If the thyroid gland is “raging”: what is hyperthyroidism?

Hyperthyroidism is a condition of hyperfunction of the thyroid gland, which is accompanied by excessive production of thyroxine and triiodothyronine. An increase in the level of hormones in the blood accelerates metabolic processes in the body and has a negative effect on almost all organ systems. Symptoms of hyperthyroidism reduce the patient's quality of life. Hyperthyroidism is a condition of hyperfunction of the thyroid gland, which is accompanied by excessive production of thyroxine and triiodothyronine. An increase in the level of hormones in the blood accelerates metabolic processes in the body and has a negative effect on almost all organ systems. Symptoms of hyperthyroidism reduce the patient's quality of life.

Adequate and timely treatment allows you to prevent complications and slow down pathological processes, up to the complete restoration of thyroid function.

What is hyperthyroidism

Thyroid hormones are called thyroid hormones. These are thyroxine (T4) and triiodothyronine (T3). They enter the bloodstream and spread to many internal organs, affecting important functions. They regulate metabolism, brain activity, the functioning of the cardiovascular and nervous systems, the functioning of the gonads and the gastrointestinal tract.

When the production of thyroid hormones increases due to hyperfunction of the gland, they speak of hyperthyroidism.

There are three forms of pathology:

• Subclinical - there are no noticeable changes in well-being, the production of the T4 and T3 hormones remains unchanged, and the level of the TSH hormone is reduced.
• Manifest - the T4 value is increased, TSH decreases even more.
• Complicated – an advanced form of the disease in which complications have appeared in other organs and systems. Frequent manifestations are heart failure, tachycardia, unstable psycho-emotional state.

Hyperthyroidism is classified according to the level of occurrence into:

• Primary – the condition is caused by diseases of the thyroid gland.
• Secondary – disorders of the thyroid gland are caused by pathologies of the pituitary gland, which is functionally interconnected with it.
• Tertiary – the root cause of the disease is pathology of the hypothalamus, which affects the work of other endocrine glands.

Folk remedies

Herbal treatment of hyperthyroidism is possible, but only in consultation with a doctor and as an additional remedy to the main conservative therapy.

Medicinal herbs are mixed. For mild forms of hyperthyroidism, 1 tablespoon of the mixture is brewed in an enamel bowl with 200 grams of hot water (600) and infused for 2 hours, then filtered and taken in three equal doses 10 minutes before meals. For severe forms, an infusion of 3 tablespoons of the mixture is recommended.

For these purposes, you can prepare an infusion of herbs:

• common wormwood, or Chernobyl, used for nervous disorders as a sedative - 2 tablespoons;
• rhizome of the evasive peony, or Maryin root, which calms the nervous system, reduces headaches and also has an anti-inflammatory effect - 1 tablespoon;
• European grasshopper, which has an anti-inflammatory effect and a pronounced sedative effect, superior to motherwort and valerian root - 3 tablespoons;
• crushed burdock root, which is intended to reduce the effects of intoxication - 1 tablespoon;
• curly thistle; it has a mild sedative and anti-inflammatory effect - 2 tablespoons.

However, you should always remember that in the presence of hyperthyroidism, treatment with folk remedies is aimed only at normalizing (to some extent) the function of the nervous system and improving sleep, but not at treating the disease itself. The use of medicinal plants is possible only after the recommendations of an endocrinologist!

Hyperthyroidism of the thyroid gland - symptoms

The initial symptoms are quite uncharacteristic; they can easily be attributed to ordinary fatigue, stress, vitamin deficiency and other factors.

Later, as disorders increase due to thyroid hyperthyroidism, symptoms appear:

• Weight loss without diets and physical activity - Appears due to the accelerated breakdown of nutrients and proteins that do not have time to be fully absorbed.
• Rapid or arrhythmic heartbeat under equal physical and emotional stress.
• Frequent mood swings, causeless irritability, bad mood, discomfort from bright light, loud sounds.
• Hair loss.
• Weakness, loss of strength.
• Insomnia.
• Trembling of the hands - hands and fingers.
• Digestive disorders - nausea, stomach upset.
• Increased thirst and frequent urination due to water imbalance.
• The appearance of a characteristic goiter on the front of the neck.
• Protrusion of eyes.

Symptoms of thyroid hyperthyroidism in women: irregular menstruation, decreased ability to conceive, miscarriages. In the initial stages of hyperthyroidism, menopausal women have few symptoms. They appear later as the functioning of the internal organs is disrupted.

Weakened libido and problems with potency are typical symptoms of thyroid hyperthyroidism in men.

