What You Need to Know About Hyperthyroidism?
If you feel tired all the time but still can’t sleep and feel drained by nervous energy, it could be because your thyroid is over active.
What is the thyroid? The thyroid is a gland in the neck, which produces thyroxine, a hormone that regulates how fast or slow the cells in the body work.
A small gland in the brain - the pituitary - sends a stimulating hormone (called TSH) to the thyroid. When there is enough thyroxine circulating the pituitary reduces its TSH output and when thyroxine levels drop then it increases the TSH.
Causes of hyperthyroidism.
· Hyperthyroidism is most commonly caused by a toxic goitre, which is often called Graves Disease. The cause of Graves is unknown, but it is an autoimmune problem which means that the body stops recognising its own organs and starts ‘attacking’ them so that they don’t work correctly so this type of hyperthyroidism may occur in people with other autoimmune diseases such as type 1 diabetes or rheumatoid arthritis.
Other causes include:
- Subacute thyroiditis which is rare and thought to be caused by a virus and is an acute inflammation of the gland. It often occurs after a viral infection like laryngitis, mumps or flu and it is self limiting, passing through stages of excess production, hyposecretion and then back to normal. 10% of patients may develop hypothyroidism as a result of the mechanisms not returning to normal
- If you take thyroxine for an underactive thyroid and take too much, you could get the symptoms of hyperthyroidism. Your doctor should check your blood levels of thyroxine regularly (about once a year).influenza
- A TSH-producing tumour, which is rare, producing the stimulating hormone from the brain’s pituitary gland.
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What are the symptoms of hyperthyroidism?
Symptoms vary and can be a bit vague. In older people they may become apparent when the patient sees the doctor about heart problems like angina or palpitations.
Other symptoms include
- being unable to sleep,
- feeling too warm and
- sweating a lot,
- weight loss +/- increased appetite,
- being irritable,
- lack of concentration,
- palpitations or fast heart rate,
- very light or absent menstrual periods
- eye complaints.
Diagnosis of thyroid disease is by a blood test and by the doctor listening to your symptom history.
What is the treatment for hyperthyroidism?
The doctor will probably refer you to an endocrinologist (hormone expert) for treatment of your thyroid disease as it’s often complicated and you will need life-long follow up. Treatment for hyperthyroidism needs to be undertaken fairly quickly after diagnosis as hyperthyroidism can put a strain on the heart.
- The options for treatment are medical intervention involving anti-thyroid medications for about 18 months. These block the secretion of the thyroxine until you have the right amount circulating. The dose can either be titrated against your own circulating thyroxine or you can take tablet thyroxine to give what doctors call a ‘block and replace’ regimen. There is a danger of relapse after stopping the treatment.
- The second option for treatment is radioactive iodine therapy with a single dose of 131 iodine taken as a liquid ‘drink’ to permanently stop thyroid function. Anti-thyroid drugs may be needed before treatment to get the disease under control and after to prevent the stored hormone being toxic when it’s released after treatment. In the long term you may need to take thyroxine tablets.
- Surgery is often needed in large goitres or where other options are ruled out. The surgery will remove all or part of the thyroid. Complications include bleeding, hypoparathyroidism (the little glands next to the thyroid are the parathyroid glands and their hormone regulates calcium) or hoarseness due to damage to the vocal cords.
- Other drugs to treat the effects of hyperthyroidism include beta-blockers until the thyroid is well controlled.
Underactive or overactive thyroid?
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