The hyperthyroidism is the set of clinical, physiological and biochemical events taking place in our bodies as a result of exposure and tissue response to the existence of an excessive amount of thyroid hormones generated by an increase in metabolic activity of the body .
There is a broader term than hyperthyroidism, with which it should not be confused, which is thyrotoxicosis, where the manifestations or symptoms that take place are the consequence of an excessive increase in thyroid hormones in the body, but they do not necessarily have to be produced by an increase in the functioning of the thyroid (it may be due to an external administration or caused by another organ other than the thyroid, as a consequence of its malfunction).
Hyperthyroidism is five times more common in women than in men.
Causes of hyperthyroidism
There is a wide range of causes of hyperthyroidism:
1. Existence of excessive production of TSH (they are very rare): it occurs in the following cases:
- Pituitary tumors: they are usually large and produce TSH, which would generate greater stimulation of the thyroid, causing this greater amount of thyroid hormones.
- Increased production of TSH without the existence of a tumor in the pituitary: it is due to a failure in the feedback loop in the cells of the pituitary, which do not respond to the increase in thyroid hormones, decreasing the production of TSH to decrease the stimulation of the thyroid gland, generating TSH in an uncontrolled way, thus increasing thyroid hormones.
2. Production of abnormal substances that directly stimulate the thyroid, causing the amount of hormones to increase:
- Graves-Basedow disease: it is an autoimmune disease, and the substances are antibodies to the receptor that the thyroid gland has for TSH to carry out its action, in such a way that they ensure that this action lasts longer.
- Hashimoto’s thyroiditis : This is rare for hyperthyroidism, but if it does, it is called hashitoxicosis.
Some uterine or testicular tumors: produce substances that stimulate the thyroid.
3. Disorders that cause autonomy of the thyroid in hormone production, breaking the feedback loop:
- Toxic adenoma: there is a single autonomous nodule (it works on its own).
- Multinodular goiter: there are multiple nodules.
4. Hyperthyroidism produced by the administration of large amounts of iodine in a person with normal thyroid gland function (Jod-Basedow phenomenon).
There are other causes of increased thyroid hormones that are not due to increased thyroid function (thyrotoxicosis without hyperthyroidism):
5. Subacute thyroiditis: the elimination of stored hormones is increased without producing more hormones.
6. Hormones that come from outside the thyroid:
- External administration of hormones to the body: by means of animal meat they are treated with thyroid hormone, pharmacological products that contain it.
- Thyroid-like tissue, with the same hormone-producing function, in another part of the body (some tumors produce it).
Symptoms of hyperthyroidism
By affected systems:
They cannot bear the heat and have excessive sweating, which is why they have hot and humid skin, with an increase in body temperature above normal.
Loss of weight and body fat, with increased appetite, diarrhea, and thirst. Nausea and vomiting
Palpitations, rapid and arrhythmic pulse, angina, heart murmurs, increased blood pressure, heart failure. The alterations in the heart are more frequent in the elderly hyperthyroid.
Nervous and muscular system
Muscle weakness and fatigue, hand tremors. These types of alterations are more frequent in young people.
Irritability, nervousness, emotional instability, insomnia .
Itching, nail injuries, hair loss.
Amenorrhea , oligomenorrhea.
The symptoms mentioned are those due to an increase in thyroid hormone in the blood; to these will be associated those of the disease that causes it.
How is it diagnosed?
Generally, the diagnosis is made clearly by the symptoms of hyperthyroidism, associated in each case with those of the disease that produces it (alterations in the skin, in the eyes), to the examination of the patient with the simple observation of its appearance ( hot, nervous, sweaty, shaky) and with palpation of the neck (diffusely enlarged thyroid, or multiple nodules, or a single nodule will be palpated or not).
The clinical diagnosis will be confirmed with a hormonal analysis: thyroid hormones (which will be increased in quantity in the blood), TSH (elevated or decreased depending on the cause of hyperthyroidism).
To differentiate the different causes of hyperthyroidism, it is necessary to perform other additional tests: antibodies against different components of the thyroid gland (to differentiate autoimmune causes), thyroid scintigraphy (to diagnose a toxic adenoma or a multinodular goiter), thyroid ultrasound.
Once hyperthyroidism is diagnosed, it must be treated, because it can present serious complications.
There are several treatment modalities:
It is the ideal treatment, and the first option that must be considered in this disease.
It is used in children, in pregnancy, in hyperthyroidism with a small goiter, before surgery and if hyperthyroidism reappears after surgery, when it is contraindicated or the patient rejects it, and before and after treatment with iodine. radioactive. The action of the drugs used is to prevent the production of thyroid hormones.
The most used are thionamides, which act by preventing the iodine that reaches the thyroid from being used for the manufacture of hormones, thereby reducing their formation. These drugs are carbimazole, methimazole, propylthiouracil and methylthiouracil (not marketed in Spain).
These drugs can cause, as a more serious side effect, a decrease in leukocytes, which, if severe, forces the drug to be discontinued. Beta-blockers are associated with thionamides, which are drugs that reduce tremor and tachycardia, especially until the former begin to take effect.
It consists of performing a partial thyroidectomy, always previously carrying out pharmacological treatment to reduce the amount of blood that reaches the thyroid, as well as the amount of hormones it releases, to reduce complications during surgery.
This treatment is used in people between 18-45 years old; in cases where hyperthyroidism is associated with a large goiter; when the goiter compresses the structures around and behind it (see concepts); when the patient prefers this type of treatment to others.
There may be complications after surgery, the most frequent being hypothyroidism, which is usually temporary and does not last more than 6 or 7 months. Hypoparathyroidism may also appear, which is also usually transitory, due to resection of the parathyroid glands. Hyperthyroidism may recur, which would be treated with drugs.
Very rarely, due to the current great perfection of the surgical technique, paralysis of the vocal cords may appear due to injury to the nerve that is responsible for them to move.
It consists of destroying the thyroid with the administration of radioactive iodine. The effect is not as immediate as in surgery, so a few months later it is necessary to continue with drug treatment. It is used in very old patients, in whom it is impossible to comply with the treatment and in diseases that prevent surgery
The disease itself is not avoidable, although its complications or lack of control are, which is called hyperthyroid crisis, in which all the symptoms of hyperthyroidism appear, taken to the maximum degree, and can be fatal.
Hyperthyroid crisis is prevented by avoiding its triggers in a hyperthyroid patient: stress , trauma, major surgical interventions. It is more frequent in the elderly, and requires treatment in an Intensive Care Unit.
You should consult your doctor when, inexplicably, you begin to feel trembling, especially in the hands, associated with heat and moisture in the skin in a generalized way, weight loss with the same or more appetite than usual; especially if these symptoms are associated with diarrhea, changes in menstruation and palpitations.
Hello Readers, I am Nikki Bella a Psychology student. I have always been concerned about human behavior and the mental processes that lead us to act and think the way we do. My collaboration as an editor in the psychology area of Well Being Pole has allowed me to investigate further and expand my knowledge in the field of mental health; I have also acquired great knowledge about physical health and well-being, two fundamental bases that are directly related and are part of all mental health.