Blood tests and imaging techniques are used to diagnose hyperthyroidism. Once hyperthyroidism is then diagnosed, several treatment options are available.
Diagnosing hyperthyroidism
The symptoms that occur with hyperthyroidism often provide the first clues to the disease. By performing a blood test to determine the concentration of the hormone TSH as well as thyroid hormones, the physician can gain further insight: If the TSH value is low, this indicates hyperthyroidism. In contrast, the concentration of thyroid hormones is usually elevated. In Graves’ disease, there is also a large amount of thyroid antibodies in the blood.
Examination with imaging techniques
After the blood test, the treating physician can support the diagnosis with imaging techniques such as ultrasound or scintigraphy. With the help of an ultrasound examination, the size and structure of the thyroid gland can be better assessed. Tissue samples may also be taken for closer examination. If there is a suspicion of thyroid autonomy, a scintigraphy is performed. For this purpose, the patient is injected with a radioactive substance into the vein. This is absorbed more strongly by the areas of the thyroid gland that produce particularly high levels of hormones (hot nodes). In this way, healthy tissue can be distinguished from diseased tissue when viewed through a special camera.
Treating hyperthyroidism
Hyperthyroidism is usually first treated with medication. However, such drug therapy alone is often not sufficient to cure the dysfunction. In such cases, further treatment options include radioiodine therapy or surgery.
Medications for hyperthyroidism
Usually, at the beginning of the treatment of hyperthyroidism, so-called thyrostatic drugs are administered, which inhibit the production of thyroid hormones. Since there is initially still an increased concentration of the hormones in the body, it takes some time before there is an improvement in the symptoms. Once the hormone concentration in the blood has returned to normal, the treating physician must decide whether additional surgery or radioiodine therapy is necessary. If Graves’ disease is the cause of the hyperfunction, the disease is initially treated with thyrostatic drugs. The therapy is carried out over a period of about one year, since relapses often occur during the first months of treatment. If the symptoms recur at a later time, other forms of therapy should be considered. In cases of thyroid autonomy, surgery or radioiodine therapy is almost always necessary, since medications cannot eliminate the autonomous regions. In some cases, beta-blockers are prescribed in addition to thyrostatic drugs to slow the heartbeat and thus attenuate symptoms such as the tremor that occurs with hyperthyroidism.
Radioiodine therapy for hyperthyroidism
Radioiodine therapy involves administering radioactive iodine to the patient, which is stored in the thyroid gland. The radioactive radiation destroys the thyroid cells. The cells that are primarily affected are those that produce a particularly large number of hormones, because they absorb increased amounts of iodine. In thyroid autonomy, especially the active nodes in the thyroid are reached by the radioactive iodine. In Graves’ disease, on the other hand, all cells are affected. As an undesirable consequence of the treatment, hypothyroidism may occur – in some cases even years after radioiodine therapy. However, such hypothyroidism can usually be well controlled by taking thyroid hormones. However, the medication must be taken for the rest of the patient’s life.
Surgery for hyperthyroidism
Surgery is performed, among other things, when thyroid autonomy is the cause of hyperthyroidism or when Graves’ disease patients relapse despite drug therapy. In addition, surgery may also be performed if the thyroid gland is severely enlarged and pressing on the trachea or if a malignant tumor is suspected. Surgery can only be performed if the thyroid hormone level has previously been normalized by medication.Possible risks of surgery include impairment of the adjacent parathyroid gland and injury to the vocal cord nerve. Often, thyroid hormones and iodide must be taken after surgery. This prevents hypothyroidism and prevents the remaining thyroid tissue from growing uncontrollably again.
Preventing hyperthyroidism
To prevent hyperthyroidism, an adequate supply of iodine is particularly important. This is especially true for adolescents, pregnant women, and nursing mothers, who have an increased iodine requirement. For adults, a daily iodine intake of 200 micrograms is recommended. Larger amounts of iodine are found in the following foods, among others:
- Sea fish
- Mussels
- Dairy products such as butter and yogurt
- Eggs
- Kiwi
- Spinach
- Beef
- Black tea
In addition, the use of iodized table salt is recommended. Hyperthyroidism caused by Graves’ disease can not be prevented. However, if thyroid disease has already occurred in your family, it makes sense to have your thyroid examined regularly.
