Overactive Thyroid (Hyperthyroidism) – Symptoms & Treatment

Overactive Thyroid (Hyperthyroidism) - Symptoms & Treatment

In the case of an overactive thyroid (hyperthyroidism), the thyroid gland produces too many hormones. Since the thyroid hormones influence our metabolism, symptoms such as sleep disorders, nervousness, increased sweating or weight loss occur. In most cases, the cause of the symptoms is either an autonomy of the thyroid gland or the autoimmune disease of Graves’ disease. If hyperthyroidism is adequately treated, those affected can usually lead an everyday life. Find out more here!

the function of the thyroid gland

The hormones triiodothyronine and thyroxine, which are vital for humans, are produced in the thyroid gland. They influence many essential processes in the body, such as circulation, metabolism, growth, and psychological well-being. The release of thyroid hormones into the blood is regulated by a hormone (TSH) produced in the pituitary gland.

If the thyroid produces too few hormones, this is referred to as an underactive thyroid or hypothyroidism. When the opposite is accurate, and too many hormones are produced, this is known as an overactive thyroid or hyperthyroidism.

 

Causes of an overactive thyroid

An overactive thyroid can have a variety of causes. In about 95 per cent of cases, the symptoms typical of hyperthyroidism are caused by Graves’ disease or thyroid autonomy. However, other rare causes can be hidden behind an overactive thyroid gland. These include, among others:

  • inflammation of the thyroid
  • hormone-producing tumours
  • too high a dose of thyroid hormone therapy

Graves’ disease as the cause

Graves’ disease – also known as Graves’ disease – is an autoimmune disease in which the immune system forms antibodies against the thyroid gland. These dock onto specific surface cells of the thyroid gland and replace the pituitary hormone TSH, which usually regulates the production of thyroid hormones.

Although the antibodies also stimulate the hormone-producing cells of the thyroid gland, this now produces hormones independently of the actual need. The result is an overactive thyroid.

 

Thyroid autonomy as a cause

If the thyroid gland is autonomous, it produces its hormones and is no longer controlled by the pituitary gland. Such autonomy can affect the entire thyroid gland or only individual areas, called autonomic adenomas.

Thyroid autonomy is often caused by iodine deficiency. If there is too little iodine in the body, the thyroid tries to compensate for the deficiency through growth: the thyroid gland (goitre) enlarges, and nodular changes occur in the tissue.

Symptoms of an overactive thyroid

One of the typical symptoms that can occur as part of an overactive thyroid is an enlargement of the thyroid (goitre). An enlarged thyroid is noticeable, among other things, through symptoms such as hoarsenessdifficulty swallowing and problems buttoning the collar button. Such a goitre occurs in about 70 to 90 per cent of all those affected.

The increased production of thyroxine and triiodothyronine accelerates the metabolism. Other typical signs of an overactive thyroid are, therefore:

  • nervousness
  • increased sweating
  • restlessness
  • sleep disorders
  • accelerated pulse
  • high blood pressure
  • Tremble
  • lack of concentration

Weight loss often occurs despite an increased appetite. Symptoms such as diarrhoea, hair loss, muscle pain and muscle weakness can also occur.

Typical symptoms of Baseow’s disease

In addition to the symptoms already mentioned, Graves’ disease can also lead to a doughy swelling of the skin on the lower legs – so-called myxedema.

In addition, the disease is particularly noticeable in the eyes: symptoms such as a foreign body sensation, sensitivity to light, increased tear flow and an uncomfortable feeling of pressure appear. The eyes often protrude, making the gaze appear fixed and staring.

 

Thyrotoxic crisis as a complication

In rare cases, a thyrotoxic crisis can occur as a complication of hyperthyroidism. Such a crisis is initially noticeable through high fever, an increased heart rate, diarrhoea and vomiting, as well as restlessness and anxiety. Disorders of consciousness can occur later – in the worst case, the patient can lose consciousness (thyrotoxic coma).

Because a thyrotoxic crisis is a life-threatening condition, a physician should be notified immediately.

The administration of iodinated drugs or X-ray contrast media often triggers a thyrotoxic crisis. In addition, other possible causes are infections, operations, stressful situations, pregnancy and stopping thyroid medication.

