Thyrotoxicosis, also called thyrotoxic crisis, is a disease which is related to the thyroid gland and its function. This disease must be treated by an experienced physician under all circumstances. In this way, late effects and further illnesses can be largely avoided.
What is thyrotoxicosis?
Thyrotoxicosis translates as “poisoning with thyroid hormones.” It is a life-threatening metabolic disorder that occurs on the basis of hyperthyroidism, or overactive thyroid. This means that the body is flooded with an excessive amount of thyroid hormones, resulting in a variety of symptoms. Thyrotoxicosis can be identified by a sharp increase in hormone levels in the blood.
Causes
The reasons for the presence of thyrotoxicosis can vary greatly from patient to patient. For example, an incorrect or excessive dosage of thyroid hormones may be a reason for the onset. Stress-related situations such as a myocardial infarction, accidents, burns, blood poisoning or surgery are also possible. Often, those affected suffer from hyperthyroidism, but it has not yet been diagnosed as such. Rarer causes of hyperthyroidism may be inflammation of the organ or hormone-producing tumors. In this case, both the thyroid gland itself and the pituitary gland may be affected by a tumor.
Symptoms, complaints, and signs
External signs of this overproduction often include an enlarged thyroid gland, also known as a “goiter.” Another cause may be functional autonomy. In this case, parts of the thyroid gland or the entire thyroid tissue produce hormones independently. These autonomous areas are then no longer controlled by the pituitary gland. Thyroid patients therefore often only receive an accurate diagnosis after many weeks or months. They often report complaints such as inner restlessness, sleep disorders, panic and anxiety attacks, increased hair loss and accelerated digestion, even diarrhea. They often feel great appetite, there is a sudden and usually severe weight loss. Sweating, rapid heartbeat and high blood pressure also occur as signs. In addition, trembling of the hands, shortness of breath or psychological changes such as irritability and nervousness can also be observed. Depending on the severity of the symptoms, the patient’s well-being may be severely impaired. For some patients, normal everyday life becomes temporarily impossible. The multitude of symptoms then has a very strong effect on the patient’s mental and physical resilience and can, for example, also promote psychological changes such as depression.
Diagnosis and course of the disease
The diagnosis of thyrotoxicosis is usually made by a competent internist or a physician specializing in hormones (endocrinologist). For this purpose, some very simple blood tests are performed on the patient. For example, the TSH value, the FT3 value, the FT4 value, as well as the TPO and TRAK values are determined. The TSH value is the value that indicates the ability of the pituitary gland to stimulate the thyroid gland to produce hormones. The FT3 and FT4 values indicate the concentration of free hormones in the blood, and the TPO and TRAK values provide a more accurate indication of autoimmune thyroid disease. These are the so-called thyroid antibodies that are responsible for diseases such as Hashimoto’s or Graves’ disease. To further confirm the diagnosis, specialists also perform an ultrasound examination of the thyroid gland to determine the size of the organ and/or arrange for a scintigram. This widely used method involves injecting a small dose of radioactive fluid into the patient’s vein prior to the examination and imaging the thyroid gland. This makes it possible to see whether and how the thyroid gland is still working. Tumors of the thyroid gland or nodules can also be diagnosed more easily with this method.
Complications
As a rule, self-healing does not occur with this disease, so those affected are dependent on treatment in any case. Complications occur mainly when no treatment is initiated and the thyroid dysfunction persists.In many patients, thyrotoxicosis leads to the formation of a goiter on the neck. This is usually visible and also clearly felt. Furthermore, underweight or overweight and inner restlessness occur. Sleeping problems or severe panic attacks can also occur and have a very negative effect on the patient’s quality of life. Many patients also suffer from hair loss and accelerated digestion. It is not uncommon for diarrhea to occur. Furthermore, psychological complaints or depression often occur, accompanied by nervousness or irritability. Treatment of thyrotoxicosis is usually always based on the root cause. In most cases, no complications occur. In the case of a tumor, those affected are dependent on chemotherapy, which is often fraught with side effects.
When should you go to the doctor?
