| Subject | Contents |
| Definition | Hyperthyroidism is an imbalance of metabolism caused by overproduction of thyroid hormone.
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| Alternative Names | Thyrotoxicosis; Overactive thyroid |
| Causes, incidence, and risk factors | The thyroid gland is located in the neck. It produces several hormones which control the way that every cell in the body uses energy ( metabolism ). The thyroid is part of the endocrine system.
Hyperthyroidism or thyrotoxicosis occurs when the thyroid releases too many of its hormones over a short ( acute ) or long (chronic) period of time. Many diseases and conditions can cause this problem. These include Graves' disease '>Graves' disease ; non-cancerous growths of the thyroid gland or pituitary gland; tumors of the testes or ovaries; inflammation (irritation and swelling with presence of extra immune cells) of the thyroid due to viral infections or other causes; ingestion of excessive amounts of thyroid hormone; and ingestion of excessive iodine. Graves' disease '>Graves' disease accounts for 85% of all cases of hyperthyroidism.
Related topics:Painless (silent) thyroiditisFactitious hyperthyroidismHypothyroidismGraves' disease |
| Symptoms | Weight lossIncreased appetite Nervousness RestlessnessHeat intoleranceIncreased sweatingFatigueFrequent bowel movementsMenstrual irregularities in women Goiter (visibly enlarged thyroid) may be present
Additional symptoms that may be associated with this disease:
WeaknessSleeping difficultySkin - clammySkin blushing/flushingPulse - boundingNausea and vomitingMenstruation - absentItching - overallHeartbeat sensationsHand tremorHair lossDiarrhea Breast development in men Blood pressure - highProtruding eyes ( exophthalmos ) |
| Signs and tests | Vital signs (temperature, pulse , rate of breathing, blood pressure ) show increased heart rate . Systolic blood pressure may be elevated. Physical examination may reveal thyroid enlargement or goiter .
Laboratory tests that evaluate thyroid function:
Serum TSH is usually decreased T3 and free T4 are usually elevated
This disease may also alter the results of the following tests:
Vitamin B-12TSITriglyceridesRT3URadioactive iodine uptakeGlucose testCholesterol testAntithyroglobulin antibody |
| Treatment | Treatment varies depending on the cause of the condition and the severity of symptoms. Hyperthyroidism is usually treated with antithyroid medications, radioactive iodine (which destroys the thyroid and thus stops the excess production of hormones), or surgery to remove the thyroid. If the thyroid must be removed with radiation or surgery, replacement thyroid hormones must be taken for the rest of the person's life.
Beta-blockers (e.g., propranolol) are used to treat some of the symptoms including rapid heart rate , sweating , and anxiety until the hyperthyroidism can be controlled. |
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| Expectations (prognosis) | Hyperthyroidism caused by Graves' disease is usually progressive and has many associated complications, some of which are severe and affect quality of life. These include complications caused by use of radioactive iodine, surgery, and medications to replace thyroid hormones. However, hyperthyroidism is generally treatable and rarely fatal. |
| Complications | Cardiac complications include rapid heart rate , congestive heart failure, and atrial fibrillation . Thyroid crisis or "storm" is an acute worsening or exaggeration of the symptoms of hyperthyroidism that may occur with infection or stress . Fever , decreased mental alertness, and abdominal pain may occur, and immediate hospitalization is indicated. Hyperthyroidism increases the risk for osteoporosis. Complications related to surgery, including visible scarring of the neck, hoarseness due to nerve damage to the voicebox, and a low calcium level because of damage to the parathyroid glands. Complications related to replacement of thyroid hormones. If too little hormone is given, symptoms of under-active thyroid can occur including fatigue, increased cholesterol levels, mild weight gain, depression, and slowing of mental and physical activity. |
| Calling your health care provider | Call your health care provider if you have symptoms which could be caused by excessive thyroid hormone production. If the symptoms are associated with a rapid, irregular heartbeat; dizziness; or change in consciousness, go to the emergency room or call the local emergency number (such as 911). Call your health care provider if treatment for hyperthroidism induces symptoms of under-active thyroid, including mental and physical sluggishness, weight gain, and depression. |
| Prevention | There are no general prevention measures to prevent hyperthyroidism.
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