Symptoms of hyperthyroidism: what they are and how to treat them

By Cristiano Antonino On Apr 4, 2023

Increased heart rate, insomnia, nervousness: these are some of the ways in which hyperthyroidism manifests itself, a condition that most frequently affects women and occurs when the thyroid gland works excessively

What is hyperthyroidism

The thyroid gland is a small, butterfly-shaped endocrine gland located at the front of the neck. It is very important to the body because it produces the thyroid hormones T4 and T3, which are involved in regulating important functions of the body, including breathing, heartbeat, body temperature, central nervous system development and body growth.

When the thyroid gland produces an excessive amount of hormones, it is called hyperthyroidism.

The main effect of excess thyroid hormones is an increase in oxygen consumption and an increase in basal metabolic rate.

Causes

The main cause of hyperthyroidism is Basedow-Graves disease, an autoimmune disease, i.e. caused by an alteration in the immune system that causes the thyroid gland to produce autoantibodies directed against the thyroid gland.

Other causes may be:

thyroiditis, i.e. inflammation of the thyroid gland, which can be caused by a viral infection, autoimmune thyroid inflammation arising after childbirth and, more rarely, chronic autoimmune inflammation;
toxic (overactive) thyroid nodules, i.e. circumscribed areas of the thyroid gland that undergo abnormal growth;
multinodular toxic goiter (also called Plummer’s disease), a condition in which many nodules are present;
excessive intake of iodine, including in the form of supplements (iodine contained in food is used by the thyroid gland to produce hormones; excessive intake of iodine supplements can, therefore, stimulate thyroid activity)
taking certain types of medication (e.g. Amiodarone used in cases of particular arrhythmias).

Symptoms of hyperthyroidism

The increase in thyroid hormones linked to hyperthyroidism causes a condition that results in an acceleration of the body’s vital functions and a series of symptoms, the most common of which are:

nervousness and anxiety
unjustified weight loss;
increased heart rate;
insomnia;
fine tremors in the hands;
visible swelling of the thyroid gland.

In women, it can also cause menstrual cycle irregularities, while atrial fibrillation and heart failure are common in the elderly.

Finally, if the cause of hyperthyroidism is Basedow-Graves disease, eye disorders (Basedowiana ophthalmopathy) may also appear in 20% of cases, i.e:

bulging eyes (exophthalmos);
diplopia (double vision);
excessive lacrimation.

Diagnosis of hyperthyroidism

The diagnosis is based, in the first instance, on the dosage of TSH (pituitary thyroid-stimulating hormone), T4 and T3 levels in the blood, to be combined with the dosage of specific autoantibodies, such as those directed against the TSH receptor, which help in the diagnosis of Graves-Basedow’s disease.

Also recommended are:

thyroid ultrasound for the detection of possible nodules;
thyroid scintigraphy, which provides information on the morphology and function of the gland.

The treatment of hyperthyroidism depends on several factors such as:

age;
physical condition of the person
cause;
severity of the disease.

The therapeutic approach, depending on the case, can be

pharmacological, with drugs that block the synthesis of thyroid hormones. These include anti-thyroid drugs, of the thionamide class;
radiometabolic, with radioactive iodine, which, taken orally, is selectively absorbed by the thyroid gland and causes a reduction in thyroid hormone production and gland volume;
surgical: thyroidectomy (i.e. removal of all or part of the thyroid gland) may be necessary when no other treatment is possible, e.g. during pregnancy, in the presence of a large goitre, in patients with frequent recurrences or drug intolerance.

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