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Hyperthyroidism
What is hyperthyroidism?
Hyperthyroidism, or overactive thyroid, happens when your thyroid gland makes more thyroid hormones than your body needs.
Your thyroid is a small, butterfly-shaped gland in the front of your neck. It makes hormones that control the way the body uses energy. These hormones affect nearly every organ in your body and control many of your body's most important functions. For example, they affect your breathing, heart rate, weight, digestion, and moods. If not treated, hyperthyroidism can cause serious problems with your heart, bones, muscles, menstrual cycle, and fertility. But there are treatments that can help.
What causes hyperthyroidism?
Hyperthyroidism has several causes. They include:
- Graves' disease, an autoimmune disorder in which your immune system attacks your thyroid and causes it to make too much hormone. This is the most common cause.
- Thyroid nodules, which are growths on your thyroid. They are usually benign (not cancer). But they may become overactive and make too much thyroid hormone. Thyroid nodules are more common in older adults.
- Thyroiditis, inflammation of the thyroid. It causes stored thyroid hormone to leak out of your thyroid gland.
- Too much iodine. Iodine is found in some medicines, cough syrups, seaweed and seaweed-based supplements. Taking too much of them can cause your thyroid to make too much thyroid hormone.
- Too much thyroid medicine. This can happen if people who take thyroid hormone medicine for hypothyroidism (underactive thyroid) take too much of it.
Who is at risk for hyperthyroidism?
You are at higher risk for hyperthyroidism if you:
- Are a woman
- Are older than age 60
- Have been pregnant or had a baby within the past 6 months
- Have had thyroid surgery or a thyroid problem, such as goiter
- Have a family history of thyroid disease
- Have pernicious anemia, in which the body cannot make enough healthy red blood cells because it does not have enough vitamin B12
- Have type 1 diabetes or primary adrenal insufficiency, a hormonal disorder
- Get too much iodine, from eating large amounts of foods containing iodine or using iodine-containing medicines or supplements
What are the symptoms of hyperthyroidism?
The symptoms of hyperthyroidism can vary from person to person and may include:
- Nervousness or irritability
- Fatigue
- Muscle weakness
- Trouble tolerating heat
- Trouble sleeping
- Tremor, usually in your hands
- Rapid and irregular heartbeat
- Frequent bowel movements or diarrhea
- Weight loss
- Mood swings
- Goiter, an enlarged thyroid that may cause your neck to look swollen. Sometimes it can cause trouble with breathing or swallowing.
Adults over age 60 may have different symptoms than younger adults. For example, they may lose their appetite or withdraw from other people. Sometimes this can be mistaken for depression or dementia.
What other problems can hyperthyroidism cause?
If hyperthyroidism isn't treated, it can cause some serious health problems, including:
- An irregular heartbeat that can lead to blood clots, stroke, heart failure, and other heart problems
- An eye disease called Graves' ophthalmopathy. It can cause double vision, light sensitivity, and eye pain. In rare cases, it can lead to vision loss.
- Thinning bones and osteoporosis
- Fertility problems in women
- Complications in pregnancy, such as premature birth, low birth weight, high blood pressure in pregnancy, and miscarriage
How is hyperthyroidism diagnosed?
Your health care provider may use many tools to make a diagnosis:
- A medical history, including asking about symptoms
- A physical exam
- Thyroid tests, such as
- TSH, T3, T4, and thyroid antibody blood tests
- Imaging tests, such as a thyroid scan, ultrasound, or radioactive iodine uptake test. A radioactive iodine uptake test measures how much radioactive iodine your thyroid takes up from your blood after you swallow a small amount of it.
What are the treatments for hyperthyroidism?
The treatments for hyperthyroidism include medicines, radioiodine therapy, and thyroid surgery:
- Medicines for hyperthyroidism include
- Antithyroid medicines, which cause your thyroid to make less thyroid hormone. You probably need to take the medicines for 1 to 2 years. In some cases, you might need to take the medicines for several years. This is the simplest treatment, but it is often not a permanent cure.
- Beta blocker medicines, which can reduce symptoms such as tremors, rapid heartbeat, and nervousness. They work quickly and can help you feel better until other treatments take effect.
- Radioiodine therapy is a common and effective treatment for hyperthyroidism. It involves taking radioactive iodine by mouth as a capsule or liquid. This slowly destroys the cells of the thyroid gland that produce thyroid hormone. It does not affect other body tissues. Almost everyone who has radioactive iodine treatment later develops hypothyroidism. This is because the thyroid hormone-producing cells have been destroyed. But hypothyroidism is easier to treat and causes fewer long-term health problems than hyperthyroidism.
- Surgery to remove part or most of the thyroid gland is done in rare cases. It might be an option for people with large goiters or pregnant women who cannot take antithyroid medicines. If you have all of your thyroid removed, you will need to take thyroid medicines for the rest of your life. Some people who have part of their thyroid removed also need to take medicines.
If you have hyperthyroidism, it's important not to get too much iodine. Talk to your health care provider about which foods, supplements, and medicines you need to avoid.
NIH: National Institute of Diabetes and Digestive and Kidney Diseases
Kidney Tests
You have two kidneys. They are fist-sized organs on either side of your backbone above your waist. Your kidneys filter and clean your blood, taking out waste products and making urine. Kidney tests check to see how well your kidneys are working. They include blood, urine, and imaging tests.