Symptoms of hyperthyroidism in old age may resemble senile dementia. Confusion, weakness and heart failure appear. There is also a predominant lesion of one organ or system of the body.

Thyrotoxic (hyperthyroid) crisis

This complication occurs as a result of untreated thyrotoxicosis or when treatment is prescribed that does not actually correspond to the necessary measures. A crisis can also be triggered by mechanical manipulations performed during examination of a patient or during surgery that in one way or another affects the thyroid gland. The possibility of a crisis developing due to stress cannot be ruled out.

1. In general, a hyperthyroid crisis manifests itself by reaching a peak with symptoms characteristic of hyperthyroidism. It begins acutely and its course is lightning fast. Patients experience severe mental agitation, and it is often accompanied by hallucinations and delusions. The trembling of the hands intensifies, in addition, the trembling spreads to the lower extremities and throughout the body as a whole. Blood pressure drops sharply, muscle weakness appears with general lethargy of the patient. Vomiting manifests itself in an indomitable form, accompanied by elevated temperature (signs indicating the relevance of the infection are absent in this case), diarrhea, and rapid heartbeat (reaching 200 beats per minute). When you urinate, you can detect the characteristic acetone odor in your urine. Temperature (up to 41 degrees) and pressure rise.
2. In some cases, jaundice develops, which manifests itself as a result of an acute form of fatty degeneration, relevant for the liver, and adrenal insufficiency can also develop.

It is important to note that the lack of timely assistance can cause the death of the patient due to the transition of the crisis to a coma. Death can occur as a result of an acute form of fatty liver disease or due to adrenal insufficiency.

Complications

Like other diseases without treatment or with improper self-medication, hyperthyroidism can cause complications. The most severe of them are complications of:

• Heart – arrhythmias, heart failure. Interruptions worsen with physical activity.
• Musculoskeletal system - changes occur in the structure of the bones, they become fragile. Metabolism is disrupted, the bone is insufficiently supplied with calcium and is depleted.
• Eyes - a characteristic disease is Graves' syndrome with ophthalmopathy. This is caused by overgrowth and swelling of the tissue behind the eyeballs. Typical patient complaints are discomfort in the eyes, lacrimation, eyelids do not close completely, increased sensitivity to light, double vision, decreased acuity.
• Skin – Graves' dermopathy. This is redness and swelling of the legs and feet.

In particularly advanced cases, a thyrotoxic crisis may occur. With it, all the symptoms of the disease sharply intensify, tachycardia and heart failure, and there may be mental disorders. The patient needs emergency help.

Disturbances in the production of hormones cannot be ignored. Over time, this fact provokes a lot of additional pathologies. In addition, hyperthyroidism causes unpleasant symptoms. All this prevents a person from living a normal life. Mood swings and irritability can poison relationships within the family and with loved ones. The problem will not go away on its own.

It is impossible and simply dangerous to treat hyperthyroidism without a thorough examination and an individually selected doctor regimen. Self-prescription of drugs has a negative impact on overall health and can lead to the development of severe pathologies and even death.

It is not necessary to endure the symptoms of hyperthyroidism. At the Kutuzovsky Children's Hospital they will diagnose diseases that cause hyperthyroidism and help you get rid of the pathology. Make an appointment with specialists at the Kutuzov Diagnostic and Treatment Center. We will help you find a healthy and fulfilling life.

Causes

Hyperthyroidism can occur for a variety of reasons. Hyperthyroidism can be primary, secondary and tertiary.

Among the main factors that contribute to the appearance of primary hyperthyroidism:

• Congenital or acquired lesions of the thyroid gland - inflammation, iodine deficiency or excess.
• Diseases of an autoimmune nature (due to improper functioning of the immune system). With them, antibodies to thyroid cells appear in the body. Autoimmune Hashimoto's thyroiditis and Basedow's disease occur, and triiodothyronine production increases.
• Nodular goiter, adenoma - the appearance of compactions and tumors in the tissues of the gland.
• Inflammation of the thyroid gland - thyroiditis, in which its follicles are destroyed, and the hormones from them enter the blood.

Secondary hyperthyroidism is a consequence of a decrease in the level of thyroid-stimulating hormone (TSH) due to disorders in the pituitary gland. TSH stimulates the activity of the thyroid gland, so there may be an increase in the functionality of a healthy thyroid gland due to the pituitary gland.

Tertiary hyperthyroidism is caused by malfunctions in the hypothalamus and a decrease in its functioning.

