Hyperthyroidism (Over active thyroid), symptoms, causes, treatment, everything

Overview:

Hyperthyroid is also known as an overactive thyroid, it is a condition in which the thyroid gland makes and secretes more hormone than the body requires, as a result, the metabolism of the body speeds up.

Symptoms are elevated heartbeat rate, anxiety, increased appetite, and weight loss.

Healthcare providers diagnose this problem by physical examination of the neck, thyroid blood tests, and by imaging tests.

Overactive thyroid Treatment is practiced by antithyroid drugs, beta-blockers, radioactive iodine, or by surgery.

What is hyperthyroidism or an overactive thyroid?

Hyperthyroidism happens when the thyroid gland produces more thyroid hormones than the body requires this condition turns out to be speedy metabolism.

The thyroid gland is a butterfly-shaped small gland situated in the front of the neck, producing two types of hormones named T3 (tri-iodothyronine) and T4 (thyroxine). The functions of the thyroid gland include

Controls heart rate
Regulate body temperature
Control the body metabolism (a process in which food is transformed into the energy that requires for normal body functions.)

When the thyroid gland works properly, the whole body will be in balance, and all of the systems functions properly. But if the thyroid performs abnormally like producing too much or less amount of hormones than normal, it will affect the whole body.

What is the Difference between hypothyroidism and hyperthyroidism?

Hyperthyroidism and hypothyroidism are associated with the number of hormones released by the thyroid gland. If thyroid hormones production exceeds the normal range called hyperthyroidism or overactive thyroid turns out speedy metabolism, and if the thyroid gland produces fewer amount hormones (T3 & T4) than the normal range known as Hypothyroidism or underactive thyroid as result slows down the metabolism of the body.

Who is more affected by

hyperthyroidism?

Hyperthyroidism is more familiar in overage (more than 60 years) people and women. Although, some factors increase the chances of getting hyperthyroidism including

A family history of thyroid disease
Having other health problems, such as pernicious anemia (caused by deficiency of vitamin B12), primary adrenal insufficiency (a disorder of hormones), or type1 and type 2 diabetes.
Eating food contains a large amount of iodine
Using nicotine products

Taking medications that contain iodine

If a woman is pregnant within the previous six months

How common is Hyperthyroidism?

Approximately 1 out of 100 Americans ages 12 yrs and older have the problem of hyperthyroidism.

Symptoms:

What are the symptoms of hyperthyroidism?

Hyperthyroidism symptoms may vary from person to person, you may experience some of these symptoms and not others, or you may have many of these at the same time. However, they can impact your whole body. Symptoms of hyperthyroidism are includes

Palpitation (Rapid or irregular heartbeat)
Intolerance to excessive sweating and heat
Increased appetite
Vision changes
Weight loss
Shaky hands
Muscle weakness
Diarrhea (Frequent bowl movement)
Thin, moist, and warm skin
Changes in the menstrual cycle
Sleep issue
Hair loss and changes in hair texture
Bulging of eyes
Swelling and enlargement of the neck due to enlarged thyroid

What are the complications of hyperthyroidism?

Untreated hyperthyroidism may affect many parts of the body. Different systems ranging from the vascular system (heart) to the skeletal system (bones) may all be impacted if anybody has an overactive thyroid or hyperthyroidism.

Complications of untreated or under-treated hyperthyroidism include,

Congestive heart failure or other heart problems
Stroke
Osteoporosis (Thinning bone)
Atrial fibrillation
Grave’s disease (an eye disease called ophthalmopathy)
Menstrual cycle or fertility issues

If someone, experiences these or some of these symptoms he should see the healthcare provider immediately especially when he experiences loss of appetite and prefer loneliness (pulling out from people), so they can decide on a proper diagnosis and suggest treatment.

Risks:

What are the risk factors for hyperthyroidism?

Risk factors for hyperthyroidism include,

Family history of thyroid diseases
A lot of iodine intake (iodine is a mineral the body uses to make thyroid hormones)
Pregnancy
Medical history includes primary adrenal insufficiency (Addison’s disease), pernicious anemia, and type 1 diabetes.

Hyperthyroidism during pregnancy:

Is there a possibility of the development of hyperthyroidism during pregnancy?

During the early days of pregnancy, the body requires to make more thyroid hormones than the normal values to help the developing fetus. However, these hormones are predominantly significant, for the development of the fetus's nervous system and brain.

