HYPERTHYROIDISM

Hyperthyroidism is caused by excessive production or effect of thyroid hormones on your body. It is more appropriately called thyrotoxicosis. Nearly 1% of people suffer from this thyroid disorder. It is 10 times more common in women than men.

Hyperthyroidism

It can cause severe symptoms and discomfort and can even threaten life when severe.  However milder forms may go unrecognized as the patient does not have any symptoms.

In these mild cases it may be diagnosed by a thyroid function test done for some other reason e.g.  prominence of eyes/ staring look, as part of checkup during pregnancy or a routine health checkup.

What are the causes of hyperthyroidism?

Graves' Orbitopathy

Graves’ Disease: The commonest cause of hyperthyroidism. Graves' disease  is common in women and patient can have a thyroid swelling, and sometimes eye swelling too. Patient may have double vision and other eye related symptoms.

A. Normal Gland  B.Thyroiditis

Thyroiditis: This condition causes inflammation of the thyroid gland. Because of this there will be leakage of the thyroid hormone stored in the gland into the blood. Excess flooding of blood by thyroid hormones causes various symptoms. There can be pain in the neck (thyroid) too.

Thyroiditis is commonly seen in women after childbirth. Unfortunately many milder cases are ignored due to lack of awareness. This can lead to untold sufferings and steal the joy of motherhood. Post-partum depression can make things worse.

Multinodular goiter: A long standing swollen and enlarged gland may finally start misbehaving after years by producing excess thyroid hormones causing hyperthyroidism.

Toxic Adenoma

Toxic Adenoma: A single lump (nodule) in the thyroid gland can turn dictator and hurt  the owner (patient)  by it’s excessive and unwanted hormone production.

Iodine excess: whether it be due to use of self-medication or quackery with iodine containing liquid medications like syrups, ‘kashayas’, kelp tablets or dietary ingestion, excess iodine is NOT good for your thyroid gland.

Medicines: given for heart problems like cordarone,  amiodarone, contrast injections for x-ray tests like CT-scan can also cause this problem.

Excess usage of thyroid hormones: Whether due to ignorance or laziness to get thyroid test regularly, what was correct dosage once upon a time can turn out excessive today for your body. Too much of a good thing.

What do you feel? ….when there is excess thyroid hormone..

• Feeling anxious, irritable, argumentative,  always angry
• Shakiness or trembling of hands.
• Hair fall
• Difficulty sleeping
• Muscle weakness
• Weight loss, despite excessive hunger and eating.
• Frequent small loose stools
• Feeling excessive heart pounding (palpitation).
• Prominence of eyes (stare or angry look)
• Excessive sweating and intolerance to heat.
• Change in monthly menstruation periods in women
• Miscarriage chances are more
• Fracture without sufficient cause (low trauma fracture)

Tests for hyperthyroidism

Blood tests like TSH and free thyroxine levels (f T4) help in making a diagnosis. Thyroid antibodies, Thyroid scan are other special tests your doctor may ask for. These tests help in finding out why your thyroid gland is functioning abnormally.

Treatment for Hyperthyroidism

Proper management of thyroid disorder requires special training. Endocrinologists have the finesse in precisely managing hyperthyroidism.

Treatment options are decided based on the type and severity of hyperthyroidism and also the preference of the patient for a given form of treatment. There are basically three lines of treatment:

Medical: Antithyroid drugs  like methimazole (Neomercazole, thyrocab), propylthiouracil (PTU) etc. Any allergic reaction may need stopping these pills.

Radioactive Iodine

Radioactive Iodine Treatment: Iodine is integral to the thyroid function. Iodine which is radioactive will therefore home into the thyroid gland and gets concentrated there.  Therefore misbehaving over functioning thyroid gland easily bites the bait of radio-iodine even in a tiny dose and patient gets treated. The dose is too little to cause major harm to rest of the body.

Thousands of patients have received radioiodine treatment, including former President of the United States George. W. Bush and his wife, Barbara. The procedure can be done without hospital admission.

Surgery: Surgery is done to remove the thyroid gland. It is not usually preferred due to the need for admission and risks of surgery etc. However sometimes it may be required in certain cases.

 Your endocrinologist may also give you supportive  treatment with beta-blockers, calcium supplements and so on as required in a given patient.

Are there any other complications?

Untreated thyroid can race your heart to the point of fatigue where it may give up, leading to heart failure. The racing heart may also falter in it’s rhythm and become irregular in  it’s beating. This is called atrial fibrillation.

Excess thyroid hormone may leach your bones of calcium. The thinned porous (osteoporosis) bone may break easily even with slight injury.

Eye involvement can be severe and cause double vision, headaches, blurring of vision, even loss of eye sight in severe cases from exposure to dust of the protruding eye balls, which can’t be shut from harm despite the best efforts of your eye lids. If you smoke tobacco (cigarettes, bidis) it can burn the eyes already hurt by your thyroid.

Hyperthyroidism if neglected completely may storm the body creating a crisis situation called thyroid storm.