to infection.
  • Beta blockers: These drugs are usually used to treat high blood pressure (hypertension) and don’t affect thyroid levels, they can ease symptoms of hyperthyroidism, such as a tremor, rapid heart rate and palpitations. For that reason, your doctor may prescribe them to help you feel better until your thyroid levels are closer to normal. These medications generally aren’t recommended for patients who have asthma, and side effects may include fatigue and sexual dysfunction.
  • Surgery (thyroidectomy): If you’re pregnant or you otherwise can’t tolerate anti-thyroid drugs and don’t want to or can’t have radioactive iodine therapy, you may be a candidate for thyroid surgery, although this is an option in only a few cases.In a thyroidectomy, your doctor removes most of your thyroid gland. Risks of this surgery include damage to your vocal cords and parathyroid glands. Four tiny glands situated on the back of your thyroid gland that help control the level of calcium in your blood.In addition, you’ll need lifelong treatment with levothyroxine (Levoxyl, Synthroid, others) to supply your body with normal amounts of thyroid hormone. If your parathyroid glands also are removed, you’ll need medication to keep your blood-calcium levels normal.

Grave’s Ophthalmopathy

If Graves’ disease affects your eyes (Graves’ ophthalmopathy), you can manage mild signs and symptoms by using artificial tears and lubricating gels and by avoiding wind and bright lights. If your symptoms are more severe, your doctor may recommend treatment with corticosteroids, such as prednisone, to reduce swelling behind your eyeballs.

Several drugs, including rituximab (Rituxan) and teprotumumab are being used to treat Graves’ ophthalmopathy, even though there isn’t a lot of definitive evidence yet to prove that they’re effective. Teprotumumab received fast-track approval from the Food and Drug Administration based on one small study. More study of both drugs as a treatment for Graves’ ophthalmopathy is needed.

In some cases, a surgical procedure may be an option:

  • Orbital decompression surgery: In this surgery, your doctor removes the bone between the eye socket and the sinuses. The air spaces next to the eye socket. When the procedure is successful, it improves vision and provides room for your eyes to return to their normal position. But there is a risk of complications, including double vision that persists or appears after surgery.
  • Eye muscle surgery: Sometimes scar tissue from Graves’ ophthalmopathy can cause one or more eye muscles to be too short. This pulls your eyes out of alignment, leading to double vision. Eye muscle surgery may help correct double vision by cutting the affected muscle from the eyeball and reattaching it farther back.

Lifestyle and Home Remedies

Once you begin treatment, symptoms of hyperthyroidism should subside, and you should start feeling much better. However, your doctor may recommend that you watch out for iodine in your diet because it can cause hyperthyroidism or make it worse.

Kelp, dulse and other types of seaweed contain a lot of iodine. Cough syrup and multivitamins also may contain iodine.

Grave’s Disease

If you have Graves’ ophthalmopathy or dermopathy, the following suggestions may help your eyes or skin:

  • Don’t Smoke: Smoking has been linked to the development of Graves’ ophthalmopathy and can make the condition worse after treatment.
  • Keep your eyes lubricated: Eyedrops may help relieve dryness and scratchiness at any time of the day. If your eyes don’t completely close, you can tape your eyelids shut, or use a lubricating gel at bedtime to keep the cornea from drying out. A cool compress can also provide relieving moisture.
  • Protect your eyes: Wear sunglasses to help protect your eyes from the sun and wind.
  • Keep your head up: Raising the head of your bed may reduce swelling and relieve pressure on your eyes.
  • Try over-the-counter creams for swollen skin: Over-the-counter creams containing hydrocortisone (Cortizone-10, others) may help relieve red, swollen skin on your shins and feet.


Coping and Support

If you’ve been diagnosed with hyperthyroidism, the most important thing is to receive the necessary medical care. After you and your doctor have decided on a course of action, there are some things you can do that will help you cope with the condition and support your body during its healing process.

  • Get regular exercise: Exercise in general will help you feel better and improve your muscle tone and cardiovascular system. Weight-bearing exercise is important for patients with Grave’s disease because it helps maintain bone density. Exercise also can help reduce your appetite and increase your energy level.
  • Learn relaxation techniques: Many relaxation techniques can help you maintain a positive outlook, especially when coping with illness. It is well-documented that in Grave’s disease stress is a risk factor, so learning to relax and achieve balance in your life can help maintain physical and mental well-being.

 

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