Hyperthyroidism

Content

Introduction

Introduction

The thyroid is a small gland located at the base of the neck, in the front. The thyroid controls many functions of the organism through the production of thyroid hormones: thyroxine (T4) and triiodiothyronine (T3) (Video). The production of thyroid hormones is, in turn, controlled by the "thyroid stimulating hormone (TSH) secreted by" pituitary, a gland located inside the skull. Thyroid hormones regulate important body functions, including breathing, heart rate, body temperature, central nervous system development and body growth (Video).

When the thyroid produces too many thyroid hormones it manifests a condition called hyperthyroidism which causes a variety of disorders (symptoms), such as nervousness, anxiety, hyperactivity, weight loss, rapid or irregular heartbeat (Video). There are many possible causes, the most common being Graves' disease, an autoimmune disease that can strike at any age.

Symptoms

Symptoms

The most frequent disorders (symptoms) in hyperthyroidism are:

  • nervousness and anxiety
  • hyperactivity, ie inability to sit still
  • weight loss, despite the increased appetite
  • rapid or irregular heartbeat
  • visible swelling of the thyroid gland
  • menstrual irregularity
  • sleep disorders

These symptoms are unlikely to occur all together.

If the cause of hyperthyroidism is Graves' disease, other disorders affecting the eyes may also appear, such as:

  • bulging eyes
  • burning, redness and swelling of the eyes
  • excessive tearing
  • blurred or double vision
  • sensitivity to light
Causes

Causes

The causes of hyperthyroidism can be different:

  • Graves' disease: is the most common cause of hyperthyroidism. It is an autoimmune disease, which is caused by an "alteration of the immune system that causes the thyroid to produce too many thyroid hormones. It is believed to result from a combination of genetic and environmental factors. It can affect the thyroid at any age and is more common. in smokers
  • thyroiditis: Inflammation of the thyroid gland can cause the release of thyroid hormones
  • thyroid nodules: in some cases they can produce excess thyroid hormones
  • taking iodine supplements: the iodine contained in food is used by the thyroid to produce hormones. Excessive intake of iodine supplements can, therefore, stimulate thyroid activity
  • taking amiodarone: this drug, used to control changes in heartbeat, contains a significant amount of iodine which can induce alterations in thyroid function
  • follicular thyroid cancer: Thyroid cancer cells can produce thyroid hormones
Therapy

Therapy

Hyperthyroidism therapy depends on various factors such as age, physical condition, cause and severity of the disease.

Possible therapies in case of hyperthyroidism are:

  • radioactive iodine: form of radiation therapy used to treat most types of overactive thyroid. The radioactivity dose of the administered iodine is very low and is not harmful. Taken by mouth, radioactive iodine is selectively absorbed by the thyroid and causes a reduction in thyroid hormone production and gland volume. Symptoms of hyperthyroidism usually subside within three to six months. The risk of radioactive iodine treatment is that thyroid hormone production becomes too low causing hypothyroidism
  • anti-thyroid drugs (thionamides): thionamides reduce the synthesis of thyroid hormones by preventing the transformation of the form of iodine circulating in the organism (iodide) into that which is used for the production of thyroid hormones (free iodine). gradually the disorders (symptoms) of hyperthyroidism, which usually begin to improve between six and twelve weeks after starting treatment. Typically, therapy should be continued for at least a year. In some cases the problem is definitively solved; in others, there may be a relapse. However, these drugs can cause liver and bone marrow problems and, therefore, should be used with caution and regular checks.
  • beta blockers: are drugs commonly used to treat hypertension and which can limit the cardiac symptoms of hyperthyroidism by controlling the heart rate. Beta-blockers can cause some side effects, including feeling tired, cold hands and feet and difficulty in sleep and not usable in case of asthma
  • surgery: surgery (thyroidectomy) is used when other treatments are not possible, for example, in pregnancy, in the presence of a large goiter, if a relapse occurs after therapy with anti-thyroid drugs, in the case of ocular disorders for Basedow-Graves disease. Surgery consists in the removal of all or a large part of the thyroid. The risk of surgery can be damage to the parathyroid glands, which help control calcium levels in our body, or a lesion of the vocal cords, with alteration of the voice. life-long synthetic thyroid hormone

Most people respond well to treatment.

Bibliography

Bibliography

Higher Institute of Health (ISS). National Congenital Hypothyroid Registry

Higher Institute of Health (ISS). National Observatory for the Monitoring of Iodoprophylaxis in Italy (OSNAMI)

In-depth link

In-depth link

Ministry of Health. Iodine and health

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