Little higher amount of thyroid hormones than normal, is ok but when these levels elevate dramatically, healthcare providers definitely need to set a proper treatment plan, because the high level of these hormones can impact not only the mother but the fetus also.

It may be difficult to diagnose hyperthyroidism during pregnancy because thyroid hormones values naturally elevate, and pregnancy symptoms mask signs of hyperthyroidism

What happens if pregnant women get hyperthyroidism?

A mild form of hyperthyroidism during pregnancy generally does not cause a problem, but severe hyperthyroidism, when untreated, may affect both the baby and the mother. If a female has hyperthyroidism and planning to get pregnant, she should take proper or scheduled appointments recommended by the health care provider to get the disease under control.

Causes of hyperthyroidism:

What causes hyperthyroidism?

Medical conditions and circumstances that can cause hyperthyroidism include

Grave’s disease
Overactive thyroid nodules
Too much iodine intake
Thyroiditis (inflammation of the thyroid gland)
Too much thyroid hormone medicine
A noncancerous tumor of the pituitary gland

1. Grave’s disease:

It is a most familiar cause of hyperthyroidism making up about 85 % of the cases. Grave’s disease is an autoimmune disease.

Grave’s thyroid gland is attacked by the body’s own immune system as a result thyroid makes too much thyroid hormone. It is a hereditary disease means if a person has Gove’s disease there are chances other family members could have it. It is more common in females who had hyperthyroidism at birth than males.

2.Overactive thyroid nodules:

Overactive thyroid nodules, or lumps in the thyroid, are common and usually noncancerous. Conversely, one or more nodules may turn out overactive and make too much thyroid hormone. It is common in older adults.

3. Thyroiditis:

An inflammation of the thyroid gland is called thyroiditis. In some types of thyroiditis thyroid hormone leaks out of the thyroid gland into the bloodstream, and as result symptoms of hyperthyroidism may develop.

There are two types of thyroiditis that cause hyperthyroidism include

Postpartum thyroiditis may develop after delivery in women
Subacute thyroiditis engages a painfully enlarged and inflamed thyroid

Painless thyroiditis is similar to postpartum thyroiditis, but it happens with no pregnancy. In this condition, the thyroid may be enlarged. Health experts assume that painless thyroiditis is possibly an autoimmune condition.

Thyroiditis may also cause symptoms of hypothyroidism or underactive thyroid. After a period of time in some cases, it may turn out underactive.

4. Consuming too much iodine

Iodine is a mineral that the thyroid gland requires for making thyroid hormones. Intravenous iodinated contrast ( iodine “dye”) receiving may also turn into hyperthyroidism. Some cough syrups and medicines for heart disease contain iodine in high amounts. Amiodarone is a medicine that may contain a high amount of iodine, which may cause hyperthyroidism. Seaweed a\sea weed supplements also contain a high amount of iodine.

Some cough syrups and medicines, including some heart medicines, may contain a lot of iodine

If iodine is taken in too much amount (in food or medication), then the body requires it, and if someone is at risk of hyperthyroidism, it may cause the thyroid to produce more thyroid hormones.

5. Excessive intake of thyroid hormones

If someone is taking thyroid hormone medicine (more than the body requires) for the treatment of hypothyroidism. It is crucial to visit the healthcare provider at least once a year to check thyroid hormone levels. There may be a need to adjust the dose if the healthcare provider finds the thyroid hormone level elevated too much.

There are some medicines that interact with thyroid hormone medicines and elevate hormone levels. So it is important during thyroid medication to ask the healthcare provider if a new medicine is added.

6. Noncancerous tumor:

Sometimes in rare cases, the noncancerous tumor develops in the pituitary gland (situated beneath the brain) and may cause hyperthyroidism.

Diagnosis:

How do doctors diagnose hyperthyroidism?

Due to the similar symptoms in other diseases and hyperthyroidism, healthcare providers may diagnose in several ways including

A physical examination is to check the neck whether is normal or larger than normal.
Imaging tests to determine the thyroid
Blood tests to determine the levels of thyroid hormones

1. Physical examination

A physical exam includes

1. Thyroid:

Healthcare provider may gently feel the thyroid gland through the outside of the neck to check if it is bumpy, enlarged, or tender.

2. Eyes:

Healthcare provider may examine the patient’s eye for, bulging, swelling, redness, and other signs of Grave’s disease.

3. Heart:

With the help of a stethoscope healthcare providers check the heart rate for a fast and/or irregular heart rate.

