Hyperthyroidism is a disorder of the function of the thyroid gland. In this case, due to various causes, there is an increased production of hormones in the thyroid gland. This oversupply by the hormones then leads to complaints and symptoms in the course of time. Typical for hyperthyroidism are therefore weight loss, hair loss and heavy sweating.
What is hyperthyroidism?
Infographic on the anatomy and location of the thyroid gland, as well as the symptoms of hyperthyroidism and hypothyroidism. Click image to enlarge. Hyperthyroidism is the term used to describe a high centralization of thyroid hormones in the body. The most important hormone gland in the human body is the thyroid gland. In addition to the thyroid hormones thyroxine and triiodothyronine, it also produces calcitonin. All thyroid hormones contain iodine and also act in almost all bodily cells. Energy metabolism is stimulated by these thyroid hormones. If the thyroid gland produces an increased amount of the hormones thyroxine and triiodothyronine, there is an excessive hormonal effect on the individual organs. The pituitary gland can no longer intervene in a regulatory manner. In this case, we speak of hyperthyroidism or hyperthyroidism.
Causes
The forms of hyperthyroidism usually have different causes. In autoimmune disease, the immune system mistakenly creates antibodies that lead to hyperthyroidism. This autoimmune disease is called Graves’ disease in medical circles. Women are affected more often than men. The exact causes of this hyperthyroidism are not known. However, it is suspected that this form of hyperthyroidism can be inherited. Another form of hyperthyroidism is autonomic hyperthyroidism. One of the most common causes of this hyperthyroidism is iodine deficiency. This deficiency leads to an enlargement of the thyroid gland and often nodular changes occur here, allowing hormones to develop without any control. Thus, in this type of hyperthyroidism, hormone production takes on a life of its own. The control and supervision of the pituitary gland is omitted here. The rather rare causes of hyperthyroidism can be, for example, inflammation of the thyroid gland or tumors on the pituitary gland. Similarly, insensitivities to thyroid hormones or the use of iodine-containing drugs cause hyperthyroidism.
Graves’ disease
Graves’ disease is an autoimmune disorder. Particularly noticeable in this case are bulging eyes, palpitations and an enlarged thyroid gland. Reasons for this autoimmune disease are mainly genetic causes, infections by viruses and external influences (e.g. environmental conditions, food). However, why the thyroid gland produces increased hormones has not yet been researched in detail. All that is known so far is that autoantibodies are formed that try to mimic the thyroid gland’s hormones.
Thyroid Autonomy
A healthy thyroid gland is controlled by the brain for its hormone production. In thyroid autonomy, this control no longer occurs and the thyroid gland manages itself independently, so to speak. The most common cause of this is again iodine deficiency. However, the entire thyroid gland is not always affected. Individual areas can also be affected by thyroid autonomy.
Symptoms, complaints, and signs
Because of the overproduced thyroid hormones, the body works at full speed. Hyperthyroidism affects metabolism, autonomic nervous system as well as organs. Therefore, the signs of this disease are very diverse and often non-specific. Often, several symptoms contribute to the suspicion of hyperthyroidism. An increased probability that hyperthyroidism could be present is offered by the following signs such as psychological abnormalities like mood swings, inner restlessness and nervousness as well as concentration disorders and aggressiveness. Cardiovascular disorders leading to increased pulse, high blood pressure and cardiac arrhythmias may also occur. Sometimes sleep disturbances are also possible. Also possible is an increase in body temperature, excessive sweating and hypersensitivity to heat.
In addition, other complaints can be caused by hyperthyroidism.These include weight loss without a change in the feeling of hunger, as well as diarrhea. Muscle cramps and unnatural tremors may also occur. Skin changes may occur in which the entire skin feels warm and moist with a velvet-like softness. Similarly, hyperthyroidism can lead to hair loss and brittle fingernails. Over a long period of time, untreated hyperthyroidism can cause bone changes. In addition, with an existing sugar disease, there may be a greater need for insulin. An external sign can be an enlargement of the thyroid gland (goiter/truma) caused by thyroid autoantibodies. Symptoms in women may also include menstrual irregularities. Likewise, decreased libido, erectile dysfunction, and eye problems are among the possible complaints. The feeling of thirst may increase due to hyperthyroidism.
Disease progression
The course of the disease depends on the causes of hyperthyroidism. Graves’ disease usually resolves itself, but may recur after several years. Nevertheless, the physician should be consulted in any case. The thyroid autonomy does not regress and the thyroid gland enlarges more and more. Since this can lead to a life-threatening situation, immediate medical treatment is necessary. If the hyperthyroidism persists for a long time, the risk of complications increases. These can also affect other parts of the body.
Complications
One of the most common sequelae of hyperthyroidism is the formation of a goiter. This is the enlargement of the thyroid gland. If the goiter is not treated medically and continues to grow unchecked, there is a risk of physical impairment. Furthermore, there is a risk of nodules developing, which in extreme cases degenerate into malignant tumors. For this reason, they must always be examined by a physician. The most serious effect of hyperthyroidism is thyrotoxic crisis. It leads to a life-threatening aggravation of hyperthyroidism and becomes noticeable with vomiting, high fever, diarrhea, sweating, accelerated pulse, restlessness and muscle weakness. If these symptoms are not treated, there is a risk of further complications such as confusion and impaired consciousness. In the worst case, the patient’s circulatory system fails and he falls into a coma. For this reason, thyrotoxic crisis represents a life-threatening emergency situation, so that intensive medical care must be provided immediately. The causes of thyrotoxic crisis vary. Most commonly, it occurs due to an excess of iodine, such as in x-ray contrast media. Other causes may include additional illnesses, anesthesia, marked infections, or accidents. An additional sequela of hyperthyroidism is stroke, which is triggered due to an abrupt onset of reduced blood flow to the brain.
