Hyperthyroidism: What you need to know?

Overview

What is Hyperthyroidism?

Hyperthyroidism aka overactive thyroid is a hyperactive medical condition in which the thyroid gland (located at the front of the neck) starts to function abnormally by producing an excessive amount of thyroid hormone, called thyroxine(T4) and triiodothyronine (T3).¹Overview| Researched based study from Clevelandclinic.org These hormones are responsible for regulating metabolism and energy production in the body, but if produced in excess, can cause health problems and may lead to lead to hypermetabolic condition called thyrotoxicosis. Women are usually found to carry hyperthyroidism disease in a high percentage as compared to men.

Types

What are the various types of hyperthyroidism?

Different types of hyperthyroidism that can develop are

Basedow Disease/Graves’ disease 

• It is an inflammatory disease in which thyroid hormone production is excessively stimulated by immune system antibodies, which makes it a type of hyperthyroidism as well as the cause for it.²Types| Researched based study from Niddk.nih.gov

Toxic nodular goiter

• It is a condition found in elder people in which nodules in the thyroid gland produce excessive amounts of thyroid hormone, leading to hyperthyroidism aka Plummer disease.

De Quervain’s thyroiditis

• This is one such type of hyperthyroidism disease that is generally caused by the presence of virus-like SARS-CoV-2, and adenovirus.

Thyroid hormone resistance disorder

• It is a genetic disorder where the body doesn’t respond to thyroid hormones even if the production of hormones is at normal level, hence becoming resistant and further leading to hyperthyroidism, this is often known as Subclinical Hyperthyroidism.

Causes

What are the causes of hyperthyroidism?

Hyperthyroidism can be impacted by a primary or a secondary cause. A primary cause is a condition that impacts the thyroid, causing unbalanced levels of thyroid hormones, while the secondary cause can be related to a different gland that may be affecting the thyroid hormones. Following are one such listed causes of hyperthyroidism to develop:

Hypophysis issues

• The ductless gland called the pituitary, is responsible for the production of TSH, which help to function the thyroid gland but if the percentage of TSH is found to be in great amount, it can cause hyperthyroidism.

Excessive iodine intake

• Consuming iodine more than the average human intake through diet or supplements can cause the thyroid gland to produce thyroid hormone in huge concentration leading to hyperthyroidism.

Medications

• Some medicines which are prescribed for different health issues can cause negative side effects which may lead to Hyperthyroidism

Thyroid cancer

• Patients who are suffering from thyroid cancer can cause the thyroid gland to produce too much thyroid hormone and hence develop hyperthyroidism.

Smoking

• Smoking increases the chance of developing Graves’ disease, and even worsens the condition including tremors and heart palpitations.

Major stress

• Stress doesn’t directly cause Hyperthyroidism but it can trigger this health condition in individuals who went through it, causing inflammation and damage to the thyroid gland, which can trigger hyperthyroidism.

Pregnancy

• A woman who recently got pregnant is found to develop thyroiditis which can later become hyperthyroidism.¹Causes| Researched based study from Clevelandclinic.org

Symptoms

Symptoms of hyperthyroidism

Below following are certain symptoms that are usually found to occur at the very early stage before it takes the shape of hyperthyroidism, they include:

Eating Habits

• It is found that if thyroid hormones, t3 or t4 are in an overproduction state it will affect your eating habits. One may feel he/she cannot consume any more intake or may have feelings of starvation.

Mental Health

• One may experience a disturbance in their mental health, which is caused by anxiety and nervousness.

Fatigue

• One may feel tired during the day, and find difficulty in sleeping which can later accompany hyperthyroidism, since the CNS is heavily stimulated by hyperthyroidism it can cause night sweats and multiple wake-up times.¹Symptoms| Researched based study from Clevelandclinic.org

Fertility and Menstruation Problems

• In women, the presence of overly produced TSH can throw other hormone levels out of whack, disrupting the menstrual cycle and causing problems during reproduction.
• Girls who haven’t started menstruating may experience delayed menstruation, while menstruating women may experience hypomenorrhea (decreased menstrual flow) or amenorrhea (missed periods).

Bowel Movements

• One may experience an urge to use the bathroom quite frequently since it is found that the thyroid affects the alimentary canal, and if the person has already developed hyperthyroidism, it can further cause diarrhea.

Hand movements

• Hyperthyroidism disease is closely associated with the involuntary movement of arms and hands, and it found that these involuntary actions worsen the disease and may take a different form called Parkinson’s disease.

Heart Palpitations

• The thyroid hormone causes an increase in heart rate which may lead to palpitations and atrial fibrillation (abnormal heart rhythm).

Heat Intolerance

• When the thyroid gland makes more thyroid hormones than one needs, the body temperature is also likely to rise, which may cause one to be extra sensitive to heat.

Skin, Hair, and Nail Changes

• There can be noticeable Changes in physical appearance like Thinning of hair or skin getting red, or graying of hair.³Symptoms| Researched based study from Mayoclinic.org

Respiratory Problems

• Several breathing and/or lung issues can result from hyperthyroidism, like, Dyspnea, Hyperventilation, and Pulmonary arterial hypertension.