Early kidney disease usually does not have signs or symptoms. Testing is the only way to know how your kidneys are doing. It is important for you to get checked for kidney disease if you have the key risk factors - diabetes, high blood pressure, heart disease, or a family history of kidney failure.
Specific kidney tests include:
- Glomerular filtration rate (GFR) - one of the most common blood tests to check for chronic kidney disease. It tells how well your kidneys are filtering.
- Creatinine blood and urine tests - check the levels of creatinine, a waste product that your kidneys remove from your blood
- Albumin urine test - checks for albumin, a protein that can pass into the urine if the kidneys are damaged
- Imaging tests, such as an ultrasound - provide pictures of the kidneys. The pictures help the health care provider see the size and shape of the kidneys, and check for anything unusual.
- Kidney biopsy - a procedure that involves taking a small piece of kidney tissue for examination with a microscope. It checks for the cause of kidney disease and how damaged your kidneys are.
NIH: National Institute of Diabetes and Digestive and Kidney Diseases
Liver Diseases
Your liver is the largest organ inside your body. It helps your body digest food, store energy, and remove poisons.
There are many kinds of liver diseases:
- Diseases caused by viruses, such as hepatitis A, hepatitis B, and hepatitis C
- Diseases caused by drugs, poisons, or too much alcohol. Examples include fatty liver disease and cirrhosis.
- Liver cancer
- Inherited diseases, such as hemochromatosis and Wilson disease
Symptoms of liver disease can vary, but they often include swelling of the abdomen and legs, bruising easily, changes in the color of your stool and urine, and jaundice, or yellowing of the skin and eyes. Sometimes there are no symptoms. Tests such as imaging tests and liver function tests can check for liver damage and help to diagnose liver diseases.
Pituitary Disorders
Your pituitary gland is a pea-sized gland at the base of your brain. The pituitary is the "master control gland" - it makes hormones that affect growth and the functions of other glands in the body.
With pituitary disorders, you often have too much or too little of one of your hormones. Injuries can cause pituitary disorders, but the most common cause is a pituitary tumor.
Porphyria
Porphyrias are a group of genetic disorders caused by problems with how your body makes a substance called heme. Heme is found throughout the body, especially in your blood and bone marrow, where it carries oxygen.
There are two main types of porphyrias. One affects the skin and the other affects the nervous system. People with the skin type develop blisters, itching, and swelling of their skin when it is exposed to sunlight. The nervous system type is called acute porphyria. Symptoms include pain in the chest, abdomen, limbs, or back; muscle numbness, tingling, paralysis, or cramping; vomiting; constipation; and personality changes or mental disorders. These symptoms come and go.
Certain triggers can cause an attack, including some medicines, smoking, drinking alcohol, infections, stress, and sun exposure. Attacks develop over hours or days. They can last for days or weeks.
Porphyria can be hard to diagnose. It requires blood, urine, and stool tests. Each type of porphyria is treated differently. Treatment may involve avoiding triggers, receiving heme through a vein, taking medicines to relieve symptoms, or having blood drawn to reduce iron in the body. People who have severe attacks may need to be hospitalized.
NIH: National Institute of Diabetes and Digestive and Kidney Diseases
Thyroid Diseases
Your thyroid is a small, butterfly-shaped gland in the front of your neck. It makes hormones that control the way the body uses energy. These hormones affect nearly every organ in your body and control many of your body's most important functions. For example, they affect your breathing, heart rate, weight, digestion, and moods.
Thyroid diseases cause your thyroid to make either too much or too little of the hormones. Some of the different thyroid diseases include:
- Goiter, an enlargement of the thyroid gland
- Hyperthyroidism, which happens when your thyroid gland makes more thyroid hormones than your body needs
- Hypothyroidism, which happens when your thyroid gland does not make enough thyroid hormones
- Thyroid cancer
- Thyroid nodules, lumps in the thyroid gland
- Thyroiditis, swelling of the thyroid
To diagnose thyroid diseases, your health care provider may use a medical history, physical exam, and thyroid tests. In some cases, your provider may also do a biopsy.
Treatment depends on the problem, how severe it is, and what your symptoms are. Possible treatments may include medicines, radioiodine therapy, or thyroid surgery.
Dept. of Health and Human Services Office on Women's Health
Thyroid Tests
Your thyroid is a small, butterfly-shaped gland in the front of your neck. It makes hormones that control the way the body uses energy. These hormones affect nearly every organ in your body and control many of your body's most important functions. For example, they affect your breathing, heart rate, weight, digestion, and moods.
Thyroid tests check how well your thyroid is working. They are also used to diagnose and help find the cause of thyroid diseases such as hyperthyroidism and hypothyroidism. Thyroid tests include blood tests and imaging tests.
Blood tests for your thyroid include:
- TSH. It measures thyroid-stimulating hormone. This is usually the first test your healthcare provider will order.
- T3 and T4.They measure the level of the different thyroid hormones in your blood.
- Thyroid antibodies test. It measures certain thyroid antibodies (markers in the blood). This test may help diagnose autoimmune thyroid disorders.
Imaging tests include:
- CT scans
- Ultrasound
- Nuclear medicine tests, including:
- Thyroid scan. It uses small amounts of radioactive material to create a picture of the thyroid, showing its size, shape, and position. It can help find the cause of hyperthyroidism and check for thyroid nodules (lumps in the thyroid).
- Radioactive iodine uptake test, or thyroid uptake test. It checks how well your thyroid is working and can help find the cause of hyperthyroidism.
NIH: National Institute of Diabetes and Digestive and Kidney Diseases