Hyperthyroidism – the excess of thyroid hormone

The thyroid gland sits on the front of the throat and produces hormones that affect almost all of the body’s functions and control the metabolism. If the thyroid gland produces too many hormones, you get hyperthyroidism. Then the metabolism increases and the body goes high. The disease can be treated with drugs, radioactive iodine or with surgery.

Hyperthyroidism is usually divided into two types. One is Graves’ disease, which is due to the immune system increasing hormone production from the thyroid gland. The second is a tuber up, which may consist of one or more tubers.

Most people get well after treatment, but there is a risk of relapse, especially in Graves’ disease. Hyperthyroidism is more common in women than in men. The disease is unusual in children.

Symptoms of hyperthyroidism

Hyperthyroidism can cause many different symptoms. The inconvenience can be staggering and many people mistakenly believe that they are due to stress, high workload or regular fatigue. Sometimes the thyroid gland is enlarged and sometimes, but not always, can then feel like a pressure on the neck.

Symptoms due to hyperthyroidism can often be unclear and difficult to distinguish from other disorders. Often, the symptoms are clearer when you are younger or middle-aged, but the elderly can also have severe symptoms. Here are some common symptoms of hyperthyroidism:

  • Sweating and warmth.
  • Fatigue and poor sleep.
  • Menstrual disorders.
  • Heart palpitations, increased heart rate, tremors.
  • Appetite loss, loose stomach, weight loss.
  • Nervous, anxious and easy to cry.
  • Irritation and anger.
  • Muscle weakness.

You can also get problems in the form of skin problems, nails that release from the nail bed and hair loss.

Older people can also suffer from high pulse and atrial fibrillation. Sometimes it may be the only symptom.

The most serious condition of hyperthyroidism, the so-called toxic crisis, is unusual and means that metabolism increases because the body is at high tide. The symptoms are severe sweating, high fever, palpitations, and restlessness. 

Some suffer from eye problems

Some who suffer from hyperthyroidism have eye problems. They can look trapped and stared and become irritated with gravel, redness, and burning. Nearly half of those who get autoimmune hyperthyroidism, ie Graves’ disease, can get this kind of trouble.

In unusual cases, eye symptoms can become more severe. Then you can, for example, have double vision, poor eyesight and protruding eyes, so-called exophthalmos.

Smoking can increase the risk of eye problems in Graves’ disease. Therefore, it is good to stop smoking in this disease.

When should I seek care?

If you have symptoms that may indicate hyperthyroidism, you should contact a health care center or GP. There you can describe your complaints to the doctor, who makes an assessment of the story and asks questions.

You can seek care at any healthcare center you want throughout the country. You also have the opportunity to have a regular doctor’s contact at the health center.

If the examination and blood tests show that you may have hyperthyroidism, you can get a referral to a specialist in internal medicine, or a specialist in hormone disorders, a so-called endocrinologist, for further investigation and treatment for hyperthyroidism. You may also need to see an ophthalmologist if you have eye problems.

If you do not receive treatment for your hyperthyroidism, or receive insufficient treatment, the heart is affected and you may have atrial fibrillation and heart failure, for example.

In very rare cases, hyperthyroidism can lead to a toxic crisis, which comes quickly and often after surgery or if you have an infection. You can then become seriously ill with a high fever and have to seek care immediately because the condition is life-threatening.

Investigations

You describe your complaints to the doctor, who makes an assessment of the story and asks questions. Then the doctor continues with this:

  • A general body examination.
  • Feel the thyroid gland.
  • Measures blood pressure and heart rate.
  • Feel the skin if it is warm, moist and sweaty.
  • Check if your fingers are shaking.
  • Check the appearance of the eyes.

Blood sample

You will then be given  blood tests to measure thyroid hormone levels in the blood . If you have elevated levels, you are likely to have hyperthyroidism.

In hyperthyroidism, the level of the thyroid hormone is low if you are healthy otherwise. The hormone is called TSH. Thyroid hormone production is also increased. The hormone that is then measured is called FrittT4.

In Graves’ disease, it is very common to have a certain type of antibody in the blood. Antibodies are proteins that trigger defense reactions that destroy infectious agents. Instead of Graves’ disease, they are directed to the thyroid gland and stimulate it. These are called thyroid receptor antibodies and are abbreviated to TRAK.

More research may be needed

If the investigation has determined that you have hyperthyroidism, the doctor will continue to try to determine what type of hyperthyroidism it is. It may be important for treatment. If you have elevated TRAK antibodies, it is most likely Graves’ disease.