Hyperthyroidism is more common in people with a genetic predisposition to endocrine diseases. Women get sick more often than men. Risk factors include living in an endemic area (with iodine deficiency), polluted environmental conditions, and frequent stress.

Hyperthyroidism is a condition in which the thyroid gland produces an excess amount of hormones. Normally, they are necessary for normal growth and development of the body, and are also responsible for all types of metabolism.

Overproduction of hormones leads to an acceleration of metabolic processes in the body, which is accompanied by an increase in the functional load on the cardiovascular system. This condition can also be called thyrotoxicosis.

A particularly dangerous manifestation of hyperfunction of the thyroid gland is thyrotoxic crisis. It is characterized by a rapid increase in pre-existing symptoms and is accompanied by profuse sweating, tachycardia, and clouding of consciousness. In such situations, immediate medical attention is needed.

Treatment is carried out mainly by conservative methods: taking antihormonal drugs and radioactive iodine drugs.

Synonyms Russian

Thyrotoxicosis.

English synonyms

Overactive thyroid, Hyperthyroidism.

Symptoms

Symptoms of hyperthyroidism can be disguised as various diseases of the cardiovascular, nervous, digestive and other organ systems. Thus, identifying this syndrome is not always an easy task.

Hyperthyroidism may present with the following symptoms:

• sudden loss of body weight, although appetite may not only be maintained, but also increased;
• rapid heartbeat (tachycardia), a feeling of interruptions in the work of the heart, arrhythmias;
• nervousness, restlessness and irritability;
• tremor - small twitching of the fingers;
• increased sweating;
• menstrual irregularities;
• increased body temperature;
• intestinal dysfunction, tendency to diarrhea;
• enlargement of the thyroid gland, which manifests itself as a tumor-like formation at the base of the neck (goiter);
• fatigue, muscle weakness;
• sleep disturbance;
• eye symptoms – enlargement of the visible part of the eyeballs, blurred vision, redness, dry eyes;
• changes in the skin around the ankles in the form of thickened skin, itchy red rashes that then turn brown.

General information about the disease

The thyroid gland is located at the base of the neck and is shaped like a butterfly. The main thyroid hormones are thyroxine (T4) and triiodothyronine (T3). They control protein, fat and carbohydrate metabolism, regulate body temperature, rhythm and heart rate. In addition, the thyroid gland synthesizes another hormone - calcitonin. It controls the level of calcium in the blood.

Regulators of thyroid function are the hypothalamus and pituitary gland, glands located in the brain. Having received a signal from the hypothalamus, the pituitary gland synthesizes thyroid-stimulating hormone (TSH). TSH is captured by receptors on thyroid cells, which stimulates the synthesis of thyroid hormones.

The amount of TSH in the blood is regulated through a feedback mechanism. Thus, with its increase in the blood, the level of T3 and T4 decreases. In turn, a decrease in the level of thyroid hormones in the blood leads to stimulation of TSH production.

In the absence of thyroid pathology, the levels of all hormones are within normal limits.

Diseases leading to hyperthyroidism:

• Diffuse toxic goiter (Graves disease) is the most common cause of thyrotoxicosis. As a result of immune disorders, antibodies are formed that stimulate the production of thyroxine (T4). Normally, antibodies protect the body from germs and viruses. In Graves' disease, antibodies act not only on the thyroid gland, but also on the tissue behind the eyeballs, which causes the growth of retrobulbar tissue (ophthalmopathy), skin, most often in the ankle area, where redness and itching occurs (dermopathy).
• Increased production of hormones by thyroid nodules (nodular toxic goiter, Plummer's disease, toxic thyroid adenoma). Adenomas are benign formations that lead to enlargement of the thyroid gland. Some of them may not produce thyroxine and do not lead to hyperthyroidism.
• Thyroiditis. Inflammation of the thyroid gland, arising from various causes. There is subacute thyroiditis, which may be accompanied by pain in the neck. Other forms are painless. In some cases, inflammation may occur after childbirth (puerperal thyroiditis).

Less common causes of hyperthyroidism are:

• Exposure to radioactive iodine or taking iodine supplements by people who previously suffered from iodine deficiency.
• Ovarian tumors (teratoma), characterized by the presence of tissues atypical for this organ. In some cases, the structure of these tumors is similar to the tissues of the thyroid gland and their cells can synthesize thyroid hormones.
• Pregnancy complicated by conditions in which the level of human chorionic gonadotropin (hCG) is increased by 100 times or more. Normally, hCG is produced by the tissues of the fetus, its action is aimed at maintaining pregnancy. Its level reaches its maximum values ​​by the 9-11th week, then hCG begins to decrease as the placenta forms. With pathological, aggressive development of embryonic tissues, this decrease does not occur. High levels of hCG stimulate TSH receptors on thyroid cells, which leads to an increase in the level of thyroid hormones in the blood.
• Pituitary tumors, thyroid cancer and its metastases.
• Iatrogenic (thyroid hormone therapy).

