Hyperthyroidism affects people of both sexes, though women are ten times more likely than men to experience it. Around 80 percent of all hyperthyroidism cases are caused by Graves' disease. This is an inherited, auto-immune disorder that appears when some people reach middle age. It is most likely triggered by a bacterial or viral infection. The antibodies produced against the infection are assumed to react with the thyroid stimulating hormone (TSH) receptors, which causes the thyroid gland to become overactive.
Causes
Graves' Disease Graves' disease, which is caused by a generalized overactivity of the thyroid gland, is the most common cause of hyperthyroidism. In this condition, the thyroid gland usually is renegade, which means it has lost the ability to respond to the normal control by the pituitary gland via TSH. Graves' disease is hereditary and is up to 5 times more common among women than men. Graves' disease is thought to be an autoimmune disease, and antibodies that are characteristic of the illness may be found in the blood.
The most common cause of hyperthyroidism is Graves' disease. Other common causes include thyroiditis, toxic multinodular goiter, toxic adenomas, and side effects of certain medications. The diagnostic workup begins with a thyroid-stimulating hormone level test. When test results are uncertain, measuring radionuclide uptake helps distinguish among possible causes.
Symptoms
Major clinical signs include weight loss (often accompanied by a ravenous appetite), anxiety, intolerance to heat, fatigue, hair loss, weakness, hyperactivity, irritability, apathy, depression, polyuria, polydipsia, and sweating. Additionally, patients may present with a variety of symptoms such as palpitations and arrhythmias (notably atrial fibrillation), shortness of breath (dyspnea), loss of libido, nausea, vomiting, osteoporosis and diarrhea. In the elderly, these classical symptoms may not be present and they may present only with fatigue and weight loss leading to apathetic hyperthyroidism. Thyrotoxic crisis comes when the sick person is having stress. Its symptoms are increase of body temperature to over 40 degrees Celsius, tachycardia, arrhythmia, vomiting, diarrhea, dehydration, icterus, coma and death.
Treatment
The main aim of the treatment is to reduce the production of thyroid hormone. This can be done with the help of drugs such as propylthiouracil, methimazole and potassium iodide. Medications called beta-blockers, including atenolol or metoprolol, can also be used to block the effects of thyroid on tissues and to treat symptoms like rapid heart rate, tremors, palpitations, sweating, and anxiety.
Generally, if Neomercazole fails to completely control the over functioning gland, the patient referred to a surgeon who will remove a minor/major portion of the gland, there by controlling the hormone production. The laboratory tests, T3 T4 TSH, indicates the surgeon on the percentage of the gland required to be removed. However, frequent monitoring is very essential because at times the patients become hypothyroid also. Though, surgeons prefer surgery, the cost associated restricts its choice.
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