4. Skin:

They will check the skin to see if it is moist or warm.

5. Hands:

Health care provider may ask the patient to outstretch the hands to see if there is a tremor, they also examine the fingernails.

2. Blood tests:

Healthcare providers may take the patient’s blood samples to determine if it is high levels of thyroid hormones, this blood test is known as thyroid function testing. In hyperthyroidism levels of the thyroid hormone (T3 and T4) are elevated and TSH (Thyroid-stimulating hormones) is lower than normal.

3. Imaging tests:

For an accurate diagnosis and to know the possible cause of hyperthyroidism, it is important to take a closer look at the thyroid gland. The imaging test that healthcare providers generally use include

4. Thyroid Ultrasound:

In ultrasound, high-frequency sound waves are used to create images of any organ. It is a non-invasive procedure in which a healthcare provider looks at the thyroid gland on the screen of an ultrasound machine. This test is used to see the nodules on the thyroid gland.

5. Thyroid scan:

The healthcare providers may use a thyroid scan to look for nodules or lumps on the thyroid gland, swelling inflammation, thyroid cancer, or goiter.

This procedure of diagnosis is an addition of the RAIU, were moreover to measure the absorbed amount o radioactivity by the thyroid gland. The patient is allowed to lie on a table with the head tilted back through a special camera (called a gamma camera) takes many images of all or certain parts of the thyroid that appear as bright on the screen.

6. Radioactive iodine uptake (RAIU)

test:

In this test of imaging, a patient is given a safe and small dose of radioactive iodine (also called a radiotracer) orally to look at how much it thyroid absorbs. After a definite time which is generally 6 and 24 hours later. Healthcare providers scan the neck with a device named a gamma probe, to look at how much of the radioactive iodine patient’s thyroid has absorbed. If the thyroid gland has absorbed plenty of the radioactive iodine, it means that the thyroid is producing an excess amount of thyroxine (T4). If this is the case, the patient probably has thyroid nodules or Grave’s disease.

Overactive thyroid treatment:

How is hyperthyroidism treated?

Healthcare providers treat hyperthyroidism to bring thyroid hormone levels back to normal. So there are several treatment options for hyperthyroidism. Healthcare providers generally discuss each option with the patient and help them to determine the best treatment plan. Yet, no single treatment works for everyone.

Treatment depends upon how severe it is or what’s causing hyperthyroidism. Before the treatment recommendations, healthcare providers consider

Age of the patient
Side effects and possible allergies of the medicines
If a patient had any surgery in past
Other conditions, like heart disease or pregnancy

However, treatment options for hyperthyroidism include

1. Antithyroid drugs:

Antithyroid drugs methimazole (Tapazole) or propylthiouracil (PTU) generally use. These antithyroid drugs block the ability of the patient’s thyroid to make hormones. They put forward rapid control of the thyroid.

2. Radioactive iodine:

Radioactive iodine damages overactive thyroid cells to shrink the thyroid gland and thyroid hormone values to decrease over a few weeks. This radioactive iodine is given orally to absorb these overactive thyroid cells. This generally leads to permanent obliteration of the thyroid, which will cure hyperthyroidism of radiation.

The amount provided by these medicines is different from the amount used for the RAIU (Radioactive iodine uptake) test and scan for diagnosis. Most of the patients who receive this treatment have to take these medications for the rest of their lives to uphold normal thyroid hormone values.

3. Surgery:

Healthcare providers may remove a patient’s thyroid gland through a surgery called a thyroidectomy. This surgery is accurate for hyperthyroidism, but it will generally turn into hypothyroidism called underactive thyroid, which needs all-time thyroid drugs to uphold hormone values normal.

4. Beta-blockers:

Beta-blockers are drugs that block or obstruct the action of thyroid hormones in the patient’s body. These drugs don’t alter the values of hormones in the blood, but they may help manage symptoms such as nervousness, shakiness, and an irregular heartbeat that are caused by hyperthyroidism. Usually, this type of treatment is not used alone and is generally paired with other options to treat hyperthyroidism over the long standing.

Health experts are looking into new techniques for the treatment of hyperthyroidism, in this way a new approach is introduced named Radiofrequency ablation (RFS). In cases where medicines or surgery do not work, RFA is used. But it is not available widely.

How long it will take to treat hyperthyroidism?

The amount of time for the treatment of hyperthyroidism depends on the cause of hyperthyroidism. For example, if the healthcare providers treat the patient’s condition with thyroid medications such as methimazole or propylthiouracil, within 6 to 12 weeks the hormone levels should be dropped to a healthy level.

