Hyperthyroidism is a thyroid gland disorder resulting from over secretion of thyroid hormones (T3 and T4). Thyroid glands are the butterfly shaped glands that are located on the front lower neck. Their main function is to produce hormones that play an important role in maintaining the overall function of the body, such as energy level, body warmth, muscles and other important functions. 

 

Hyperthyroidism result from any condition that affects the thyroid gland, leading to over production of T4 hormones, such as a thyroid tumor, graves disease (an autoimmune disorder where the body keep on producing more thyroid hormones.

 

The level of thyroid hormone is usually regulated by another hormone known as TSH (thyroid stimulating hormones) that is produced by pituitary glands. When there is an increased amount of T4 hormones in the blood, the pituitary gland try to compensate by decreasing the amount of TSH it produces. 

 

Hyperthyroidism Signs and Symptoms

If hyperthyroidism is not controlled, it can leads to a thyroid storm. A thyroid storm can be triggered by several factors such as, a surgical procedure, during intense period of stress, radioactive therapy, heart attack or overdose of thyroid synthetic hormones.

 

Thyroid Storm Signs and Symptoms

Hyperthyroidism Diagnostic Tests

The following are different tests that can be used to diagnose hyperthyroidism:

 

TSH Serum Test

Serum measurement of TSH, T3 and T4 - expected findings - increased T3 and T4, decreased TSH. Individuals with milder cases of hyperthyroidism may have increased level of T3, normal T4 and decreased TSH. For subclinical cases of hyperthyroidism, they may have normal T3 and T4 but decreased TSH.

 

Antibody tests - Anti-thyroid peroxidase (anti-TPO) antibody and thyroid stimulating immunoglobulin (TSI).

 

Autoantibody Titers Tests

Graves disease - expected findings - significantly increased anti-TPO and TSI.  Toxic multi-nodular enlargement (goiter) and Toxic Adenoma (thyroid benign tumor) - Anti-TPO may be absent or low. Individuals with active hyperthyroidism may also have mild levels of anti-TPO.

 

Scintigraphy - a thyroid test that involves taking an oral solution to produces structural images of the thyroid gland in order to determine the size, function and other thyroid gland abnormalities.

 

Hyperthyroidism Treatment and Management

The management of hyperthyroidism is directed towards reducing the hyperactivity of the thyroid glands in order to relieve various symptoms. Medical management may include;

 

Antithyroid Medications - used for a long time management of hyperthyroidism in children, pregnant women and adults waiting for a radioactive treatment.

 

Medications to control increased pulse rate (tachycardia) and to decrease palpitation, such as propranolol and beta blockers.

 

Radioactive Iodine Treatment - hyperthyroidism treatment of choice for adults and non pregnant women.  Radioactive iodine works by destroying the thyroid gland. However, it is not given to individuals with severe cases of ophthalmopathy. Surgery may performed for severe cases of ophthalmopathy (orbital decompression). Other way to manage ophthalmopathy is through  radiation therapy.

 

Removal of thyroid gland (thyroidectomy) - for severe cases of hyperthyroidism that do not respond to other therapies.

 

Other non pharmaceutical management of hyperthyroidism include;