Hyperthyroidism

BY.HARITH RYADH

Introduction

•What is Hyperthyroidism?• “Hyperthyroidism” refers to overactivity of the

thyroid gland leading to excessive synthesis of thyroid hormones and accelerated metabolism in the peripheral tissues. The secretion of thyroid hormone is no longer under the regulatory control of the hypothalamic-pituitary center.

Other causes of hyperthyroidism can include:

• excess iodine, a key ingredient in T4 and T3• inflammation of the thyroid (thyroiditis) that causes T4

and T3 to leak out of the gland• benign tumors of the thyroid or pituitary gland• large amounts of tetraiodothyronine taken through dietary

supplements or medication

Causes

• Graves’ disease - the most common cause• A toxic nodular goitre (a goitre is an enlarged thyroid

gland)• A solitary toxic thyroid adenoma (an adenoma is a clump

of cells)• Thyroiditis (infection or inflammation of the thyroid

gland) which is temporary

Clinical Statistics

• Graves Disease is the most common cause of hyperthyroidism (60-80%) of all cases.

• Females are affected more frequently than men 10:1.5

• Monozygotic twins show 50% concordance rates• Incidence peaks from ages 20-40• Incidence is similar in whites and Asians, but is

somewhat decreased for African Americans

Symptoms of hyperthyroidism If you have hyperthyroidism, you may experience some of the following symptoms:•hyperactivity•mood swings – such as anxiety, irritability and nervousness•difficulty sleeping (insomnia)•feeling tired all the time (fatigue)•muscle weakness needing to pass stools (faeces) or urine more frequently• excess fats in your stools – which can make them greasy and difficult to flush down the toilet (steatorrhoea)

• sensitivity to heat and excess sweating • unexplained or unexpected weight loss – despite

having an increased appetite (though in a small number of cases, the increase in appetite can lead to weight gain)

• very infrequent or light periods, or periods stopping altogether

• Infertility• loss of interest in sex • If you have diabetes, your diabetic symptoms,

such as extreme thirst and tiredness, may be made worse by hyperthyroidism.

Exopthalamos in Graves Disease

Lid Lag in Graves Disease

Eyes that bulge out, or "protrude" (in patients with Graves' disease)

How To Diagnose Hyperthyroidism

• Hyperthyroidism is diagnosed based on symptoms, physical exam, and blood tests to measure levels of thyroid stimulating hormone (TSH) and a high thyroxine (T4) level indicate hyperthyroidism. Your doctor may also decide to order either an ultrasound or a nuclear medicine scan of your thyroid to see if it has nodules, or whether it is inflamed or  overactive

• Anti-thyroperoxidase antibody levels• TSH-receptor stimulating autoantibody levels (TSI

levels)

Treatments for Hyperthyroidism

References

• Hyperthyroidism: www.emedicine.com/med/topic1109.htm

• Hyperthyroidism: www.emedicine.com/ped/topic1099.htm

• Pictures from: www.thachers.org/ images/Graves.jpg