Hyperthyroidism: symptoms, causes, treatment [Doctor's Advice].

• low TSH levels,
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• too high concentrations of FT3 and/or FT4.
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The accepted norms for TSH and thyroid hormones are:

• TSH: 0.45-4.5 µU/ml
.
• FT3: 4.0-7.8 pmol/l
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• FT4: 10-25 pmol/l
.

Remember that thyroid hormone concentrations depend on lifestyle and age. Fluctuations can be caused by diet, menstruation, pregnancy or medication. The limits of normal for TSH "increase" with age. A concentration of 3.7 µU/ml may be as optimal for a 34-year-old businesswoman as 6.9 µU/ml for a 75-year-old retiree.

Primary and secondary hyperthyroidism

Hyperthyroidism can occur in primary or secondary formand.

Primary hyperthyroidism is associated with a dysfunction of the gland itself, which produces too much hormone while at the same time the TSH level is reduced.

Recurrent hyperthyroidism is caused by inappropriate secretion of TSH, leading to increased production of FT3 and FT4.

In a nutshell: primary hyperthyroidism refers to disorders of the thyroid gland itself, and secondary hyperthyroidism refers to problems with the pituitary gland, which is responsible for TSH production.

Subclinical hyperthyroidism

As with hypothyroidism, hyperthyroidism also has its dormant, subclinical form. It is found when TSH levels are low and FT3 and FT4 are normal. It is experienced by approximately 2% of peopleand, although the percentage may be higher in areas with iodine deficiencies, such as in the daily diet.

Pharmacological hyperthyroidism

Hyperthyroidism can be triggered by the use of certain drugs. Drug-induced hyperthyroidism will produce different symptoms - depending on which pharmaceutical was taken. The medications that most commonly cause temporary hyperthyroidism areand:

• amiodarone,
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• iodine-containing contrast agents,
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• lithium and its derivatives,
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• interferon-alpha,
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• some anticancer drugs,
.

Hypothyroidism and Graves' disease

Graves-Basedow disease is an autoimmune disease that is one of the most common causes of and the onset of hyperthyroidism. The immune system and antibodies attack the thyroid gland, leading to an overproduction of hormones.

Graves-Basedow disease is more common in women than men. A 2011 study  shows that who develops the disease is primarily influenced by genetics, although environmental factors   are also not insignificant.

Who is affected?

What are the symptoms of hyperthyroidism?

Hyperthyroidism produces both physical, psychological and neurological symptomsand. These most commonly include, but are not limited to,  :

• Skin: moist, glowing, red and thickened skin (mainly on feet and lower legs), urticaria;
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• Hair and nails: brittle nails, thin, brittle and falling hair;
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• Cardiovascular system: increased blood pressure, palpitations; 
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• Nervous system: anxiety, irritability and nervousness, mood swings, sleep problems (insomnia, difficulty falling asleep); 
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• Bones and muscles: tremors in limbs, muscle weakness, osteoporosis, pain in limbs (especially in children).

Other symptoms characteristic of hyperthyroidism are: 

• enlargement of the thyroid gland and growing goiter (applicable to Graves-Basedow disease),
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• eye changes - exophthalmos, eyelid retraction, double vision, swelling, redness of the eyelids or conjunctiva (applies to Graves-Basedow disease),
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• disruption of the menstrual cycle (less frequent and scanty periods), 
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• decrease (or increase) in libido,
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• erectile dysfunction,
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• excessive sweating,
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• increased appetite,
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• increased weight loss,
• inflammation and fatigue,
• inflammation.
• diarrhoea and disordered bowel movements,
• diarrhoea and disordered bowel movements.

Hypothyroidism and appearance

Hypothyroidism can cause changes in appearance, which can be seen particularly in the face. Typical symptoms include eye exophthalmos, slowed blinking and a flushed, damp complexion. Symptoms that affect the whole body include sudden weight loss, increased sweating and weakened hair and nails.

Hyperthyroidism - skin symptoms

With hyperthyroidism, the skin of the face is excessively shiny and appears oily. Reddish patches may appear on the neck and the rest of the body, which are easily mistaken for an allergic reaction. The skin is prone to irritation and minor infections, and acne problems associated with the accumulation of microorganisms also occur.

The skin is prone to irritation and minor infections.

With hyperthyroidism, some people may have thinning and oily hair. Over time, hair loss may also occur, and women may begin to experience curved, brittle and wrinkled nails. 

Hypothyroidism - psychological and neurological symptoms

Typical psychiatric symptoms in hyperthyroidism are primarily:

• anxiety,
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• impulsivity,
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• emotional vacillation,
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• sleeping problems,
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• problems with memory and concentration,
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• periods of elevated and low mood.
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Psychiatric symptoms can occur in up to 40% of hyperthyroidism patientsand.

