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Hyperthyroidism
Disclaimer: people in the picture are models.
What should I know about the
thyroid gland?
The thyroid is a gland located in the front of your neck. It produces
hormones called “thyroid hormones” that affect the functions of almost
all the cells in your body. Two main hormones, T3 (triiodothyronine) and
T4 (tetraiodothyronine or thyroxine), control your body’s basal metabolic
rate (the rate at which your body stores and uses energy). They affect
your heart rate and body temperature. They also affect growth and
development in children. The thyroid hormone production is stimulated
by the Thyroid Stimulating Hormone (TSH), a hormone secreted by the
pituitary gland (a small gland located at the base of your brain).
What is hyperthyroidism?
Hyperthyroidism or overactive thyroid is the condition characterized by
excessive secretion of T3 or T4. It increases your body’s metabolism and
results in the overall increase in most body functions.
What are the symptoms of
hyperthyroidism?
The most common symptoms of hyperthyroidism are:
• Weight loss
• Muscle weakness, especially in the arms and thighs
• Rapid heartbeats, palpitations (feeling that your heart is racing or
pounding), and in some cases irregular heart rhythm
• Tremors, usually in the hands
• Excess sweating
• Inability to tolerate heat
• Nervousness or irritability
• Fine and soft hair
• Increased appetite
• Irregular menstrual periods
• Frequent bowel movements
• Dryness and burning sensation in the eyes in addition to eyelid swelling
What are the causes of
hyperthyroidism?
The most common causes include:
• Graves' disease: It is an autoimmune condition in which the body's
immune system mistakenly attacks your thyroid gland and stimulates
it to produce an excessive amount of thyroid hormone. It is the most
common cause of hyperthyroidism, and it is especially common in
women. Mainly, this disease appears to run in families.
• Thyroid nodules (known as toxic nodular or multinodular goiter): These
occur when one or more nodules (lumps) in your thyroid gland cause
your thyroid to secrete excess hormones in your blood.
• Thyroiditis: It is an inflammation in your thyroid gland, and it leads to the
leakage of thyroid hormones into your blood.
• Factitious or iatrogenic hyperthyroidism: If you are taking thyroid
hormone without any medical reason or if you have hypothyroidism but
are taking much more hormones than your body needs.
How do I know if I have
hyperthyroidism?
If you have any of the above mentioned symptoms, you should contact
your doctor who will perform a physical examination and request some
further tests. He/she will examine your thyroid gland for any enlargement
or for any palpable lump. He/she will also check your heart rate, skin,
reflexes and eyes.
The blood tests will measure the levels of TSH, T3, and T4. Low TSH and
high T4 and/or T3 levels indicate that you have hyperthyroidism. In some
cases, low TSH could be an early sign of hyperthyroidism even if T3 and T4
levels are normal.
Your doctor might also request thyroid imaging (thyroid scan) and/or an
additional test (called radioactive iodine uptake) to determine the reason
of hyperthyroidism.
What are the complications of
hyperthyroidism?
If your hyperthyroidism is untreated or improperly treated, it can lead to
severe health problems such as:
• Heart problems (atrial fibrillation or heart failure)
• Osteoporosis and bone fractures
• Eye problems (red and swollen eyes, sensitivity to light, or double vision)
• Skin problems (Graves' dermopathy, redness and swelling of the skin)
• Thyrotoxic crisis (exacerbation of hyperthyroidism that requires
immediate medical care)
How can I treat hyperthyroidism?
Several treatments for hyperthyroidism exist. Treatment depends on your
medical condition and age.
• Medication: Antithyroid medications such as methimazole and
propylthiouracil (PTU) control your overactive thyroid by preventing
it from secreting excess hormones. These medications might cause
damage to your thyroid gland, and you might be more susceptible to
infections and experience side effects such as fever and sore throat. If
you have any of the symptoms, call your doctor immediately.
Beta blockers such as atenolol and propranolol could be used to control
your symptoms (rapid heart rate, palpitations, and tremors).
• Always take your medications exactly as prescribed by
your doctor.
• Check with your doctor if you can continue taking these
medications during pregnancy.
• Radioactive iodine therapy: It is the most common treatment for
hyperthyroidism available as a capsule that contains radioactive iodine. It
destroys your overactive thyroid cells with little effect to other cells in the
body. You will have to stay in an isolation room for a few days when you
take radioactive iodine to avoid transmitting radiation to people around
you. In some rare cases, the radioactive iodine might kill an excessive
amount of thyroid cells and decrease the function of the thyroid gland
after radioactive iodine therapy (develop hypothyroidism). In this case,
you will need to take life-long thyroid hormone supplements.
Please refer to “Iodine Therapy” handout for more information.
• Anti-inflammatory medications and steroids (cortisone): If the
hyperthyroidism turns out to be due to thyroiditis, your doctor may
prescribe anti-inflammatory medications and sometimes cortisone (if
the inflammation is severe).
• Surgery (thyroidectomy): It involves removing all or part of your
thyroid. After the surgery, you might need to take life-long thyroid
hormone supplements.
Remember the tips below:
• Consult your doctor or dietician to plan a diet rich in calories
and proteins to compensate for the lost weight. Make sure to
choose the right snacks (such as raw vegetables).
• Check with your doctor if you need to receive supplements
of vitamin D and calcium.
• If you have Graves’ disease, wear sunglasses in sunlight and
use lubricating eye drops to avoid eye irritation, dryness,
and/or excessive tearing.
• Follow up frequently with your doctor to check for
hypothyroidism (decreased function of the thyroid gland).
This educational material provides general information only.
It does not constitute medical advice. Consult your health care provider to
determine whether the information applies to you.
Copyright 2015 American University of Beirut. All rights reserved.