Thyroid disease is a common condition with a lifetime incidence of around 12% in the United States. Women tend to have more thyroid problems than men and it is estimated that around 2 to 3 % of the population will develop hyperthyroidism sometime during their lifetime.
What is hyperthyroidism?
Hyperthyroidism is a condition in which the thyroid gland is overactive making an excessive amount of thyroid hormone. Located in the front of your neck, the thyroid gland releases hormones controlling your metabolism or the rate at which you burn calories. This involves your breathing, heart rate, nervous system, weight, body temperature, along with other functions in the body.
What are the symptoms?
When the thyroid is overactive – hyperthyroidism – processes of the body are speeded up causing the following symptoms:
· Fatigue or muscle weakness
· Hand tremors
· Mood swings
· Nervousness or anxiety
· Rapid heartbeat
· Heart palpitations or irregular heartbeat
· Skin dryness
· Trouble sleeping
· Weight loss
· Increased frequency of bowel movements
· In women, light periods or skipping periods
· Excessive sweating
· Some may develop a goiter which is an enlarged thyroid gland feeling like a swelling in the front of the neck
What causes hyperthyroidism?
There can be a number of causes of hyperthyroidism. There are a couple of hormones the thyroid gland makes called thyroxine (T4) and triiodothyronine (T3). If the thyroid is making too much of these hormones, you will be diagnosed with hyperthyroidism.
The most common cause though is Grave disease which is when the body makes an antibody called thyroid-stimulating immunoglobulin (TSI) causing the thyroid gland to produce too much thyroid hormone. This disease runs in families with more women being diagnosed with it than men.
Other causes include:
· Nodular or multinodular goiter – these are lumps found in the thyroid gland causing the gland to make excessive amounts of thyroid hormones.
· Thyroiditis – inflammation of the thyroid gland resulting from a virus or a problem with the immune system
· Consuming too much iodine either from foods or supplements – the recommended daily requirement is 150 micrograms ages 19 and up - or taking a medication containing iodine such as amiodarone which might cause the thyroid gland to overproduce thyroid hormones.
· Some women may develop hyperthyroidism during pregnancy or within a year after giving birth.
How is it diagnosed?
Diagnosis is made through a physical exam, the patient’s symptoms, and blood tests measuring levels of thyroid stimulating hormone (TSH) and thyroid hormones T3 and T4.
How is it treated?
Fortunately there are several treatment for hyperthyroidism. Depending on a person’s age, gender, physical condition, and the underlying cause, will determine which treatment option is best.
· Radioactive iodine
This treatment has been used for over 60 years and has been shown to be usually safe. It is taken by mouth with the thyroid gland absorbing it helping to shrink the gland relieving symptoms within about three to six months. This treatment will slow thyroid activity which can result in an underactive thyroid or hypothyroidism where you may need to take medication every day to replace thyroxine.
· Anti-thyroid medications
Taking these medications will reduce symptoms of hyperthyroidism by preventing the thyroid gland from producing excess amount of hormones. Within about six to twelve weeks, symptoms will usually begin to improve but the total treatment usually continues at least a year or longer. Even though some people will have the symptoms cleared permanently, there are risks associated with this treatment ranging from the medications causing to serious liver damage, allergic reactions, skin rashes, hives, fever, or joint pain.
· Beta blockers
Commonly used to treat high blood pressure, they won’t reduce thyroid levels but they can reduce a rapid heartbeat and prevent palpitations making a person feel better.
· Surgery (thyroidectomy)
If a woman is pregnant, or a person can’t tolerate anti-thyroid drugs or the radioactive iodine therapy, thyroid surgery is another option. The surgery involves removing most of the thyroid gland but there can be risks. It could damage the vocal cords and parathyroid glands which help control the level of calcium in the blood. Since most of the thyroid gland is removed, a person will have to take lifelong medications of levothyroxine (Synthroid or others) to supply the body with normal amounts of thyroid hormone. Removal of the parathyroid gland will also need medication to keep blood calcium levels normal.