Hyperthyroidism occurs when the thyroid gland produces too much thyroid hormone. This disorder occurs in about 1% of all Americans and affects women much more often than men. In its mildest form, hyperthyroidism may not cause noticeable symptoms; however, in some patients, excess thyroid hormone and the resulting effects on the body can have significant consequences. Show
Causes of HyperthyroidismHyperthyroidism can be caused by a number of things:
Symptoms of HyperthyroidismWhen hyperthyroidism develops, patients may experience some of the following signs or symptoms:
How is Hyperthyroidism Diagnosed?There are signs and symptoms of hyperthyroidism that can be identified by a physician. Signs and symptoms of hyperthyroidism are often non-specific and can also be associated with many other causes. Laboratory tests are used to confirm the diagnosis of hyperthyroidism and probable cause. A primary care physician may make the diagnosis of hyperthyroidism, but help may be needed from an endocrinologist, a physician who is a specialist in thyroid and other endocrine diseases. The best test to determine overall thyroid function is the thyroid stimulating hormone (TSH) level. TSH is produced in the brain and travels to the thyroid gland to stimulate the thyroid to produce and release more thyroid hormone. A high TSH level indicates that the body does not have enough thyroid hormone. A TSH level lower than normal indicates there is usually more than enough thyroid hormone in the body and may indicate hyperthyroidism. When hyperthyroidism develops, free thyroxine (T4) and free triiodothyronine (T3) levels rise above normal. Other laboratory studies may help identify the cause of hyperthyroidism. Thyroid-stimulating immunoglobulins (TSI) can be identified in the blood when Graves' disease is the cause of hyperthyroidism. Thyroid peroxidase antibodies and other anti-thyroid antibodies are also seen in some disorders leading to hyperthyroidism. Treatments for HyperthyroidismCurrently, there are several effective treatments available for hyperthyroidism depending on the cause, severity, and several other factors. The most common treatments for hyperthyroidism include antithyroid medications, radioactive iodine, and thyroid surgery. Antithyroid medication (most often methimazole) decreases thyroid hormone production. Antithyroid medicine does not cure the disease but works while the patient takes the medication. It is not usually recommended as a long term solution, although in some patients the hyperthyroidism does go into remission and the medication can be discontinued. If the hyperthyroidism does not go into remission after two years, a more definitive treatment is often recommended (thyroidectomy or radioactive iodine). Radioactive iodine (RAI) is a common treatment for hyperthyroidism. The thyroid is one of the few organs in the body that avidly takes up iodine. This allows radioactive iodine to selectively damage the thyroid gland without affecting other parts of the body. The thyroid gland is eventually destroyed and disappears and the body no longer produces its own thyroid hormone. In general, this treatment can be used in patients with Graves' disease or in those patients with nodules in the thyroid gland causing hyperthyroidism. Not all cases of hyperthyroidism respond well to radioactive iodine. After radioactive iodine most patients will require thyroid hormone replacement with levothyroxine (Synthroid, Levothroid, and other brand names). Thyroid hormone levels will be checked frequently at the beginning, and then often are only checked once a year after the correct dose of thyroid hormone for the patient has been determined. Some patients will have their hyperthyroidism treated by having part or all of their thyroid surgically removed. Deciding which treatment for hyperthyroidism is the right treatment is made on a case by case basis according to each individual patient’s medical, social, and family history. Often, surgical thyroidectomy is recommended over RAI in the following circumstances:
What’s Special About University of Michigan’s Treatment of Graves’ Disease?UM is one of the few places in the country that has a multidisciplinary group dedicated to the treatment of patients with Graves’ disease. UM’s multidisciplinary group consists of endocrinologists, endocrine surgeons, ophthalmologists, nuclear medicine physicians, rheumatologists and psychiatric professionals. Our group sees Graves’ disease patients from around the country and is involved with one of the most well-known national organizations concentrating on helping patients and families coping with Graves’ disease and Graves’ eye disease. Our group routinely publishes papers with new research results on Graves’ disease. The ophthalmologists in our group specialize in the treatment of Graves’ eye disease which can require complex management. Most ophthalmologists have little experience treating patients with Graves’ disease and Graves’ eye disease. For those patients with Graves’ eye disease, it is the severity of the eye disease which drives the selection of the type of treatment for hyperthyroidism if these two problems occur together. While those patients with no Graves’ eye disease or only mild eye disease may be candidates for any of the three types of treatments for hyperthyroidism, those who have moderate to severe eye disease are often referred for surgical thyroidectomy as RAI has a higher chance of worsening the eye disease than surgery does. Which of the following correctly list the hormones produced by the thyroid gland?The thyroid gland releases triiodothyronine (T3) and thyroxine (T4). These hormones play an important role in regulation of your weight, energy levels, internal temperature, skin, hair, nail growth, metabolism and is an important part of the endocrine system.
Which of these would be an effect of an excess of thyroid hormones?Hyperthyroidism, also called overactive thyroid, is a condition where your thyroid makes and releases high levels of thyroid hormone. This condition can make your metabolism speed up. Symptoms of hyperthyroidism include a rapid heartbeat, weight loss, increased appetite and anxiety.
Which symptom would a client exhibit if having a thyrotoxic crisis?Symptoms of overt thyrotoxicosis include heat intolerance, palpitations, anxiety, fatigue, weight loss, muscle weakness, and, in women, irregular menses. Clinical findings may include tremor, tachycardia, lid lag, and warm moist skin.
What clinical manifestations does the nurse recognize would be associated with a diagnosis of hyperthyroidism?Hyperthyroidism may manifest as weight loss despite an increased appetite, palpitation, nervousness, tremors, dyspnea, fatigability, diarrhea or increased GI motility, muscle weakness, heat intolerance, and diaphoresis.
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