Home > Hyperthyroidism
Hyperthyroidism (thyrotoxicosis or "fast thyroid gland") is the clinical syndrome caused by an excess of circulating free thyroxine (T4) and free triiodothyronine (T3), or both. Major causes in humans are Graves' disease (the most common etiology with 70-80%), toxic thyroid adenoma , toxic multinodular goitre , and subacute thyroiditis .1 Signs and symptoms
Major clinical features in humans are weight loss (often accompanied by a ravenous appetite), fatigue, weakness, hyperactivity, irritability, apathy, depression, polyuria and sweating. Additionally, patients may present with a variety of symptoms such as palpitations and arrhythmias (notably atrial fibrillation), dyspnea, infertilityInfertility is the inability of a couple to naturally conceive, carry or deliver a healthy child. The International Council on Infertility Information Dissemination (INCIID) considers a couple to be infertile if they have not conceived "after a year of un, loss of libidoLibido in its common usage means Sexual desire, however more technical definitions, such as found in the work of Carl Jung, are more general, referring to libido as the free creative, or psychic, energy an individual has to put toward personal development, nauseaNausea is the sensation of unease and discomfort from the stomach, with the sufferers feeling that they may vomit. Nausea is a symptom of many conditions, including motion sickness, morning sickness during pregnancy, viral infections, and other diseases., vomitingVomiting (or emesis is the forceful expulsion through the mouth of the contents of one's stomach. It is a mechanism for expelling ingested illness-causing food poisons. The act may be triggered by stimuli which might indicate the possibility of poisoning,, and diarrheaDiarrhea in American English, (spelt diarrhoea elsewhere) is a condition in which the sufferer has frequent and watery bowel movements. This condition can be a symptom of injury, disease or foodborne illness and is usually accompanied by abdominal pain, a.
Neurological manifestations are tremorTremor is the shaking movement of the whole body or just a certain part of it, caused by problems of the neurons responsible from muscle action. Tremor may occur as an isolated symptom and usually of unknown cause ( essential tremor) or a part of the symp, choreaChorea is the occurrence of continuous rapid, jerky, involuntary movements that may involve the face and limb and result in an inability to maintain a posture. It is also known as St. Vitus Dance disease and is seen mostly in children. When chorea is seri, myopathy , and periodic paralysis . Stroke of cardioembolic origin due to coexisting atrial fibrillation may be mentioned as one of the most serious complications of hyperthyroidism.
As to other autoimmune disorders related with thyrotoxicosis, an association between thyroid disease and myasthenia gravis has well been recognised. The thyroid disease, in this condition, is often an autoimmune one and approximately 5% of patients with myasthenia gravis also have hyperthyroidism. Myasthenia gravis rarely improves after thyroid treatment and relation between two entities is yet unknown. Some very rare neurological manifestations that are reported to be dubiously associated with thyrotoxicosis are pseudotumor cerebri, amyotrophic lateral sclerosis and a Guillain-Barré like syndrome.
2 Diagnosis
A diagnosis is made through a blood test, by measuring the level of T4 in the blood. High T4 levels are considered indicative of hyperthyroidism. If the index of suspicion is low, many doctors prefer to measure thyroid-stimulating hormone (TSH). If TSH is suppressed, there may be uncontrolled production of T4, while a normal TSH generally rules out thyroid disease. Measuring specific antibodies, such as anti-TSH-receptor antibodies in Graves' disease, may contribute to the diagnosis. Additionally, scintigraphy may be required.