Mood swings, insomnia and loss of attention are particularly characteristic symptoms. There are situations where one day a person with hyperthyroidism does not get out of bed, contemplates or sleeps, and the next day has a flurry of thoughts, is highly stimulated and full of energy.

What are the main causes of hyperthyroidism?

There is not just one factor that causes hyperthyroidism. The most common ones are primarilyand:

• Graves-Basedow disease,
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• thyroid nodules (both benign and toxic or malignant),
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• thyroiditis (e.g. subacute thyroiditis or postpartum thyroiditis),
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• disorders of the pituitary gland or hypothalamus,
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• consumption of too much iodine (both in your diet and in the medicines or supplements you take).

Who is at greatest risk of hyperthyroidism?

Factors at increased risk of developing hyperthyroidism are primarilyand:

• gender - women get the disease more often than men,
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• age - people over 60 are more likely to be ill,
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• family history of thyroid disease,
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• health problems such as anemia caused by vitamin B12 deficiency, diabetes (types 1 and 2) or primary adrenal insufficiency and Addison's disease,
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• use of iodine-containing medication,
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• pregnancy within the last 6 months,
• pregnancy.
• smokingand.
.

How to diagnose hyperthyroidism - research

If you want to confirm or rule out hyperthyroidism, go for a hormonal thyroid test.

Check your blood TSH levels to assess the function of the gland, as well as the levels of the thyroid hormones FT3 and FT4.

There is more to it than that, however.

To select the best therapy, it is necessary to determine the cause of hyperthyroidism. Tests such as the following will be helpful:

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• USG of the thyroid gland,
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• serum anti-thyroid antibodies, especially anti-TSHR, elevated levels of which suggest Graves' disease,
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• thyroid biopsy - performed in the case of nodules,
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• thyroid scintigraphy - used as an adjunct to morphological studiesand.

How to treat hyperthyroidism?

Treatment of hyperthyroidism is most commonly done in three ways. These are medication, radiation treatment and surgery. The form of therapy depends mainly on the established cause of the hyperthyroidismand.

Pharmacological treatment

Antithyroid drugs, or so-called thyreostatics, are primarily intended to inhibit the production of thyroid hormones. The most commonly used substances are thionamides, in particular thiamazole (methimazole)  and propylthiouracil . The first effects are visible approximately after 2-4 weeks of application.

The doctor will individually determine the dose for you based on your clinical assessment and thyroid test results. It may vary depending on your health condition, symptoms and progress in treatment.

Unfortunately, many side effects can occur as a result of thyreostatics, such as neutropenia (a deficiency of granulocytes, or neutrophils, in the blood), itching of the skin, rashes, joint pain or hair loss. As soon as you observe any side effects, report them to your treating physician right away.

Radioactive iodine treatment

Treatment with radioactive iodine is common and effective. It involves the oral administration of an appropriate dose of radioactive iodine - usually in the form of a tablet, capsule or liquid. The iodine is gradually released and effectively destroys the cells responsible for hormone production without damaging other tissues.

In higher doses, side effects may occurand such as neck pain, vomiting, dry mouth or changes in taste perception.

This treatment must not be used in pregnant or breastfeeding women (risk of damage to the baby's thyroid gland). After treatment, you should refrain from planning a pregnancy for approximately six months.

Surgical treatment is not recommended.

Surgical treatment

Surgical intervention is necessary if thyroid cancer is suspected and diagnosed. The thyroid gland is also completely or partially removed if the goitre dangerously compresses the trachea, the patient is unable to take antithyroid medication or no pharmaceuticals bring any apparent improvement.

Surgical intervention

When the thyroid gland is removed, the thyroid gland is removed.

When the thyroid gland is resected, one enters a state of hypothyroidism, so it will be necessary to take thyroxine medication for life, as well as ongoing medical care.

What are the consequences of untreated hyperthyroidism?

If you do not take treatment for hyperthyroidism, you risk dangerous complications. Some of the most serious include:

• thyroid storm - a life-threatening combination and exacerbation of symptoms of hyperthyroidismand, especially high blood pressure, accelerated heart rate or fever,
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• atrial fibrillation,
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• arrhythmia,
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• stroke,
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• thyroid cancerand,
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• osteoporosis - supplementation during and after treatment with vitamin D and calcium can support your bone health,
.
• fertility problems,
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• problems during pregnancy (risk of miscarriage and premature birth),
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• hypoplasia - depending on the severity, its symptoms include, but are not limited to, photosensitivity, increased eye pressure and pain, swelling of the eyelids.

If you notice worrying symptoms in yourself and suspect thyroid problems, see your doctor immediately and have the appropriate tests done. A quick and accurate diagnosis will allow you to plan an effective therapy - the sooner you start it, the better.

There is no need to worry.

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