If the healthcare provider decides to give a high dose of iodine drops (don’t use radioactive), this will get back normalized within 7 to 10 days. But this is a short-term treatment. So the permanent and effective treatment is a surgery called a thyroidectomy, it is considered a permanent solution to hyperthyroidism.

Are there any risks of treatment of hyperthyroidism?

Most of the treatments have their side effects. It is significant for the patient to discuss with healthcare providers about the effects and side effects before going to start treatment.

However, some of these risks of treatment are included

Medication side effects
Methimazole and propylthiouracil are the medicines usually used in the treatment but they have some side effects.
One rare side effect which also impacts less than 1 % but has serious side effects is agranulocytosis (is a condition in which severe fall in white blood cell count. Another rare side effect impacting less than 1 % of people is potential liver damage, which can be permanent in the case of PTU.

These side effects may impact patients of any age, and there is also an opportunity for an allergic reaction to these medicines, which happens in 5 % of people.

This medication may transfer from the mother to the fetus through the placenta. This may lead to the development of goiter or hyperthyroidism in the fetus. That’s why pregnant women are closely monitored throughout the pregnancy period.

1. Radioactive materials:

If radiation is involved in the treatment plan for hyperthyroidism there is a possibility of cancer. However, presently there is no association between the development of cancer if using radioactive iodine for the treatment of hyperthyroidism. This theory is considered to be improbable and low-risk.

Sometimes after radioactive iodine therapy (RAI) patients may lose sensation in their mouths. It is common and may last for up to a few months, the sensation does come back to your mouth over time.

Another risk that is recognized is between breastfeeding or pregnant women and their babies. That’s why these women are advised not to take radioactive iodine during pregnancy or lactation (breastfeeding) because it may impact the baby’s thyroid gland.

2. Surgery:

Surgery is generally considered a very effective treatment for hyperthyroidism. In rare circumstances, complications such as paralysis of vocal cords (inability to speak) and damage to parathyroid glands can happen, which results in low calcium in the blood.

There are always definite risks associated with surgery, such as bleeding and infection.

After treatment, patients most probably require to take replacement thyroid hormones for the rest of their lives. Because some of these treatments especially surgery, eliminate these hormones by eradicating the thyroid or reducing thyroid hormones by removing decreased thyroid hormone values. There will be the need of reintroducing the thyroid hormones back into the patient’s body system by taking regular medicines.

Is hyperthyroidism curable?

Destroying thyroid medicines or removing the thyroid through surgery will cure hyperthyroidism, and this is a permanent treatment for hyperthyroidism.

Conversely, once the thyroid gland is destroyed or eradicated, there will be the need to take thyroid replacement medicines for the rest of their lives. The body still requires thyroid hormones, not just at such high values as patients have hyperthyroidism. Though a patient needs to take the medicines and check in with their healthcare providers regularly, this is manageable for thyroid disease.

What is a thyroid storm?

A thyroid storm is a serious complication of hyperthyroidism, also known as a thyrotoxic crisis or thyroid crisis. It occurs as a result of untreated hyperthyroidism, the body enters overdrive, which turns out too much amount of thyroid hormones in its system because the thyroid gland creates and releases a huge amount of thyroid hormone in a short amount of time.

Thyroid storm symptoms include

Tachycardia (Rapid heart rate) that can go above 140 beats/minute.
High fever (104 to 106 degrees Fahrenheit)
Congestive heart failure
Loss of consciousness
Feeling agitated
Delirium
A complication of Grave’s disease which is one of the causes of hyperthyroidism is called Grave’s eye disease (also known as Grave’s ophthalmopathy). This medical condition may not be prevented. It causes complications include
Vision loss
Bulging eyes
Light sensitivity
Double vision

How do the diet, eating habits, and nutrition affect hyperthyroidism?

As we discuss above the thyroid gland uses iodine to create thyroid hormones. If anyone has an autoimmune disease or Grave’s disease, he is probably sensitive to dangerous side effects from iodine.

Eating food that is rich in iodine, for example, dulse, kelp, Algae, alginate, or another kind of seaweed, can cause hyperthyroidism or worsen hyperthyroidism. Intake of iodine supplements can have the same effects, so it is significant to talk with healthcare providers about it.

What kind of food should be avoided or limited?

Any multivitamins or cough syrup are taking which contains iodine
If taking an iodine supplements.

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