In the case of thyrotoxicosis, the affected person is usually always dependent on treatment by a medical professional. There can be no self-healing in this disease, and without treatment of thyrotoxicosis, the symptoms usually continue to worsen and have a very negative impact on the quality of life of the affected person. The earlier thyrotoxicosis is detected and treated, the better the further course of this disease usually is. In the case of thyrotoxicosis, a doctor should be contacted if the affected person suffers from sleep problems or general inner restlessness. In many cases, there is also hair loss or severe panic attacks, and some affected persons suffer from severe diarrhea due to the disease. Heart palpitations or high blood pressure may also occur. Increased irritability is also not uncommonly indicative of thyrotoxicosis. The disease can be detected by a general practitioner. Further treatment then depends on the exact cause and is carried out by a specialist. Since thyrotoxicosis can also cause psychological upset or depression, psychological counseling should also be sought.
Treatment and therapy
The treatment of the patient can be completely different, depending on the cause of thyrotoxicosis. If, for example, the cause of the symptoms is a tumor on the pituitary gland, this must be surgically removed and, if necessary, subsequent chemotherapy must still be initiated. In Graves’ disease, a functional disorder in which the thyroid gland can become very enlarged and growths form, the thyroid gland is often partially or completely removed. In combination, preparations are also usually administered to inhibit the function of the thyroid gland. Patients who suffer from artificially induced thyrotoxicosis because they have taken too high a dose of thyroid hormones over a period of time benefit from a reduction in the hormone dose. Treatment of thyroid disease can be quite lengthy. The body often does not respond to the hormonal changes for days or weeks. Therefore, a great deal of patience is required on the part of the patient and the treating physician during the course of therapy. Any concomitant diseases that may develop must also be treated. For example, osteoporosis or eye disease.
Prevention
Preventing thyrotoxicosis is not easy and not always possible. However, those who experience the symptoms already mentioned above and are not quite sure should definitely see a doctor. Those who have a genetic family history of thyroid disease should be particularly vigilant. Patients already taking thyroid hormone supplements should have regular checkups with their doctor. Determining the hormone level at least twice a year is the best choice here. Depending on the type and course of the disease, an examination once a quarter or more frequently may even be indicated. The intervals are determined by the specialist.
Follow-up care
In pathological hyperthyroidism, an excessive amount of hormones is secreted. For the organism, this pathological condition represents a burden. In many cases, secondary symptoms caused by thyrotoxicosis occur. The most common conditions include high blood pressure and an increased pulse rate, an intense need to eat while losing weight, and drowsiness or inner restlessness.There is a risk of goiter formation on the thyroid gland. For this reason, follow-up care is necessary. The physical symptoms should be treated and eliminated so that the patient can once again live symptom-free. At regular follow-up appointments, the thyroid gland is checked for growths. Treatment is carried out by administering medications to regulate hormone production. The specialist checks the healing success and tolerance. In case of side effects he prescribes more suitable medicine. If there is no noticeable improvement or the healing takes too long, he varies the dosage. After a successful therapy, follow-up care is scheduled. For this, the patient must appear for a check-up appointment at certain intervals. During the examination, the physician determines both the activity and the extent of the thyroid gland, so that changes can be diagnosed at an early stage. If goiter is suspected, a biopsy of the thyroid tissue will provide further information.
What you can do yourself
Individuals with thyrotoxicosis suffer from numerous symptoms that interfere with their usual daily lives. In order to counteract these symptoms and positively influence one’s own quality of life, various self-help measures are possible. For example, people with thyrotoxicosis often suffer from nervousness and even anxiety. Relaxation techniques that are integrated into everyday life are suitable for alleviating these complaints. These techniques can serve both mental and physical relaxation. Examples include meditation, yoga, autogenic training or Pilates. Sporting activities also help to reduce nervousness and states of agitation. Endurance sports are particularly suitable. For example, patients with thyrotoxicosis can go jogging or swimming regularly. Sports can also help to reduce the muscle weakness that also accompanies thyrotoxicosis, as the muscles are actively trained and developed. If patients suffer from weight loss despite sufficient caloric intake, a nutritionist should be consulted after the doctor. This person will create a meal plan tailored to the individual patient, which will allow for increased caloric intake. If the body weight still decreases, drug interventions may be necessary. Those affected can also counteract hair loss, at least in part, with an adapted diet and a generally healthy lifestyle that is as stress-free as possible.