Sudden Paralysis

• This is mostly found to occur in men where one may feel severe muscle weakness due to the presence of high hormone levels.

Weight Fluctuations

• The condition of hyperthyroidism closely affects the weight of the person due to the appetite changes which can either cause a person to lose weight or in exceptional cases even gain weight.⁴Symptoms| Researched based study from Nhs.uk

Diagnosis

Diagnosing hyperthyroidism

Sometimes the diagnosis can be difficult, since the doctor may find symptoms to be relatable with a different disease. But in general, the diagnosis of hyperthyroidism involves the following procedures:

Physical Observation

• The Healthcare professional will look for symptoms of hyperthyroidism, like an enlarged thyroid gland, Increased heart rate.

Blood Sample Test

• The doctor will take blood samples to measure levels of hyperthyroidism-causing hormones like TSH, which is lower, and T3 and T4, which are higher, if found hyperthyroidism.

Imaging tests

• Doctor may ask you to intake a small amount of radioactive iodine, and with the help of a scanner will measure the amount of iodine in the thyroid that may be causing hyperthyroidism.⁵Vulnerability| Researched based study from Hopkinsmedicine.org

Tests and Ultrasound

• If the condition is found to be worsened, the healthcare professional will require the patient’s test results which are specifically for thyroid disease.
• The doctor may take blood samples for Anti- TSHR and TSI tests, accompanied by the ultrasound report of the thyroid to look for any abnormalities.

In addition to all this, the doctor may also ask about your medical history, family history of thyroid disease, and any medications you are taking to help make a diagnosis.

Vulnerability

Who are at risk? 

There exist certain factors which may cause the chance of getting hyperthyroidism condition in certain sets of individuals. People who generally fall under such category depend on the following risk factors:

• Gender: it is generally found that women are more likely to develop hyperthyroidism as compared to men, especially during pregnancy or during the menstruation cycle.
• Age: It is also found that people who are elder, i.e., above 60 years of age become more prone to developing hyperthyroidism. It is so because, at this age, the body stops functioning properly which may result in overproduction of thyroid hormone.
• Family history: if a person has had thyroid disease in the past, or a person belonging to his/her family has it, there is a higher chance of him getting hyperthyroidism.⁵Vulnerability| Researched based study from Hopkinsmedicine.org
• Radiation exposure: Radiations are generally harmful, and long-term exposure to them can be life-threatening and may increase the risk of developing hyperthyroidism.
• Certain medications: Certain medications such as amiodarone or interferon alpha can increase the risk of hyperthyroidism.

Management

Management and Treatment

Finding the underlying cause of the hyperthyroidism issue may be necessary to plan the appropriate course of treatment. The procedures listed below can be used to treat it. They consist of:

Drug therapy

• Doctors often prescribe medications like Propranolol at the very early stage if they find the symptoms like palpitation, tremors, and anxiety which may lead to hyperthyroidism, and may recommend Propylthiouracil, methimazole to those who have already developed the condition. This will block the conversion of t4 to t3 and act as an Anti-thyroid drug in the body.⁴Management| Researched based study from Hopkinsmedicine.org

Radioactive iodine therapy

• Patients aged 40 and above or who are vulnerable to medications can go through this treatment, which ultimately damages the thyroid tissue cells that too with single-dose treatment.

Surgery

• Thyroidectomy (Subtotal Thyroidectomy) a surgical procedure to remove the thyroid gland or nodule, is one such option, in which some portion of thyroid tissue is kept while the rest is removed during the surgery. This procedure is frequently advised by the healthcare professional.

Prevention

How one can prevent hyperthyroidism?

Hyperthyroidism cannot be prevented completely, but following a certain step of routine one can reduce the risk and prevent it before it worsens. This includes:

• Follow-up care: One must go through all the necessary healthcare checkups and tests by visiting the concerned doctor timely.
• Quit Smoking: Avoid smoking to lower the chance of developing thyroid disease
• Request for Thyroid Collar: if you going for an X-ray of your body, do always ask for a Thyroid collar. Protecting your neck area from radiation while getting an X-Ray done is extremely important.
• Eating health: add a nutritious and balanced diet to your eating routine. Avoid Iodine and Sodium rich food. 
• Managing mental health: Calm your mind down by keeping all the thoughts away and practice meditation and yoga which will help you recover from anxiety and nervousness, which are one of those symptoms of hyperthyroidism.

Prognosis

Prognosis of hyperthyroidism

The Prognosis for people with the condition of Hyperthyroidism is usually good. For people who catch the symptoms at a very early stage, the chance of developing Hyperthyroidism is reduced, since they start following preventive measures and make frequent visits to doctors and get healthcare checkups regularly. While others who have already developed this, have to go through prescribed medications and in some cases get the thyroid tissue removed through surgical means. if left untreated, it can take various forms and cause complications related to heart, osteoporosis, or a life-threatening condition called thyroid storm. It’s necessary and important to consult a doctor to ensure optimal thyroid health and prevent complications associated with the condition. Eating a healthy diet and practicing self-care routines like Yoga and meditation can help in stress management which is found to be a considerable factor in developing Hyperthyroidism.