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    Hyperthyroidism

    Thyrotoxicosis

    Hyperthyroidism is a condition in which the thyroid gland makes too much thyroid hormone. The condition is oftencalled overactive thyroid.

    Causes

    The thyroid gland is an important organ of the endocrine system. It is locatedatthe front of the neck just above where your collarbones meet. The glandmakes the hormones that control the way every cell in the body uses energy. This process is called metabolism.

    Many diseases and conditions can cause hyperthyroidism, including:

    • Eating too much of foodsthat containiodine
    • Graves disease (most cases of hyperthyroidism)
    • Inflammation (thyroiditis) of the thyroid due to viral infections, after pregnancy,or other causes
    • Noncancerous growths of the thyroid gland or pituitary gland
    • Some tumors of the testes or ovaries
    • Taking large amounts of thyroid hormone
    • Getting medical imaging testswith contrast dye that has iodine

    Symptoms

    Common symptoms include:

    • Difficulty concentrating
    • Fatigue
    • Frequent bowel movements
    • Goiter (visibly enlarged thyroid gland) or thyroid nodules
    • Hand tremor
    • Heat intolerance
    • Increased appetite
    • Increased sweating
    • Irregular menstrual periods in women
    • Nervousness
    • Restlessness
    • Sleep problems
    • Weight loss (or weight gain, in rare cases)

    Other symptoms that can occur with this disease:

    • Breast development in men
    • Clammy skin
    • Diarrhea
    • Hair loss  
    • High blood pressure
    • Itching - overall
    • Lack of menstrual periods in women
    • Nausea and vomiting
    • Protruding eyes (exophthalmos)
    • Rapid, forceful, or irregular heartbeat (palpitations)
    • Skin blushing or flushing
    • Weakness

    Exams and Tests

    The health care provider will do a physical exam. The exam may find the following:

    • High systolic blood pressure (the first number in a blood pressure reading)
    • Increased heart rate
    • Enlarged thyroid gland
    • Shaking of the hands
    • Swelling or inflammation around the eyes

    Blood tests are alsoordered to measure your thyroid hormones TSH, T3, and T4.

    You may also have blood tests to check:

    • Cholesterol levels
    • Glucose
    • Radioactive iodine uptake

    Treatment

    Treatmentdepends on the cause and the severity of symptoms. Hyperthyroidism is usually treated with one or more of the following:

    • Antithyroid medications
    • Radioactive iodine to destroy the thyroid gland and stops the excess production of hormones
    • Surgery to remove the thyroid

    Ifyour thyroid is removed with surgery or destroyed with radiation, you must take thyroid hormone replacement pills for the rest of your life.

    Medicines called beta-blockersmay be prescribed to treat symptoms such asfast heart rate, sweating, and anxiety until the hyperthyroidism can be controlled.

    Outlook (Prognosis)

    Hyperthyroidism is treatable. Some of its causes may go away without treatment.

    Hyperthyroidism caused by Graves disease usually gets worse over time. It has many complications, some of which are severe and affect quality of life.

    Thyroid crisis (storm), also called thyrotoxicosis, is a sudden worsening of hyperthyroidism symptoms that may occur with infection or stress. Fever, decreased alertness, and abdominal pain may occur. Patients need to be treated in the hospital.

    Other complications of hyperthyroidism include:

    • Heart problems such as fast heart rate, abnormal heart rhythm, heart failure
    • Osteoporosis

    Surgery-related complications, including:

    • Scarring of the neck
    • Hoarseness due to nerve damage to the voice box
    • Low calcium level due to damage to the parathyroid glands (located near the thyroid gland)
    • Hypothyroidism (underactive thyroid)

    When to Contact a Medical Professional

    Call your health care provider if you have symptoms of hyperthyroidism. Go to an emergency room or call the local emergency number (such as 911), if you have:

    • Change in consciousness
    • Dizziness
    • Rapid, irregular heartbeat

    Call your health care provider if you are being treated for hyperthyroidism and you develop symptoms of underactive thyroid, including:

    • Depression
    • Mental and physical sluggishness
    • Weight gain

    References

    Bahn RS, Burch HB, Cooper DS, et al. Hyperthyroidism and other causes of thyrotoxicosis: Management Guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Endocr Pract. 2011;17:457-520.

    Mandel SJ, Larsen PR, Davies TF. Thyrotoxicosis. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM. Williams Textbook of Endocrinology. 12 ed. Philadelphia, Pa.: Elsevier Saunders; 2011: chap 12.

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    • Hyperthyroidism

      Animation

    • Endocrine glands

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    • Goiter

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    • Brain-thyroid link

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    • Thyroid gland

      illustration

    • Hyperthyroidism

      Animation

    • Endocrine glands

      illustration

    • Goiter

      illustration

    • Brain-thyroid link

      illustration

    • Thyroid gland

      illustration

    A Closer Look

    Tests for Hyperthyroidism

      Review Date: 6/7/2013

      Reviewed By: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.

      The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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