When should you go to the doctor?
A physician should be consulted as soon as a persistent or increasing feeling of malaise develops in the affected person. A feeling of illness, internal weakness, or severe weight loss without an understandable reason are worrisome and should be clarified. Changes in the hair, thin hair or hair loss are further signs that indicate a hormonal imbalance and should be presented to a doctor. If the affected person suffers from heavy sweating despite normal physical activity and there is the formation of unpleasant night sweats, an examination is needed. Fluctuations in mood, changes in voice color, or an abnormality in sexual desire are also indications of a health irregularity. If behavioral abnormalities, an aggressive demeanor, disturbances in concentration and a decrease in cognitive performance are evident, a visit to the doctor should be made. Irregularities of the heart rhythm should be examined and treated as soon as possible to avoid complications. High blood pressure, elevated body temperature, or hypersensitivity to heat should be presented to a physician. If the affected person complains of diffuse muscle discomfort, cramps, trembling of the limbs, and changes in the appearance of the skin, a physician should be consulted. If there is a change in vision, erectile dysfunction, and irregularities in the female cycle, there is cause for concern.Thirst and diarrhea are also among the symptoms triggered by hyperthyroidism and should be monitored by a doctor.
Treatment and therapy
As a rule, the hormones in the blood are determined in the case of a possible hyperthyroidism. Subsequent treatment is then with drugs to inhibit the increased hormone formation. Not infrequently, surgery is also performed to reduce the size of the thyroid gland so that fewer hormones can be formed. Radioiodine therapy has also shown good results. Depending on the form and severity of the hyperthyroidism, various treatment approaches exist. As a rule, all therapies for hyperthyroidism are well tolerated and effectively improve the developing symptoms of hyperthyroidism. The excessive thyroid hormone production can be inhibited by administering drugs such as thyrostatic agents. By taking the thyrostatic drugs for hyperthyroidism, the thyroid function calms down and there is a slight weight gain that was prevented by the hyperthyroidism. In some cases, the patient is prescribed beta blockers for hyperthyroidism. These are intended to suppress unpleasant symptoms, such as tremors, rapid heartbeat, anxiety, etc. In about one to two months, the metabolism may normalize. In the case of hyperthyroidism, regular check-ups or checking of thyroid levels are advisable. In the case of severe hyperthyroidism or if the thyrostatic drugs are not effective, radiation, radioiodine therapy or even surgery may be necessary. In radioiodine therapy, the patient receives individually dosed radioiodine gelatin capsules. The radioiodine remains in the body longer due to the sufficient supply of fluid. If radioiodine therapy is used for hyperthyroidism, there are special centers or practices that perform this type of therapy. In very severe cases of hyperthyroidism, surgery may be recommended. This is called thyroidectomy. If surgery is performed for hyperthyroidism, part or all of the thyroid gland is removed.
Prevention
The causes of hyperthyroidism are unpredictable. Therefore, preventive measures are basically nonexistent. If the causes of hyperthyroidism lie in an overdose by iodine or other hormones, the exact amount should be checked and adjusted here. Since hyperthyroidism can have different causes, there are only limited effective measures to prevent such a dysfunction. Adequate iodine intake can be useful in preventing hyperthyroidism. As a rule, this is the best prevention against nodule formation or high thyroid growth. In the case of Graves’ disease hyperthyroidism, no adequate prevention exists.
Follow-up
If hyperthyroidism must be treated surgically, aftercare plays an important role. For example, it takes time for the patient to recover from the procedure. Ultimately, the duration of the recovery process also depends on the type and extent of the surgery. It usually takes one to two weeks before the patient can return to work and to his or her usual activities. During this period, heavy objects should not be lifted to avoid strain on the neck. To ensure that recovery after surgery is optimal, the so-called fast-track concept is used. It begins immediately after the operation and includes optimized pain management, a rapid supply of nutrition and early mobilization of the patient. Furthermore, drains, catheters and infusions should be dispensed with as soon as possible. If tension is present, physiotherapy exercises and the application of fango packs can help to relieve it. Special breathing, inhalation and cold applications are sometimes performed. From the first day, the patient is already allowed to move freely in the hospital ward. Usually, the patient can leave the hospital after two to four days.
What you can do yourself
Hyperthyroidism is usually treated with medication by the attending physician. Self-help in everyday life is oriented to the symptoms that often make the clinical picture so unpleasant.It can alleviate these, but without being able to positively influence the underlying disease. Self-help in everyday life is therefore primarily aimed at the patient’s well-being. Hyperfunction often leads to patients sweating quickly and having a low heat tolerance. The remedy here tends to be cool, well-ventilated rooms. A classic sign of hyperfunction is often restlessness or anxiety, often associated with palpitations or heart palpitations. Rest is the wrong approach here. On the contrary, moderate endurance training is often a means of efficiently counteracting the symptoms of hyperthyroidism. Metabolism is often significantly increased in hyperthyroidism. This can also affect digestion and trigger diarrhea. These can be treated naturally with psyllium preparations. The lack of fluids caused by diarrhea can be specifically replaced with water and herbal teas. Stress and agitation is a common trait of often agitated hyperthyroid patients. Here, progressive muscle relaxation according to Jacobsen or even yoga help to become calmer again. For sleep that really brings rest, regular and well-dosed endurance training is also recommended.