Diagnose an overactive thyroid.

blood test and imaging tests are used to diagnose an overactive thyroid. The symptoms that occur with an overactive thyroid often provide the first indications of the disease. A blood test,  in which the concentration of the hormone TSH and the thyroid hormones is determined, can give the doctor further insights: If the TSH value is low, this indicates hyperthyroidism.

In contrast, the concentration of thyroid hormones is usually increased. Graves’ disease also has many thyroid antibodies in the blood.

Examination with imaging methods

After the blood test, the doctor treating you can support the diagnosis with imaging methods such as ultrasound or scintigraphy.

With the help of an ultrasound examination, the size and structure of the thyroid gland can be better assessed. Tissue samples may also be taken for closer examination.

If thyroid autonomy is suspected, scintigraphy is performed. For this purpose, the patient gets a radioactive substance injected into the vein. This is increasingly absorbed by the areas of the thyroid gland that produce a massive amount of hormones (hot nodules ). In this way, healthy tissue can be distinguished from diseased tissue when viewed through a particular camera.

 

Treating an overactive thyroid

Hyperthyroidism is usually treated first with medication. However, such drug therapy alone is often not enough to heal the functional disorder. In such cases, radioiodine therapy or surgery are available as further treatment options.

Medication for hyperthyroidism

As a rule, at the beginning of treating an overactive thyroid gland, so-called antithyroid drugs are administered, inhibiting the production of thyroid hormones. Since there is initially an increased concentration of hormones in the body, it takes some time before the symptoms improve. Once the hormone concentration in the blood has returned to normal, the attending doctor must decide whether an operation or radioiodine therapy is also necessary.

If Graves’ disease is the cause of the hyperfunction, the disease is first treated with antithyroid drugs. The therapy takes place over about a year, as relapses often occur in the first few months of treatment. If the symptoms recur at a later point in time, other forms of therapy should be considered.

In the case of thyroid autonomy, an operation or radioiodine therapy is almost always necessary since the drugs cannot eliminate the autonomous regions.

In some cases, along with antithyroid drugs, beta-blockers are also prescribed, which slow the heart rate and reduce symptoms such as the tremors associated with an overactive thyroid.

Radioiodine therapy for hyperthyroidism

In radioiodine therapy, the patient is given radioactive iodine stored in the thyroid gland. The radioactive radiation destroys the thyroid cells. The cells that are primarily affected produce many hormones because they take up more iodine. In the case of thyroid autonomy, the active nodes in the thyroid are particularly affected by the radioactive iodine. In Graves’ disease, on the other hand, all cells are affected.

Hypothyroidism can occur as an undesirable consequence of the treatment – ​​in some cases, even years after radioiodine therapy. However, such a hypofunction can usually be controlled by taking thyroid hormones. However, the medication must be taken for life.

 

Surgery for hyperthyroidism

An operation is performed, among other things, when thyroid autonomy is the cause of the hyperfunction or when Graves’ disease patients suffer a relapse despite drug therapy. In addition, surgery can also be performed if the thyroid gland is severely enlarged and is pressing on the trachea or if a malignant tumour is suspected.

Surgery can only be performed after the thyroid hormone levels have been normalized by medication.

Possible risks of an operation are an impairment of the adjacent parathyroid gland and an injury to the vocal cord nerve. Thyroid hormones and iodide must often be taken after the operation. In this way, hypofunction is prevented, and the remaining thyroid tissue is prevented from growing uncontrollably again.

Prevent an overactive thyroid.

An adequate supply of iodine is essential to prevent an overactive thyroid gland. This applies to young people, pregnant women and breastfeeding mothers who have an increased need for iodine. A daily iodine intake of 200 micrograms is recommended for adults.

More significant amounts of iodine are found in the following foods, among others:

  • Seefisch
  • Shellfish
  • Dairy products like butter and yoghurt
  • Owner
  • Kiwi
  • Spinach
  • beef
  • black tea

The use of iodized table salt is also recommended.

Hyperthyroidism caused by Graves’ disease cannot be prevented. However, if thyroid disease has already occurred in your family, having your thyroid checked regularly makes sense.

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