Hyperthyroidism
What is hyperthyroidism? Everything about its causes, symptoms, consequences, and the most effective treatments to manage it.
Symptoms and Causes
Hyperthyroidism is caused by an excess of thyroid hormone in the body, which accelerates metabolism. When the thyroid gland is overactive, the levels of T4 (thyroxine) and T3 (triiodothyronine) in the blood increase, making it easily detectable with a blood test. The rise in thyroxine and triiodothyronine in the body may be due to increased production or a defect in their synthesis.
Depending on its nature and underlying causes, hyperthyroidism is classified into two types:
- Primary hyperthyroidism: Occurs when a thyroid gland disorder causes it to produce more hormones than the body needs.
- Secondary hyperthyroidism: Develops when the brain produces an excess of TSH hormone, usually due to a tumor.
Thyroid hormones regulate energy use in the body; therefore, when they are excessively elevated, multiple organs are affected. However, despite the severity of the symptoms, most patients respond well to treatment, which typically involves medication or surgery.
Symptoms
Although elderly individuals may develop apathetic hyperthyroidism, which lacks obvious signs other than cardiac abnormalities, hyperthyroidism symptoms are generally noticeable. Most are related to an acceleration of bodily functions and are common among all affected individuals:
- Insomnia and difficulty falling asleep.
- Chronic diarrhea due to increased intestinal transit speed.
- Palpitations, arrhythmias, and tachycardia.
- Goiter, which is the enlargement of the thyroid gland.
- Tremors in the hands or fingers.
- Fatigue.
- Weight loss despite increased appetite.
- Increased sweating.
- Bulging eyes when caused by Graves' disease.
Causes
The main cause of an overactive thyroid is Graves' disease, an autoimmune disorder that attacks the thyroid gland and disrupts its function. Other possible causes include:
- Plummer's disease or multinodular goiter, which causes adenomas in the thyroid that produce excess hormones.
- Autoimmune or idiopathic thyroiditis, which leads to thyroid inflammation of unknown origin.
Risk Factors
Certain characteristics increase the likelihood of developing hyperthyroidism. The most significant risk factors include:
- Being female, as it occurs at a higher rate in women than in men.
- Having a family history of thyroid disorders, particularly Graves' disease.
- Recent pregnancy, which increases the risk of thyroid inflammation.
Complications
Hyperthyroidism complications can be very serious, potentially even life-threatening. However, when treatment is followed correctly, they can be resolved without major difficulty. The most common complications include:
- Heart problems, such as atrial fibrillation, which accelerates heart rate and increases the risk of stroke, or heart failure, which impairs oxygen delivery to the body.
- Eye problems, including double vision, extreme light sensitivity, bulging eyes, or eye pain.
- Thyrotoxic crisis, caused by excessive thyroid hormones, leading to fever, nausea, dehydration, delirium, tachycardia, and confusion.
- Osteoporosis, due to decreased calcium in the bones.
Prevention
Due to its primarily genetic nature, hyperthyroidism cannot usually be prevented. However, maintaining a healthy lifestyle and reducing stress levels can help lower the risk of developing the condition.
Which doctor treats hyperthyroidism?
An endocrinologist is the specialist responsible for treating hyperthyroidism.
Diagnosis
The diagnosis of hyperthyroidism is based on evaluating the results of several essential tests:
- Medical history, family history, and physical examination, particularly palpation of the neck.
- Blood tests to determine if thyroid hormone levels (thyroxine and triiodothyronine) are elevated.
- Blood tests for antibodies, including anti-thyroglobulin, antimicrosomal, and TSI, to confirm that Graves' disease is the cause of hyperthyroidism.
- Thyroid scan or ultrasound to assess the nature of goiter.
Treatment
Depending on the characteristics and causes of hyperthyroidism, treatments vary to suit each patient. The most effective treatments, which can sometimes cure the condition, include:
- Medication, such as antithyroid drugs or beta-blockers, with duration depending on individual cases.
- Radioactive iodine therapy, used to treat goiter when surgery is not an option.
- Total or partial thyroidectomy, performed when goiter is excessively large and causes severe symptoms, such as vision problems or excessive pressure in the neck.
