Who knew that one little butterfly shaped organ could cause so much turmoil in the body? Thyroid hormone plays a significant role in the pace of many processes in the body. These processes are grouped together to form your metabolism. If there is too much thyroid hormone, every function of the body tends to speed up. It is not surprising then that some of the symptoms of hyperthyroidism are nervousness, irritability, increased sweating, heart racing, hand tremors, anxiety, difficulty sleeping, thinning of your skin, fine brittle hair and weakness in your muscles—especially in the upper arms and thighs. You may have more frequent bowel movements, but diarrhea is uncommon. You may lose weight despite a good appetite and, for women, menstrual flow may become lighter and menstrual periods may occur less often. Since hyperthyroidism increases your metabolism, many individuals initially have a lot of energy. However, as the hyperthyroidism continues, the body tends to break down, so being tired is very common.
Hyperthyroidism usually begins slowly but in some young patients these changes can be very abrupt. At first, the symptoms may be mistaken for simple nervousness due to stress. If you have been trying to lose weight by dieting, you may be pleased with your success until the hyperthyroidism, which has quickened the weight loss, causes other problems.
The most common cause of hyperthyroidism (in more than 70% of people) is overproduction of thyroid hormone by the entire thyroid gland. This condition is also known as Graves’ disease. Graves’ disease is caused by antibodies in the blood that turn on the thyroid and cause it to grow and secrete too much thyroid hormone. This type of hyperthyroidism tends to run more in families and it occurs more often in young women. Little is known about why specific individuals get this disease. Another type of hyperthyroidism is characterized by one or more nodules or lumps in the thyroid that may gradually grow and increase their activity so that the total output of thyroid hormone into the blood is greater than normal. This condition is known as toxic nodular or multinodular goiter. Also, people may temporarily have symptoms of hyperthyroidism if they have a condition called thyroiditis. This condition is caused by a problem with the immune system or a viral infection that causes the gland to leak stored thyroid hormone. The same symptoms can also be caused by taking too much thyroid hormone in tablet form. In these last two forms, there can be excess thyroid hormone but the thyroid is not overactive.
If we suspect that you have hyperthyroidism, diagnosis takes several steps. A physical examination usually detects an enlarged thyroid gland and a rapid pulse. We will then look for moist, smooth skin and a possible tremor of your fingers. Your reflexes are likely to be fast, and your eyes may have some abnormalities if you have Graves’ disease.
The diagnosis of hyperthyroidism will be confirmed by laboratory tests that measure the thyroid hormones— thyroxine (T4) and triiodothyronine (T3)—and thyroid-stimulating hormone (TSH) in your blood. A high level of thyroid hormone in the blood plus a low level of TSH is common with an overactive thyroid gland. If blood tests show that your thyroid is overactive, we may also need to measure levels of thyrotropin receptor antibodies (TRAbs), which when elevated confirm the diagnosis of Graves’ disease. Sometimes we will want to obtain a picture of your thyroid (a thyroid scan). The scan will find out if your entire thyroid gland is overactive or whether you have a toxic nodular goiter or thyroiditis (thyroid inflammation). A test that measures the ability of the gland to collect iodine (a thyroid uptake) may be done at the same time.
No single treatment is best for all patients with hyperthyroidism. The appropriate choice of treatment will be influenced by your age, the type of hyperthyroidism that you have, the severity of your hyperthyroidism, other medical conditions that may be affecting your health, and your own preference. It is a good idea to consult with us here at Palmetto Endocrinology where we are experienced in the treatment of hyperthyroid patients. If you are unconvinced or unclear about any thyroid treatment plan, a second opinion is also a good idea. Call us for an appointment.
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