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Hyperthyroidism

April 17, 2012

Hyperthyroidism

C.Bittfield

Introduction

This is a blog that will be covering the pathogenesis, etiology, diagnosis, treatment, incidence and mortality, and resources about the autoimmune disease hyperthyroidism.  Hyperthyroidism is normally an autoimmune disease, because of the autoantibodies that will target the thyroid cells.  Hyperthyroidism falls into the category of a metabolic disease.  Hyperthyroidism is a condition where there is an overproduction of the thyroid hormone.  This will then cause levels of the thyroid hormone in the blood to be high.  It is important to check the thyroid levels because the thyroid gland is such an important part in our bodies.  The thyroid gland is in charge of secreting the hormones into the bloodstream. 

Pathogenesis

Hyperthyroidism is initiated by secreting too much thyroid hormone from the thyroid.  Hyperthyroidism is an autoimmune disease.  The autoantibodies will target the thyroid cells. This autoimmune disease falls under the category of the metabolic disease. 

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Signs and Symptoms of hyperthyroidism:

  • Nervousness or irritability
  • Fatigue or muscle weakness
  • Trouble sleeping
  • Heat intolerance
  • Hand tremors
  • Rapid and irregular heartbeat
  • Frequent bowel movements or diarrhea
  • Weight loss
  • Mood swings
  • Goiter
  • Bulging eyes

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Hyperthyroidism can develop in both women and men.  It is more likely to develop in women instead of men.  Women can get diagnosed with this easier than men because they go and get blood tests that will detect the thyroid problems.  According to http://endocrine.niddk.nih.gov/pubs/Hyperthyroidism/#causes the factors to increase your chances of developing thyroid disorders are as followed:

  • Have had thyroid problem before
  • Have had previous anemia
  • Have had a family history of thyroid disease
  • Eat large amounts of food containing iodine
  • Are older than 60 years of age
  • Have been pregnant or delivered a baby in the last 6 months

Hyperthyroidism can be resolved depending on the severity of the disease.  Different treatments can be done for each type of hyperthyroidism.

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Etiology

There are several difference causes of hyperthyroidism.   Hyperthyroidism is can be caused by Graves’ disease, thyroid nodules, thyroiditis, taking in too much iodine, or over medicating with synthetic thyroid hormone.

 The hyperthyroidism that is caused by Graves’ disease can be also called toxic diffuse goiter.  This is the most common cause of hyperthyroidism.  Graves’ disease is the most common cause of hyperthyroidism because of the immune system that makes an antibody that will then mimic the TSH (thyroid stimulating hormone) and cause the thyroid to make too much thyroid hormone.

The hyperthyroidism that is caused by the thyroid nodules is where there are lumps in the thyroid.  When someone hears that there are lumps in the thyroid they are normally thinking that they could be cancerous.  However, with these nodules that are noncancerous.  These nodules will become overactive and produce too much hormone.

The hyperthyroidism that is caused by thyroiditis-  Thyroiditis is noted when there is inflammation of the thyroid gland.  When people think about hyperthyroidism they normally think that it is caused by overproducing of the thyroid hormone.  In this condition, stored thyroid hormone will leak out of the inflamed gland and can cause the hormone levels in the blood to rise.

The hyperthyroidism that is caused by taking in too much iodine can be dangerous.  Most people don’t realize that your thyroid gland needs iodine to make the thyroid hormone. When you take in too much iodine, it will cause your thyroid to make too much thyroid hormone.  It is important to pay attention to the medications that you are taking in.  It is common to have an increased amount of iodine in medications which could lead to hyperthyroidism.

The hyperthyroidism that is caused by overmedicating with thyroid hormone is caused by people who take too much medication (overdose) the amount of thyroid hormone they take into their body.  It is important to make sure that you check with your doctors about your thyroid hormone levels.

