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Hyperthyroidism / Thyrotoxicosis

What is hyperthyroidism?

Hyperthyroidism or thyrotoxicosis, is where the thyroid gland produces too much of the thyroid hormones. The thyroid is a butterfly- shaped gland in the lower neck, just in front of your windpipe.

Having too much of these hormones can cause unpleasant and potentially serious problems than need treatment. Hyperthyroidism is more common in women and typically occurs between 20 and 40 years of age.

What are the symptoms of hyperthyroidism?

Hyperthyroidism can cause a whole range of symptoms including:

  • Weight loss
  • Heat intolerance
  • Tremor
  • Anxiety
  • Mood disturbance
  • Difficulty sleeping
  • A racing or irregular heart beat (Palpitations)
  • A swelling in the lower neck from an enlarged thyroid (Goitre)

How do you test for hyperthyroidism?

A blood test organised through your local doctor can be performed that will confirm the diagnosis.

What investigations do I need for my hyperthyroidism?

  • Blood tests – Blood tests can measure thyroxine and thyroid stimulating hormone (TSH) can confirm the diagnosis. The normal blood picture is a raised thyroxine and a low (suppressed) TSH. Further blood tests looking at anti-thyroid antibodies are useful as they are often elevated in Graves disease, a common cause of an over active thyroid.
  • Thyroid scan – a small amount of radioactive iodine is given and scans are performed to see how it accumulates within the thyroid gland. This can help confirm Graves’ disease or identify an overactive thyroid nodule.
  • Thyroid Ultrasound – allows assessment of the size of the thyroid and confirm the presence of nodules within the gland.

What are the causes of hyperthyroidism?

There are many causes for an over active thyroid gland. These include:

  • Graves’ disease – a condition where you immune system attacks and damages the thyroid gland. This is the most common cause of hyperthyroidism.
  • Thyroid nodules – this is when a nodule within the thyroid independently causes excess production of thyroid hormones.
  • Medications – some medical treatments may cause over active thyroid gland function.

How do you treat hyperthyroidism?

Overactive thyroids are normally treated by an endocrinologist ( a specialist in hormone conditions). The main treatments are:

  • Medicine – Anti-thyroid medications gradually reduce symptoms of hyperthyroidism by preventing the thyroid gland from producing excess hormones. Symptoms usually begin to improve within several weeks and treatment is needed for up to a year and sometimes longer.
  • Radioactive iodine – Taken by mouth, radioactive iodine is taken up by the thyroid gland where it causes the gland to shrink and reduce hormone production. The treatment may cause the thyroid to stop producing hormones entirely and you will need to take medication (thyroxine) every day to replace this.
  • Surgery – If you are pregnant, can’t tolerate anti-thyroid medications or don’t wish radioactive iodine you may be a candidate for surgery. In this situation, part or the whole of your thyroid gland is removed to treat the underlying problem.

The best treatment approach depends on your age, physician condition, the underlying cause and personal preference.

What is Graves’ disease?

Graves’ disease is an auto-immune disorder that causes hyperthyroidism. With this disease, your immune system attacks the thyroid and causes it to make more thyroid hormones than your body needs.

How do you treat Graves’ disease?

Graves disease can be treated with either medication (anti-thyroid drugs), radioactive iodine or surgery.

Do you need surgery for Graves’ disease?

This may be the best option for treatment if:

  • your thyroid gland is severely swollen due to a large goitre.
  • you have severe eye problems related to your over active thyroid.
  • you cannot have other treatments.
  • your symptoms return after either medical treatment or radioactive iodine.