Hyperthyroidism (Overactive Thyroid); Causes, Symptoms and Treatment

Manka’a and her husband have been using protections, but last month she missed her period, which had always been quite regular. She took two home pregnancy tests, but both turned out negative. Feeling confused, she went to the Health Center, where a blood test showed abnormally high T3 (active thyroid hormone) and T4 (inactive thyroid hormone in storage). She was diagnosed of Hyperthyroidism.

Hyperthyroidism is a condition where the thyroid gland produces too much thyroid hormone. It can also be caused by an overdose of thyroid supplement or by ingesting foods that increase thyroid production or that provoke an autoimmune response.

What causes hyperthyroidism?

The most common cause of hyperthyroidism is the autoimmune disorder Graves’ disease. Around 80% of known cases of hyperthyroidism are caused by Graves’ disease. In this disorder, the body makes an antibody called thyroid-stimulating immunoglobulin (TSI) that causes the thyroid gland to make too much thyroid hormone. Graves’ disease runs in families and is more commonly found in women.

It also may be caused by lumps or nodules in the thyroid gland that cause the thyroid to produce excessive amounts of thyroid hormones.

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.

Who can suffer from Hyperthyroidism?

According to medical statistics, women are 8 to 10 times more likely than men to be diagnosed with hyperthyroidism. And as many as 15% of known cases occur in patients 60 years old or older.

What are the Symptoms?

The symptoms of hyperthyroidism can vary based on age. Younger patients are more likely to experience tremor, anxiety, and hyperactivity. Older patients come in with symptoms such as heart palpitations, dyspnea (shortness of breath), and weight loss.

The most common symptoms include:

Nervousness or anxiety, irritability
Heart palpitations or irregular heartbeat, rapid heartbeat (tachycardia)
Panic/anxiety attacks
Increased perspiration
Weight loss
Fatigue or muscle weakness – especially in the upper arms and thighs
Insomnia / trouble sleeping
Increased frequency of bowel movements
Hair loss
Hand tremors
Mood swings
Light periods or skipping periods
Skin that is dry and thinning
Fine, brittle hair
Eyes that bulge or seem enlarged, due to elevated upper lids .
Swelling of the front of the neck (goiter).

Similarities with Hypothyroidism (under-active thyroid)

Hyperthyroidism (overactive Thyroid) just like Hypothyroidism (under-active Thyroid) can’t be diagnosed on the basis of symptoms alone.

One reason for this is that in the early stages of hyperthyroidism, you can experience a mix of hypothyroid and hyperthyroid symptoms.

In some cases, thyroid levels can fluctuate between excess and insufficiency, which slowly and steadily destroys the thyroid gland. This might cause the thyroid gland to react by overproducing thyroid hormone and flooding the body with it, causing temporary hyperthyroidism.

Besides correcting symptoms , why is it important to diagnose and treat it?

Without proper care, those with hyperthyroidism risk the following complications:

Arrhythmias (abnormal heartbeat)
Cardiac dilation and congestive heart failure
Sudden cardiac arrest
Hypertension
Osteoporosis
Eye problems which, untreated, can lead to vision loss
Brain damage
Neonatal hyperthyroidism (for pregnant women)
Red swollen skin
Thyrotoxic crisis (or Thyroid Storm) – a sudden intensification of hyperthyroid symptoms, leading to fever, rapid pulse, and even delirium

Diagnosis

Hyperthyroidism is diagnosed based on symptoms, physical exam, and blood tests to measure levels of thyroid stimulating hormone (TSH) and thyroid hormones T₃ and T₄. Your doctor may also decide to order an ultrasound of your thyroid to see if it has nodules, or whether it is inflamed or overactive.

Treatment of Hyperthyroidism

Hyperthyroidism can be treated with antithyroid medications that interfere with the production of thyroid hormones.

Another option is radioactive iodine therapy to damage the cells that make thyroid hormones.

In rare cases in which women do not respond to or have side effects from these therapies, surgery to remove the thyroid (either one part of the entire gland) may be necessary.

The choice of treatment will depend on the severity and underlying cause of your symptoms, your age, whether you are pregnant, other conditions you may have, and the potential side effects of the medication.

How do You Prevent Hyperthyroidism?

Iodine intake in the form of supplements and foods should be avoided as it can worsen.

Vitamin B12, zinc and iron-rich foods should be included in the diet because people with hyperthyroidism are more likely to suffer from these nutrient deficiencies.

Excessive weight loss can be managed by taking protein rich foods such as nuts and legumes (like beans).

When hyperthyroidism is not treated, it may lead to osteoporosis. Including calcium-rich foods such as dairy products can help prevent such complications.

Following a healthy lifestyle by avoiding alcohol, quitting smoking and engaging in regular physical activities can help improve the overall health.

References

https://www.endocrineweb.com/conditions/hyperthyroidism/hyperthyroidism-overview-overactive-thyroid

https://www.huffingtonpost.com/alan-christianson/hyperthyroidism-too-much-_b_11028164.html

https://www.medindia.net/patients/patientinfo/hyperthyroidism.htm