Diagnosis

There are different tests that you can take for hyperthyroidism.  There are a few tests that you can take to diagnose that you have hyperthyroidism.   These tests include a thyroid-stimulating hormone test and a thyroid hormone tests.  They thyroid-stimulating hormone test is a blood tests that detects the levels of TSH.  When you have low levels of TSH, the doctor will want you to take more tests.  The thyroid hormone tests are blood tests that measure your levels of type different types of thyroid hormones.  These two hormones are the T3 and T4.  When you have high levels of thyroid hormone, that means that you have hyperthyroidism.

There are tests that you take when you are being treated for hyperthyroidism.  It is important that you have your doctor check the levels of your TSH and thyroid hormone frequently to make sure that they are where they should be.  After you have hyperthyroidism you may take the antithyroid antibody test, radioactive thyroid scan, and radioactive iodine uptake tests.  The antithyroid antibody tests checks to see if you have the antibodies that will attack the thyroid tissue.    This test is also commonly used to help diagnose Graves’ disease and the autoimmune thyroiditis.  The radioactive thyroid scan and radioactive iodine uptake tests are tests that use radiation to detect what causes hyperthyroidism.  The radioactive iodine uptake test will detect the amount iodine that is in the thyroid.

Treatment

Treatment for hyperthyroidism varies from human to human.  There are different severities of hyperthyroidism, depending on the severity of your disease will determine which type of treatment you can use.  There are three common treatment options that are available.  These options include medications, radioiodine therapy, and surgery.

Medications:  It is common for a doctor to prescribe a drug with a beta blocker.  The beta clovker is used to reduce your symptoms until other treatments take effect.  They relieve different symptoms like tremors, rapid heartbeat, and nervousness.  The beta blockers do not stop thyroid hormone production, they are only used to help relieve symptoms and ease the tension.  Antithyroid drugs will interfere with the thyroid hormone. Doctors  prescribe methimazole and propylthiouracil.  Antithyroid drugs can not treat thyroiditis.  When you take antithyroid drugs you can get side effects.  These may include allergic reactions, decrease in white blood cells, or liver failure.

Radioiodine Therapy:  This is a treatment where the radioactive iodine collects in the thyroid and acts as regular iodine.  Then it will slowly destroy the cells that are in the thyroid gland. 

Thyroid Surgery:  Surgery is the least common route used to treat hyperthyroidism.  This may seem weird and unusual but we have to remember that hyperthyroidism is not cancer.  During the surgical process the surgeons will remove part of the thyroid.  The surgeon can remove part or all of your thyroid.  Depending on the amount that they remove, will determine what kind of post treatment will take place.  If the entire thyroid was removed, the patient will have to take thyroid hormones the rest of their life.  If they removed only part of the thyroid, there is risk for hypothyroidism.

Incidence and Mortality

The incidence of hyperthyroidism according to www.ncbi.nlm.nih.gov was 13.5/100,00 per year seen in 1999.  Mortality rate increases in the elderly but is uncommon in most cases.

Research, Charities, and Support Groups

Current research is being studied about hyperthyroidism through the website www.ClinicalTrials.gov.  For more information on the current studies they are doing about hyperthyroidism, please visit the listed website.

http://www.wellspan.org/body.cfm?id=1710 is a website that is there to help people with hyperthyroidism.  They do charity care.  They have provided 17.2 million in free care to patients who participated in their charity care program.

http://www.allthyroid.org/research/summaries/archive/hyperthyroidism/02_07_antithyroid.html is a website that is doing current research on hyperthyroidism.  They are studying the antithyroid drug and seeing if the therapy is effective in patients with amiodarone-induced hyperthyroidism.

 

Resources

http://endocrine.niddk.nih.gov/pubs/Hyperthyroidism/#causes

http://ehealthmd.com/content/what-hyperthyroidism

http://www.medscape.com/medline/abstract/6134495

 Essentials of Human Disease by Leonard V. Crowley

http://www.endocrineweb.com/conditions/thyroid/thyroid-gland-function

http://www.webmd.com/a-to-z-guides/hyperthyroidism-exams-and-tests

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