HYPERTHYROIDISM

General Information

DEFINITION--Overactivity of the thyroid, an endocrine gland that regulates all body functions. The most common form of hyperthyroidism is called Graves' disease.

BODY PARTS INVOLVED--Thyroid gland and most other body organs, especially the endocrine system, which includes the pituitary gland, parathyroid glands, pancreas, adrenal glands, and ovaries or testicles.

SEX OR AGE MOST AFFECTED--Adults between ages 20 and 50, mostly women.

SIGNS & SYMPTOMS

• Hyperactivity.
• Feeling warm or hot all the time.
• Tremors.
• Sweating.
• Itching skin.
• Pounding, rapid, irregular heartbeat.
• Weight loss, despite overeating. Older persons may gain weight.
• Marked anxiety and restlessness.
• Sleeplessness.
• Fatigue and weakness.
• Protruding eyes (exophthalmos) and double vision (sometimes).
• Diarrhea (sometimes).
• Hair loss (sometimes).
• Goiter (enlarged thyroid) (sometimes).

CAUSES

• Autoimmune disorder (body develops antibodies that stimulate excessive amounts of thyroid hormone).
• Thyroid nodules or tumors.
• Thyroiditis (inflammation of thyroid gland).

RISK INCREASES WITH

• Family history of hyperthyroidism.
• Stress.
• Female gender.
• Other autoimmune disorders.

HOW TO PREVENT--No specific preventive measures.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory blood studies.
• ECG (See Glossary).
• Radioactive studies such as I-131 uptake (See Glossary).

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.
• Appropriate treatment will depend on the size of the goiter, the causes, your age and how long surgery may be delayed (if you are a candidate for it).
• Medication controls the problem in most patients.
• Surgery to remove part of the thyroid (see Thyroid-Gland Removal in Surgery section) if needed.

> "Thyroid storm"--

a sudden worsening of all symptoms. This is a life-threatening emergency.

• Misdiagnosis as a psychiatric anxiety reaction.

PROBABLE OUTCOME--Usually curable with medication or surgery. Allow 6 months of treatment for the condition to stabilize. Some forms may return to normal without treatment.

How To Treat

GENERAL MEASURES--

• Since this condition develops gradually, symptoms may be difficult to recognize. If family and friends mention changes in your behavior or appearance, consult your doctor.
• It is important for your doctor to monitor the treatment. Be sure to keep follow-up appointments.

MEDICATION--Your doctor may prescribe:

• Antithyroid drugs to depress thyroid activity.
• Beta-adrenergic blockers to decrease a rapid heartbeat.
• Radioactive iodine, which selectively destroys thyroid cells.

ACTIVITY--Limit activity as much as possible until the disorder is controlled. Modify activities according to disease severity.

DIET--

• Eat a diet high in protein to replace tissue lost from thyroid overactivity.
• Weight loss diet if you are overweight (see Weight-Loss Diet in Appendix).

Call Your Doctor If

• You have symptoms of hyperthyroidism.
• Symptoms worsen suddenly, especially after surgery.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.