Hyperthyroidism develops when the thyroid gland becomes overactive and produces too much thyroid hormone. The thyroid gland is a butterfly-shaped gland in the front of the neck. It produces hormones called T3 and T4. They control the body's metabolism.
Hyperthyroidism may be caused by:
These factors increase your chance of developing hyperthyroidism:
Tell your doctor if you have these risk factors.
Symptoms come on slowly. They may be mistaken for stress. As the thyroid becomes more overactive, symptoms may include:
The doctor will ask about your symptoms and medical and family history. A physical exam will be done. The exam often reveals:
Your doctor may order the following tests:
Treatment will depend on:
Treatment options include:
Antithyroid drugs work best for Graves' disease. Examples include:
If the disease goes into remission, you may no longer need medication.
You may need to take beta-blockers . These drugs relieve rapid heart rate and jitters. Examples include:
This is a common treatment in the US. It is the definitive treatment for a toxic nodular goiter. Radioactive iodine is taken orally. It is then absorbed by the thyroid gland. Once there, it damages most of the thyroid cells. These cells can no longer produce thyroid hormones. Within days, the excess iodine passes out of the body in the urine or changes into a nonradioactive state. You may need to take a daily thyroid hormone replacement supplement.
Surgery is rare for the treatment of hyperthyroidism. It may be an option when medical therapy fails.
After surgery, you will need to take a daily thyroid supplement.
If there are eye symptoms like dry red eyes or double vision, your doctor may prescribe:
If you are diagnosed with hyperthyroidism, follow your doctor's instructions . You may be referred to an eye specialist.
RESOURCES:
The
American Thyroid Association
http://www.thyroid.org/
National Graves' Disease Foundation
http://www.ngdf.org/
CANADIAN RESOURCES
Health Canada
http://www.hc-sc.gc.ca/index_e.html/
Thyroid Foundation of Canada
http://www.thyroid.ca/
References:
American Association of Clinical Endocrinologists. Medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism. Endocrine Practice . 2002;8:457-469.
American Association of Clinical Endocrinologists website. Available at: http://www.aace.com/ . Accessed November 9, 2009.
Graves' disease. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated June 2008. Accessed July 7, 2008.
Reducing your risk of hyperthyroidism. EBSCO Health Library website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=81 . Updated May 2007. Accessed July 7, 2008.
Shomon M. Frequently asked questions on Graves' disease & hyperthyroidism. Thyroid-Info website. Available at: http://www.thyroid-info.com/articles/hyperthyroidism-faq.htm . Updated July 2008. Accessed July 7, 2008.
Subclinical hyperthyroidism. N Engl J Med . 2001;345:512-516.
Van Geest RJ, Sa sim IV, Koppeschaar HP, et al. Methylprednisolone pulse therapy for patients with moderately severe Graves' orbitopathy: a prospective, randomized, placebo-controlled study. Eur J Endocrinol. 2008;148:229-237.
Weetman AP. Graves' disease. N Engl J Med. 2000;343:1236-1248.
Woeber K. Update on the management of hyperthyroidism and hypothyroidism. Arch Intern Med . 2000;160:1067-1071.
1/30/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Nyirenda MJ, Taylor PN, Stoddart M, Beckett GJ, Toft AD. Thyroid-stimulating hormone-receptor antibody and thyroid hormone concentrations in smokers vs nonsmokers with Graves disease treated with carbimazole. JAMA. 2009;301:162-164.
7/6/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Safety: propylthiouracil. US Food and Drug Administration website. Available at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm164162.htm . Published June 4, 2009. Accessed July 7, 2009.
Last reviewed November 2009 by Bridget Sinnott, MD, FACE
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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