Who is at risk?

• Pregnant women.
• Persons with a genetic predisposition to thyroid pathology.
• Those located under conditions of radioactive influence.
• Living in conditions of iodine deficiency.

Diagnostics

If hyperthyroidism is suspected, the following tests may be ordered:

• Thyroid-stimulating hormone (TSH), the level of which in the blood will be reduced. Rarely, its amount may be within normal limits or even increased. This occurs if the cause of hyperthyroidism is a pathology of the pituitary gland.
• Total triiodothyronine (T3) and total thyroxine (T4) reflect the total amount of hormones synthesized by the thyroid gland. Their level is usually elevated. Total T4 may remain normal in asymptomatic forms of hyperthyroidism.
• Free triiodothyronine (free T3) and free thyroxine (free T4) are biologically active forms of hormones. Their number will also be increased.
• Serum calcitonin – its amount can also increase with hyperthyroidism.
• T-Uptake (thyroxine-binding ability of blood) is the ability of the blood to bind thyroxine through proteins, thereby converting it into an inactive form. When the blood is oversaturated with hormones, it decreases, and vice versa. Thus, T-Uptake will be reduced in true hyperthyroidism and increased in cases of impaired binding of thyroxine to plasma proteins.

Additionally, to diagnose Graves' disease you can use:

• Antibodies to TSH receptors (anti-pTTG) are protective proteins of the immune system, which, in pathology, are produced to receptors located on the cells of the thyroid gland, which stimulates the production of T3, T4.
• Antibodies to thyroid peroxidase (anti-TPO). TPO is an enzyme responsible for activating the iodine molecule and including it in the synthesis of thyroid hormones. An increase in the production of such antibodies speaks in favor of an autoimmune process.
• Antibodies to thyroglobulin (antiTG), a protein from which thyroid hormones are formed. An increase in their titer may indicate an autoimmune lesion.

To diagnose hyperthyroidism caused by thyroid tumors or inadequate therapy with L-thyroxine (a drug used for thyroid hormone replacement therapy), blood determination is used:

• Thyroglobulin is a protein that is a precursor of thyroid hormones. Its level increases in cancer pathology and decreases in hyperthyroidism caused by replacement therapy.

Additional research:

• Clinical blood test: an increase in the level of leukocytes and ESR may be observed, which may indirectly indicate an inflammatory process in the tissues of the thyroid gland.
• Biochemical blood test: the level of total protein, glucose, cholesterol may be reduced, the amount of calcium increased.
• Radioisotope study with iodine. The thyroid gland needs iodine to synthesize hormones. Therefore, to assess its hormonal activity, the patient is asked to drink a solution with labeled iodine atoms. Then the intensity of the entry of this iodine into the blood, and therefore the intensity of hormone synthesis, is monitored.
• Ultrasound of the thyroid gland. The structure of the gland, the nature of pathological changes, the number and size of nodes are determined.

The scope of additional examination is determined by the attending physician.

Treatment

Treatment consists of taking antihormonal drugs and radioactive iodine drugs, which suppress the overactivity of the thyroid gland. B-blockers, drugs that reduce heart rate, can also be used as symptomatic treatment. If conservative therapy is ineffective, surgical treatment is performed. In this case, almost the entire thyroid gland is removed.

Moisturizing eye drops are used to treat eye manifestations in the initial stages. In advanced stages, prednisolone injections into the postorbital tissue are used. If these methods are ineffective, surgical removal of the overgrown tissues of the orbits is performed.

Recommended tests

• Thyroid-stimulating hormone (TSH)
• Free thyroxine (free T4)
• Total thyroxine (T4)
• Total triiodothyronine (T3)
• Free triiodothyronine (free T3)
• Serum calcitonin
• Antibodies to TSH receptors (anti-pTTH)
• Antithyroglobulin antibodies (antiTG)
• Antibodies to thyroid peroxidase (anti-TPO)
• Thyroglobulin
• T-Uptake

Diagnostics

If signs of hyperthyroidism appear, consultation with an endocrinologist is necessary. At the appointment, the doctor will examine the patient and talk to him. You will need to answer the following questions:

• Do any close relatives have thyroid disease?
• How long ago did the signs appear?
• Nature of the work.
• Existing diseases and other issues.