Scintigraphy

If the antibodies are not elevated, the examination can proceed with an image of the thyroid, so-called scintigraphy. This study helps to distinguish between Graves’ disease and so-called nodose toxic trauma, ie tuberculosis. You then get a syringe in the blood with a radioactive substance, often technetium. After 15 minutes, how much of the radioactive substance you have in the thyroid gland is measured? The study shows how the thyroid works and what it looks like. It shows if the high amount of hormone is due to the hormone leaking from the thyroid gland, or if it is instead caused by an increased new hormone formation. In Graves’ disease, the whole thyroid gland produces the hormone. If there is tuberculosis, hormone production is uneven and is only found in tubers. Scintigraphy does not show how much hormone is produced from the thyroid gland

Spårjodundersökning

Another study is called trace iodine and shows hormone production. It shows how much hormone is formed, which is important in certain types of treatment.

You get to drink a flavorless aqueous solution containing a small amount of radioactive iodine. In many hospitals, uptake in the thyroid gland is measured after 24 hours and once again after a few days, but there are hospitals that have other routines.

Sometimes it is not appropriate to carry out these studies. Among other things, they should be avoided during pregnancy and breastfeeding, as the function of the thyroid gland is investigated using radioactive substances.

fine-needle biopsy

Sometimes a so-called fine needle biopsy is also done. Then small amounts of tissue are extracted from the thyroid using a very thin needle. The tissue is then examined by a microscope. The examination is carried out, among other things, when the doctor has known a node in the thyroid gland and is unsure what it may be.

Ultrasound of the thyroid gland

Ultrasound is made in some cases when the thyroid is enlarged. You can be examined at the reception directly or at an X-ray department. Sometimes a fine needle biopsy can be done together with an ultrasound. The ultrasound examination can show whether tubers look benign or not. A fine-needle biopsy can then provide further answers to what kind of lump is.

Treatment for hyperthyroidism

There are three ways to treat hyperthyroidism:

  • drug
  • radioactive iodine
  • Operation.

All treatments for hyperthyroidism are effective. The treatment you receive depends on several things.

What determines what type of treatment you should receive is this:

  • What kind of hyperthyroidism you have.
  • How old are you?
  • The size of your thyroid gland.
  • How powerful the overproduction of hormone is.
  • How affected you are by the disease.
  • If you have any other illnesses.
  • If you are pregnant or want to get pregnant soon.
  • If you have eye problems with Graves’ disease.

The most common treatment for both Graves’ disease and tuberculosis is radioiodine treatment. Before you can start it, you may need to get drug treatment to relieve the symptoms. You also usually get medicines that reduce the production of hormones.

Before surgery, you also usually receive medication to relieve the symptoms and reduce thyroid hormone production.

Sometimes medication is the only treatment if you have Graves’ disease and are not so affected by the disease.

For children, adolescents and pregnant women, drug treatment is also the most common option.

Treatment with drugs

You can be treated with medication if you have a mild form of hyperthyroidism. In half of the cases, the disease often heals without recurrence. The relapse of the disease is common. The chances of becoming healthy in the long term with only medication are less if you have high levels of thyroid hormone in the body and are very affected by the disease. Other treatment methods are often needed.

Treatment with radioactive iodine

Treatment with a weak radioactive iodine solution is a type of radiation therapy that works directly on the thyroid gland itself.

Before the radiation treatment is done, you must drink an aqueous solution or swallow a capsule with radioiodine. Most of the iodine is absorbed by the thyroid gland and emits radiation with a very short range. Therefore, the radiation works primarily within the thyroid gland. The organs that lie next to it get insignificant with radiation.

There is a very low risk that people in your area will be affected. However, as an extra precaution, you usually get the advice to avoid contact with pregnant and young children two weeks after treatment. You also usually get information that for a time you should keep a certain distance from people when you stay near them for more than an hour. This applies, for example, when traveling or sharing a bedroom. Treatment is simple and the risk of complications is small. In most cases, you do not need to be hospitalized.

After the treatment, you slowly get better, which is usually noticed after three to four weeks. If a treatment does not produce sufficient effect, it can be repeated.

Too little hormone production in Graves’ disease

In the long term, most people with Graves’ disease who have been treated with radioiodine develop a malfunction of the thyroid gland. It means that it produces too little hormone. It is treated by taking tablets containing thyroid hormone.

Before treatment with radioactive iodine, always check if you have eye symptoms or not and if you have Graves’ disease. Sometimes you cannot receive radioactive iodine treatment or be treated with cortisone for a few weeks. The reason is that in Graves’ disease there are studies that show a slightly increased risk of eyes when treated with radioactive iodine.

It is especially important that patients with Graves’ disease stop smoking before radioiodine treatment since the risk of eye problems is therefore likely to decrease.

Everyone who has been treated with radioiodine must be checked at regular intervals. In the beginning, it is done quite often and then more rarely. It is individually how often you need to be in control. A good basic schedule is checking after six weeks, three months, six months and one year and then once a year. This applies both if you receive medication afterward and if you do not receive it. The checks can be done at a general practitioner.

Pregnant and lactating women do not receive radioiodine treatment because it is a radioactive substance.

Treatment with surgery

If you are operated on, the surgeon removes part of the thyroid gland on each side or the entire thyroid gland. Surgery is suitable if you have a greatly enlarged thyroid gland or if you, as a young person, have a relapse after drug treatment.

