Learn About Hyperthyroidism

What is the definition of Hyperthyroidism?

Hyperthyroidism is a condition in which the thyroid gland makes too much thyroid hormone. The condition is often called overactive thyroid.

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What are the alternative names for Hyperthyroidism?

Thyrotoxicosis; Overactive thyroid; Graves disease - hyperthyroidism; Thyroiditis - hyperthyroidism; Toxic goiter - hyperthyroidism; Thyroid nodules - hyperthyroidism; Thyroid hormone - hyperthyroidism

What are the causes of Hyperthyroidism?

The thyroid gland is an important organ of the endocrine system. It is located at the front of the neck just above where your collarbones meet. The gland makes the hormones that control the way every cell in the body uses energy. This process is called metabolism.

Thyroid gland

Many diseases and conditions can cause hyperthyroidism, including:

  • Graves disease (most common cause of hyperthyroidism)
  • Inflammation (thyroiditis) of the thyroid due to viral infections, some medicines, or after pregnancy (common)
  • Taking too much thyroid hormone (common)
  • Noncancerous growths of the thyroid gland or pituitary gland (rare)
  • Some tumors of the testes or ovaries (rare)
  • Getting medical imaging tests with contrast dye that has iodine (rare, and only if there is a problem with the thyroid)
  • Eating too much of foods that contain iodine (very rare, and only if there is a problem with the thyroid)
What are the symptoms of Hyperthyroidism?

Common symptoms include:

  • Anxiety
  • Difficulty concentrating
  • Fatigue
  • Frequent bowel movements
  • Goiter (visibly enlarged thyroid gland) or thyroid nodules
  • Hair loss
  • Hand tremor
  • Heat intolerance
  • Increased appetite
  • Increased sweating
  • Irregular menstrual periods in women
  • Nail changes (thickness or flaking)
  • Nervousness
  • Pounding or racing heart beat (palpitations)
  • Restlessness
  • Sleep problems
  • Weight loss (or weight gain, in some cases)
Goiter

Other symptoms that can occur with this disease:

  • Breast development in men
  • Clammy skin
  • Diarrhea
  • Feeling faint when you raise your hands
  • High blood pressure
  • Itchy or irritated eyes
  • Itchy skin
  • Nausea and vomiting
  • Protruding eyes (exophthalmos)
  • Skin blushing or flushing
  • Skin rash on the shins
  • Weakness of the hips and shoulders
Endocrine glands
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What are the current treatments for Hyperthyroidism?

Treatment depends on the cause and severity of symptoms. Hyperthyroidism is usually treated with one or more of the following:

  • Antithyroid medicines (propylthiouracil or methimazole) which reduce or block the effects of the extra thyroid hormone
  • Radioactive iodine to destroy the thyroid gland and stop the excess production of hormones
  • Surgery to remove the thyroid

If your thyroid is removed with surgery or destroyed with radioactive iodine, you must take thyroid hormone replacement pills for the rest of your life.

Medicines called beta-blockers may be prescribed to treat symptoms such as fast heart rate, tremor, sweating, and anxiety until the hyperthyroidism can be controlled.

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What is the outlook (prognosis) for Hyperthyroidism?

Hyperthyroidism is treatable. Some causes may go away without treatment.

Hyperthyroidism caused by Graves disease usually gets worse over time. It has many complications, some of which are severe and affect quality of life.

What are the possible complications of Hyperthyroidism?

Thyroid crisis (storm) is a sudden worsening of hyperthyroidism symptoms that may occur with infection or stress. Fever, decreased alertness, and abdominal pain may occur. People need to be treated in the hospital.

Other complications of hyperthyroidism include:

  • Heart problems such as fast heart rate, abnormal heart rhythm, and heart failure
  • Osteoporosis
  • Eye disease (double vision, ulcers of the cornea, vision loss)

Surgery-related complications, including:

  • Scarring of the neck
  • Hoarseness due to nerve damage to the voice box
  • Low calcium level due to damage to the parathyroid glands (located near the thyroid gland)
  • Hypothyroidism (underactive thyroid)

Tobacco use may make some complications of hyperthyroidism worse.

When should I contact a medical professional for Hyperthyroidism?

Call your provider if you have symptoms of hyperthyroidism. Go to an emergency room or call 911 or the local emergency number if you have:

  • Change in consciousness
  • Dizziness
  • Rapid, irregular heartbeat

Call your provider if you are being treated for hyperthyroidism and you develop symptoms of underactive thyroid, including:

  • Depression
  • Mental and physical sluggishness
  • Weight gain
What are the latest Hyperthyroidism Clinical Trials?
Randomized Controlled Trial of Preoperative Corticosteroids in Autoimmune ThyroidDisease

Summary: This study proposes to randomize patients about to undergo surgery for their autoimmune, inflammatory thyroid disease, and determine if a short course of corticosteroids decreases the inflammation of the gland and makes surgery less difficult.

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Single-centre, Safety and Efficacy, Open-label Study Evaluating Antithymocyte Globulin Treatment in Subjects With Graves Orbitopathy

Summary: The overall objective of the study is to evaluate the safety and efficacy of rabbit antithymocyte globulin in the treatment of Graves orbitopathy (GO) after ineffective treatment with moderate-to-high doses of glucocorticoids.

What are the Latest Advances for Hyperthyroidism?
Thyroid storm complicated by corpus callosum infarction in a young patient: A case report and literature review.
Teprotumumab (Tepezza) for Thyroid Eye Disease.
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Concomitant methimazole-induced agranulocytosis and cholestatic jaundice in a young woman.
Who are the sources who wrote this article ?

Published Date: August 29, 2020
Published By: Brent Wisse, MD, board certified in Metabolism/Endocrinology, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

Hollenberg A, Wiersinga WM. Hyperthyroid disorders. In: Melmed S, Auchus, RJ, Goldfine AB, Koenig RJ, Rosen CJ , eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 12.

Ross DS, Burch HB, Cooper DS, et al. 2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis. Thyroid. 2016;26(10):1343-1421. PMID: 27521067 pubmed.ncbi.nlm.nih.gov/27521067/.

Wang TS, Sosa JA. Management of hyperthyroidism. In: Cameron AM, Cameron JL, eds. Current Surgical Therapy. 13th ed. Philadelphia, PA: Elsevier; 2020:767-774.

Weiss RE, Refetoff S. Thyroid function testing. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 78.