Hyperthyroidism

How is it produced?

Hyperthyroidism is a hypermetabolic state caused by increased production of thyroid hormones, that is, T4 and T3.

The frequency of this disorder in the general population is approximately 1%, being more prevalent in the female sex.

The most common causes are multinodular goiter, a tumor of the thyroid gland that makes thyroid hormones, Graves' disease, and taking more pills for hypothyroidism. Other less frequent causes are inflammatory processes of the thyroid gland and follicular cancer of the thyroid gland.

Graves' disease is the most common cause of hyperthyroidism in the middle-aged adult, and especially in women. It is a disease due to antibodies that stimulate the TSH receptor.

Multinodular goiter is the most frequent cause of hyperthyroidism in the elderly, presenting a longer course than the previous condition and less symptomatic.

On the other hand, on other occasions this pathology may be secondary to prolonged treatment with a drug called amiodarone, or the presence of a cancer that produces thyroid hormones or thyroid stimulating hormone.

Symptoms

The manifestations of hyperthyroidism indicate that there is involvement of many systems of our body.

• gastrointestinal manifestations: weight loss, diarrhea, nausea, vomiting, increased appetite.
• respiratory manifestations: choking sensation.
• Cardiac manifestations: palpitations, rapid heart beat, elevated blood pressure.
• Neuromuscular manifestations: tiredness, fine tremor in the hands.
• Skin manifestations: heat intolerance, hair loss, hot and humid skin.
• Neuropsychiatric manifestations: irritability, nervousness, anxiety, insomnia, decreased ability to concentrate.
• Other manifestations: menstrual disturbances.

Diagnosis

The suspicion of hyperthyroidism based on the symptoms of hyperactivity of different body systems will be followed by a blood test with determination of the thyroid hormones, T3, T4 and TSH. The hormonal alteration characteristic of hyperthyroidism is a decrease in TSH and an elevation of T3 and T4.

It is also important to carry out an immunological study to confirm if there are antithyroid antibodies causing the condition.

thyroid scintigraphy and thyroid ultrasound help to know the size of the thyroid and see its characteristics, guiding us towards a specific cause of hyperthyroidism.

Treatment

The hyperthyroidism of Graves' disease is treated by decreasing the synthesis of thyroid hormones, giving antithyroid drugs, or reducing the amount of thyroid tissue through radioactive iodine treatment or thyroid gland surgery. The antithyroid drugs are methimazole also called thiamazole, trade name TRIRODRIL and carbimazole.

In addition, there are other medications as symptomatic treatment. These are drugs called beta-blockers, such as propanolol.

Surgery is another therapeutic alternative, especially if there is no response to the previous measures or if the growth of the gland compresses any of the adjacent structures, such as the airway.

Precautionary measures

Prevention measures should be applied to people taking heart and hypothyroid medications, particularly amiodarone.