Before surgery, you are treated with drugs so that the thyroid hormone levels in the body areas it should be. Thyroid aesthetics are mostly used. When thyroid hormone levels in the body become correct, you often also get thyroid hormones in the form of, for example, Levaxin until the operation. It is needed to avoid getting too low hormone levels.

You can also get so-called beta-blockers which reduce the problems caused by excess thyroid hormone. The advantage of using beta-blockers before surgery is that it can then be done fairly quickly after the hyperthyroidism is discovered. In a couple of weeks, the symptoms can decrease significantly. The disadvantage is that beta-blockers do not affect the actual hormone levels in the body.

If you smoke, it is good to stop smoking before an operation. The wounds heal faster and the blood circulation and fitness improve to recover faster. You should stop smoking altogether. If you are unable to do so, it is good if you can refrain from smoking before the operation and even the first weeks afterward. Your doctor can tell you what support you can get if you need help quitting smoking.

Are there any risks with the operation?

The parathyroid glands are located very close to the thyroid gland and may be disturbed by the operation. The more that is removed by the thyroid gland, the greater the risk. The parathyroid glands control calcium metabolism in the body.

Therefore, after an operation, the doctor must always check that the lime values ​​are as they should be. If you lose parathyroid glands after surgery, you need to receive vitamin D tablet therapy for the rest of your life to control the calcium content of your body.

Another unusual complication in surgery is that the nerve that goes to the vocal cords can be damaged. You will then become hesitant and may need to be treated by a speech therapist.

Treatment of eye problems

If you have eye problems, you should be treated by an ophthalmologist who works with a specialist in internal medicine or an endocrinologist. The symptoms often decrease or disappear when the hormonal balance is corrected. Sometimes special treatment with anti-inflammatory drugs is needed. In some cases, eye surgery may also be necessary.

After the treatment

Symptoms such as fatigue and anxiety can last for a long time after treatment, even though blood levels are good. But they usually disappear in most people.

There is a certain risk of relapse after treatment. It is most common after treatment with thyroid aesthetics but also occurs after other types of treatment.

There is also always a certain risk that you develop a malfunction of the thyroid gland. Therefore, you need to go for regular check-ups with doctors throughout your life.

What happens in the body?

The thyroid gland, also called thyroid, sits on the front of the neck just below the larynx. It produces essential hormones that affect almost all of the body’s functions. The most important function of the thyroid gland is to control the metabolism of the body. It occurs by the thyroid forming hormone called thyroxine, T4, and triiodothyronine, T3. The thyroid function is in turn controlled by the hormone TSH, the thyroid-stimulating hormone, which is formed in the pituitary gland of the brain.

Hyperthyroidism – too much thyroid hormone

Hyperthyroidism is called the condition when the thyroid gland produces too much thyroid hormone. This means that you get too high metabolism and your body is going high.

In order for the body to be balanced, the thyroid hormone must be produced in sufficient quantity. On the other hand, if the thyroid gland produces too little hormone, it feels like the body is running at low rpm. The condition is called hypothyroidism and can be treated with drugs.

What is the cause of various inconveniences?

You can lose weight because hyperthyroidism causes the body to go up high and increase energy consumption.

Muscle weakness is due to increased energy consumption and muscle breakdown.

You may get loose stomachs because the food passes through the gut faster.

Tremors are due to an increase in sensitivity to certain substances in the nervous system. 

What is Hyperthyroidism?

The most common cause of getting too much thyroid hormone in the body is an over-function of the thyroid gland. This condition is often called venomous hemorrhage, although the thyroid gland is not always enlarged.

Hyperthyroidism can be a so-called autoimmune disease. This means that the body’s immune system stimulates the thyroid to form too much hormone. Such a disturbance explains more than half of the cases. It is not clear why the body’s immune system reacts in this way.

Hyperthyroidism, of the autoimmune type, can also be called Graves’ disease, Basedow’s disease, or toxic diffuse stroma.

Hyperthyroidism may also be due to the formation of too much hormone in one or more thyroid nodules, so-called toxic nodular stroma. This is unusual before the age of 30.

In some cases, a single node in the thyroid gland can produce too much hormone. It is called solitary toxic adenoma.

There is also a certain type of hyperthyroidism that you can get if you get too much iodine. This can happen, for example, when you are treated with heart medicines containing amiodarone or when using contrast agents for x-ray containing iodine.

Inflammation of the thyroid gland, thyroiditis, can cause the gland to temporarily produce too much hormone. There are several types of inflammation that cause hormone overproduction.

Hyperthyroidism can be hereditary

Thyroid diseases are partially hereditary. If you have thyroid disease in your family, you are more likely to get the disease yourself. Within the same genus, the risk of both high and low function of the thyroid gland may be increased. Hyperthyroidism does not infect.

Leave a Reply