With the help of palpation of the gland, its approximate size, structure, pain, and density are determined.

To establish and clarify the diagnosis, the following are prescribed:

• Hormonal studies - determination of the level of TSH, hormones T3 and T4. Based on their values, you can determine the type of disease and the degree of impairment. Such tests are especially important for older women, since symptoms of hyperthyroidism may be absent during menopause.
• Blood test - which evaluates the presence of antibodies to TSH (a sign of autoimmune diseases), the number of lymphocytes, monocytes and eosinophils, cholesterol levels and other indicators.
• Ultrasound of the thyroid gland to assess its size, structure and other parameters.
• Scintigraphy is a study of the rate of iodine absorption to clarify the causes of hyperthyroidism.
• Biopsy is the removal of a tissue sample from the gland (under ultrasound guidance) for cytological examination.
• Chest X-ray to assess the degree of compression of the airways and blood vessels by the resulting goiter.

To take a blood test for hormones, it is recommended to come on an empty stomach (when more than 10 hours have passed since your last meal) and first avoid heavy physical activity for two days. If you need to take tests again (for example, to monitor the effectiveness of treatment), it is important to come at approximately the same time of day as the previous time. This recommendation is due to the fact that the level of thyroid-stimulating hormone changes throughout the day.

How to treat hyperthyroidism

Methods and timing of therapy depend on the type of hyperthyroidism, its causes, other diseases in the patient, and his age.

Conservative treatment is used:

• Preparations with iodine isotopes - they reduce the activity of the gland, accumulating in its tissues (compensation option). The organ returns to normal size, its functioning is normalized. Treatment is carried out under the supervision of a doctor and periodic monitoring of the patient’s health. If the process is uncontrolled, the activity of the thyroid gland may be excessively suppressed, which leads to hypothyroidism (low levels of hormones).
• Medicines to suppress the production of thyroid hormones. Relief of the patient's condition is observed within 2-3 weeks from the start of therapy, and the course as a whole lasts up to a year. Periodic examinations are also necessary in this case - antithyroid drugs can affect the liver and immune system. At the same time, she will react with allergies or decreased immunity - an increase in the incidence of acute respiratory viral infections and other colds.
• Relief of symptoms - medications are prescribed to normalize blood pressure, heart rate and eliminate other symptoms.

In severe cases of advanced hyperthyroidism, when the thyroid gland is significantly enlarged or there are tumors in it, the doctor may recommend surgery. It removes the affected part of the gland or the entire organ. After removal, you will have to take hormonal medications for life to correct their deficiency.

Operation

In order to decide whether to undergo surgery, the patient is offered different types of treatment, and it is also necessary to decide on the volume and type of surgery, if intervention is required.

The need for surgery is not indicated for all patients and it consists of partial removal of the thyroid gland. Surgery is needed for patients in whom a single nodule or an enlarged area of ​​the thyroid gland has increased secretion. After surgery, the remainder of the thyroid gland will function normally.

Unlike the United States, in Russia surgical treatment of hyperthyroidism is used quite widely. Operations are indicated, in particular, due to oncological alertness in patients with nodular or diffuse toxic goiter, as well as in the case of diffuse toxic goiter that has not been cured with antithyroid products within 4-6 months. The frequency of malignant neoplasms of the thyroid gland has increased significantly since the Chernobyl disaster: tumors are found in 8-10% of patients who have undergone surgery on the thyroid gland.

Prevention

To maintain a healthy thyroid gland, you need to ensure that your diet contains foods rich in vitamins (especially A, groups B and C), selenium and copper. Give up bad habits, make sure you get enough rest, and don’t exhaust yourself with physical and emotional stress.

The thyroid gland is an important organ for humans. Pay attention to your health and undergo periodic examinations to notice diseases and prevent them in the early stages.

At the Kutuzovsky Treatment and Diagnostic Center you can get advice from qualified medical specialists. Our doctors have extensive experience behind them and are constantly studying modern therapeutic techniques. We use new developments to effectively treat thyroid diseases. We use promising treatment regimens with proven effectiveness.

To examine the functioning of the thyroid gland, we conduct instrumental and laboratory tests that allow us to accurately determine the source of the problem. The best equipment and highly qualified specialists are what makes the work of our center effective and beneficial for patients. Make an appointment with an endocrinologist at the Kutuzovsky Children's Hospital to receive quality medical care without queues or waiting.