General Practice 2022

Hyperthyroidism: symptoms, causes and treatment

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Hyperthyroidism: symptoms, causes and treatment
Hyperthyroidism: symptoms, causes and treatment

Hyperthyroidism is a condition characterized by excessive production of hormones by the thyroid, leading to the development of some signs and symptoms, such as anxiety, hand tremors, excessive sweating, swelling of the legs and feet and changes in the menstrual cycle, women's case.

This situation is more common in women between the ages of 20 and 40, although it can also occur in men, and is usually associated with Graves' disease, which is an autoimmune disease in which the body itself produces antibodies against the thyroid. In addition to Graves' disease, hyperthyroidism can also be a result of excessive iodine consumption, an overdose of thyroid hormones, or a thyroid nodule.

It is important that hyperthyroidism is identified and treated according to the endocrinologist's recommendation so that it is possible to alleviate the signs and symptoms related to the disease.

Main symptoms

Due to the greater amount of thyroid hormones circulating in the blood, it is possible that some signs and symptoms may appear, such as:

  • Increased heart rate;
  • Increased blood pressure;
  • Changes to menstrual cycle;
  • Insomnia;
  • Weight loss;
  • Trembling of hands;
  • Excessive sweating;
  • Swelling in the legs and feet.

In addition, there is a higher risk of osteoporosis due to the faster loss of calcium from the bones. Check out other symptoms of hyperthyroidism.

Possible causes

Hyperthyroidism happens due to increased production of hormones by the thyroid, which mainly happens due to Graves' disease, which is an autoimmune disease in which the immune system's own cells act against the thyroid, which has the effect the increased production of excessive amounts of hormones. Learn more about Graves' disease.

In addition to Graves' disease, other conditions that can lead to hyperthyroidism are:

  • Presence of thyroid nodules or cysts;
  • Thyroiditis, which corresponds to inflammation of the thyroid gland, which can happen postpartum or due to virus infection;
  • Excessive dose of thyroid hormones;
  • Excessive consumption of iodine, which is essential for the formation of thyroid hormones.

It is important that the cause of hyperthyroidism is identified, because this way the endocrinologist can indicate the most appropriate treatment.

How to confirm the diagnosis

The diagnosis of hyperthyroidism is possible through the measurement of thyroid-related hormones in the blood, and the doctor requests an assessment of the levels of T3, T4 and TSH. These exams should be performed every 5 years from the age of 35, mainly in women, but people who are at greater risk of developing the disease should perform this exam every 2 years.

In some cases, the doctor may also recommend performing other tests that evaluate thyroid function, such as antibody dosage, thyroid ultrasound, self-examination and, in some cases, thyroid biopsy. Discover the tests that evaluate the thyroid.

Subclinical Hyperthyroidism

Subclinical hyperthyroidism is characterized by the absence of signs and symptoms indicative of thyroid alteration, however, in the blood test, low TSH can be identified and T3 and T4 are with normal values.

In this case, the person must undergo new tests within 2 to 6 months to confirm the need to take medication, because normally it is not necessary to perform any treatment, being this only reserved for when there are symptoms.

Hyperthyroidism in pregnancy

The increase in thyroid hormones during pregnancy can cause complications such as eclampsia, miscarriage, premature birth, low birth weight, and heart failure in women.

Women who had normal values ​​before becoming pregnant and who were diagnosed with hyperthyroidism from the beginning to the end of the first trimester of pregnancy, usually do not need to undergo any type of treatment, because a slight increase in T3 and T4 during pregnancy. However, the doctor may prescribe medication to normalize the T4 in the blood, without harming the baby.

The dose of the drug varies from one person to another and the first dose indicated by the obstetrician is not always the one that is maintained during treatment, because it may be necessary to adjust the dose, after 6 to 8 weeks after starting the treatment. use of the medicine.Learn more about hyperthyroidism in pregnancy.

How the treatment is done

Treatment for hyperthyroidism should be carried out according to the general practitioner's or endocrinologist's guidance, according to the levels of hormones in the blood, age, severity of the disease and symptoms, and may be indicated:

1. Medicines

The use of drugs corresponds to the first line of treatment for hyperthyroidism as they act directly on the regulation of hormone levels, and they can inhibit the synthesis of T4 and block its conversion to T3, thus reducing the amount of circulating thyroid hormones in the blood.

The main drugs recommended by the doctor to treat hyperthyroidism are Propylthiouracil and Methimazole, however the dose will depend on the levels of circulating hormones, response to treatment over time and side effects experienced. Thus, during treatment, it may be necessary to make dose adjustments over time, and the doctor may maintain, increase or decrease the dose of the medicine.

To assess whether the medication is in the right dose and whether it is having the desired effect, blood tests will be ordered to assess the levels of TSH, T3 and T4 hormones in the body, and the right dose of medication can be achieved between 6 to 8 weeks of treatment. Learn more about medications for hyperthyroidism.

2. Radioactive Iodine

Treatment with radioactive iodine, also known as iodine therapy, consists of the ingestion of a capsule containing this substance, being indicated when treatment with drugs was not effective. This method promotes intense inflammation of thyroid cells, resulting in decreased production of hormones.

Often, just 1 dose of radioactive iodine can be enough to treat hyperthyroidism, but there may be cases where it is necessary for the doctor to prolong the treatment for some time.

This type of treatment is not recommended for women who are pregnant or breastfeeding, and it is recommended that pregnancy be delayed for 6 months after the end of treatment for women who are planning to become pregnant.Understand how radioiodine therapy works for hyperthyroidism.

3. Surgery to remove the thyroid

Surgery to remove the thyroid, also called thyroidectomy, is a definitive treatment that consists of reducing thyroid tissue in order to decrease hormone production. However, due to the fact that part of the thyroid is removed, this type of surgery is also associated with a greater chance of developing hypothyroidism. Therefore, it is important that the person has a regular follow-up by the doctor.

This surgery is indicated in cases where other treatments have not worked or when there is the presence of nodules, exaggerated thyroid enlargement or cancer, and, according to the severity of the disease, it can be total or partial, that is,, if the entire thyroid is removed or just a part.

Recovery from surgery is very simple, after which it is only recommended to avoid making efforts to avoid swelling or bleeding at the cut site. See how thyroid surgery is performed.

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