Definition

Hyperthyroidism is a condition characterized by excessive thyroid hormone production by the thyroid gland, leading to metabolic disorders. This condition is also known as an overactive thyroid.

Cause

The thyroid is a butterfly-shaped gland located in the basal region of the neck. The thyroid gland produces two main hormones: triiodothyronine (T3) and thyroxine (T4). This hormone influences the rate at which the body utilizes carbohydrates and fats, helps regulate temperature, affects cardiac rate, and regulates protein synthesis. It exerts its effects on all cells within the body.

When the thyroid gland produces an excessive amount of thyroid hormone in the circulation, hyperthyroidism develops. The following conditions may contribute to hyperthyroidism:

• Graves disease

Graves' disease is classified as an autoimmune disorder due to the immune system's targeted destruction of the thyroid gland. This results in an overproduction of thyroid hormone by the thyroid. Graves' disease is the prevalent etiology of hyperthyroidism.

• Overactive thyroid nodule

This disorder is also known as toxic adenoma, toxic multinodular goiter, and Plummer's disease. An adenoma is a benign tumor that can lead to an enlargement of the thyroid gland beyond its usual size. Thyroid adenomas typically result in the overproduction of thyroid hormones, leading to hyperthyroidism.

• Thyroiditis

This condition is characterized by inflammation of the thyroid gland. This is occasionally the result of an autoimmune disorder. In other instances, the precise cause remains unclear. Inflammation can lead to the release of thyroid hormone deposits into the circulation, resulting in symptoms of hyperthyroidism.

Risk factor

The following are risk factors for hyperthyroidism:

• A history of thyroid disease in the family, particularly Graves' disease
• A medical background of specific chronic conditions such as pernicious anemia and primary adrenal gland insufficiency
• A recent history of pregnancy that elevates the risk of thyroiditis

Symptoms

Hyperthyroidism symptoms may resemble those of other health conditions, complicating the diagnostic process. Hyperthyroidism can result in several symptoms, including:

• Uncontrolled weight loss
• Arrhythmia
• Palpitation
• Increased appetite (prone to feeling hungry)  
• Anxious
• Tremors typically manifest as trembling in the hands and feet.
• Hyperhidrosis
• Changes in the menstrual cycle
• Increased sensitivity to warm temperatures
• Increased frequency of bowel motions
• Thyroid gland enlargement, known as goiter, can manifest as swelling near the base of the neck.
• Fatigue
• Muscle weakness
• Sleep disorders
• The skin is frequently warm and moist.
• Skin atrophy
• Fragile and thin hair

It is more prevalent among the elderly to exhibit symptoms that can be difficult to diagnose. An irregular heartbeat, weight loss, depression, and fatigue or weakness during daily activities are examples of these symptoms.

Diagnosis

Hyperthyroidism is diagnosed using a combination of medical history, physical examination, and blood tests. Additional testing may be necessary if abnormalities are detected in the blood test findings.

• Medical history and physical examination. During a physical examination, the doctor may check for:
• Tremors in your fingers and hands
• Excessive body reflexes
• Rapid or irregular pulse
• Eyes become more prominent
• The doctor will also inspect your thyroid gland while you swallow to discover if it has enlargement, tumors, or pain.
• Blood examination. Blood tests that assess the hormones T4 T3, and TSH can confirm the diagnosis of hyperthyroidism. High T4 levels and low TSH are typically reported in people with hyperthyroidism. Blood testing is necessary, especially for the elderly because classic symptoms of hyperthyroidism are uncommon.

If the blood test results suggest hyperthyroidism, the doctor will recommend one of the tests to help identify the cause of hyperthyroidism:

• Radioiodine scan and uptake test. For this test, you will take a small quantity of radioactive iodine, called radioiodine, to observe how much is absorbed by the thyroid gland and where it is absorbed in the thyroid gland.
• Thyroid ultrasound. This examination uses high-frequency sound waves to obtain images of the thyroid.

Management

There are multiple treatments available for hyperthyroidism. The choice of therapy depends on your age and health status. The underlying etiology of hyperthyroidism and its severity are also decisive. Therapy may include:

• Antithyroid medication. This drug slowly improves the symptoms of hyperthyroidism by preventing the thyroid gland from producing too much hormone. Antithyroid drugs include metamizole and propylthiouracil.
• Beta-blocking drugs (beta-blockers). This drug does not affect thyroid hormone levels but can reduce symptoms of hyperthyroidism such as tremors, fast heartbeat, and palpitations.
• Radioiodine therapy. The thyroid gland will absorb radioiodine, causing it to decrease in size.
• Thyroidectomy. This procedure removes a portion or all of the thyroid gland. It is rarely used to treat hyperthyroidism, although it may be a choice for pregnant women and people who are unable to take medicine or who do not respond to antithyroid or radioiodine therapy.

Complications

Hyperthyroidism can lead to the following complications:

• Cardiovascular complications. Several of the most potentially harmful consequences of hyperthyroidism concern the heart, including
• Atrial fibrillation is a heart rhythm abnormality that raises the risk of a stroke.
• Heart failure is a disorder in which the heart cannot circulate enough blood to meet the body's needs.
• Osteoporosis. Untreated hyperthyroidism can lead to weak and brittle bones. This disorder is known as osteoporosis. Too much thyroid hormone causes calcium metabolism issues in the body's bones, even though the strength of bones depends on their calcium level.
• Eye complications. Some people with hyperthyroidism develop thyroid eye disease. The condition is more common in smokers and affects the muscles and connective tissue surrounding the eyes. Symptoms of thyroid eye disease are:
• Protruding eyes.
• Gritty sensation in the eyes.
• Pain or pressure in the eyes.
• Eyelids are puffy or feel pulled.
• Red or irritated eyes.
• Sensitivity to light.
• Double vision
• Changes in skin color and edema. Graves' disease can potentially result in Graves' dermopathy. The skin becomes discolored and swollen with this disorder, frequently around the lower extremities.
• Thyrotoxic crisis. This uncommon disease is also known as thyroid storm. Hyperthyroidism raises the chance of a thyroid crisis. The condition creates severe, sometimes life-threatening symptoms that necessitate prompt medical intervention. Symptoms could include:
• Fever
• Tachycardia
• Nausea
• Vomiting
• Diarrhea
• Dehydration
• Confusion
• Consciousness

Prevention

There are several things you could accomplish to prevent thyroid disease:

• Avoid processed foods. Several substances can interfere with thyroid hormone synthesis.
• Quit smoking. Toxins generated during smoking can make the thyroid gland more sensitive, leading to thyroid problems.
• Reduce stress. Stress is a significant factor in many health issues, including thyroid disease.

When to see a doctor?

You should see a doctor if you experience unexpected weight loss, a quick heartbeat, excessive sweating, swelling at the base of your neck, or any other hyperthyroidism symptoms. Tell your doctor about your symptoms, even if they aren't particularly uncomfortable. After being diagnosed with hyperthyroidism, most patients will require regular doctor visits to monitor their condition.

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