Hyperthyroidism Treatment: Causes of Excessive Secretion of Thyroid Glands

Hyperthyroidism Treatment: Causes of Excessive Secretion of Thyroid Glands .

What is Hyperthyroidism?

Hyperthyroidism is a condition caused due to excessive secretion by thyroid glands. In most hyper thyroids, both T3 and T4 plasma levels are raised. Much T3 is secreted directly by the thyroid and plasma levels are increased above ‘normal’ and are usually evident earlier, than those of T4.

Causes of Hyperthyroidism

• Grave’s disease (commonest form); toxic multi-nodular goitre or single functioning nodule (occasionally an adenoma).
• Ingestion of thyroid hormones.
• Rare causes are secretion of a thyroid stimulating hormone (TSH) by tumors, struma ovarii (thyroid tissue in ovarian teratoma), and administration of iodine to a subject with iodine-deficiency goitre and TSH secreting tumour of the pituitary.
  
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• Hyperthyroidism due to diffuse hyperplasia of the thyroid causing exophthalmoses.
• It is more common in females than males.
• It occurs in young adults.
• This disease is hereditary.
• Environmental and psychogenic factors. Emotional stress causes over-stimulation of hormones.

Symptoms of Hyperthyroidism

• Goitre: There is swelling of thyroid gland, diffuse with or without bruit.
• Fever, anxiety and restlessness.
• Weight loss, fatigue, apathy, sweating and heat intolerance.
• Cardiovascular tachycardia (increased heart beat), large pulse pressure with flushing of face and neck in warm atmosphere. Ectopic beats, paroxysmal tachycardia and atrial fibrillation can be seen.
• Eyes: Exophthalmoses (protrusion of eyeballs) with blurring of vision.
• Gastro-intestinal weight loss despite eating well, diarrhea, steatorrhoea and vomiting.
  
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• Behaviour and emotion: Nervousness and agitation.
• Reproductive system: Oligomenorrhoea (decrease in menstrual flow) and infertility.
• Dermatological: Itching of skin and thinning of hair.
• Neuro-muscular: Tremor and muscular weakness (exophthalmoses).
• Other features: Pigmentation usually confined to orbital regions, rarely diffuse. Profuse perspiration. Premature whitening of hair. Clubbing of fingers.

Diagnosis of Hyperthyroidism

• Thyroid function test: Elevated levels of T4 and T3 with undetectable serum TSH. In few cases T4 values are normal and T3 is elevated.
• Measurement of serum auto-antibodies: Against thyroglubulin and thyroid perioxidase/microsomal antigen are found in up to 80% of people with grave’s disease.
• Thyroid scan: It can be done to differentiate between a diffuse and nodular goitre. Metastatic goitre can also be detected.

Treatment for Hyperthyroidism

• Anti-thyroid drugs need to be administered. It blocks formation of thyroxin, diminishing the amount of free iodine available for the purpose of uniting with tyrosine to form thyroxin.
• Beta-blockers are used for short term before use of anti-thyroid drugs.
• Sub-total thyroidectomy: Surgery is needed to remove thryoids when there is recurrent hyperthyroidism, sensitive reaction to anti-thyroid drugs, severe thyrotoxicosis, large goitre with respiratory obstruction and poor drug compliance.
• Radioactive iodine is given to the patient. It acts by destruction of functional thyroid cells.
• General treatment with rest, sedatives, vitamins and psychotherapy is given.