Updated visitor guidelines. Causes of Hyperthyroidism Hyperthyroidism can be caused by a number of things: Toxic nodule - A single nodule or lump in the thyroid can produce more thyroid hormone than the body needs and lead to hyperthyroidism. Toxic multinodular goiter - If the thyroid gland has several nodules, those nodules can sometimes produce too much thyroid hormone causing hyperthyroidism.
This is most often found in patients over 50 years old. In many cases, a person may have had a multinodular goiter for several years before it starts to produce excess amounts of thyroid hormone. Graves' disease - Graves' disease is an autoimmune disorder in which the body's immune system attacks the thyroid. In some patients, the eyes may be affected. Patients may notice the eyes become more prominent, the eyelids do not close properly, a gritty sensation and general irritation of the eyes, increased tear production, or double vision.
Like other autoimmune diseases, this condition may occur in other family members and is much more common in women than in men. Sub-acute thyroiditis - This type of hyperthyroidism can follow a viral infection which causes inflammation of the thyroid gland.
This inflammation causes the thyroid to release excess amounts of thyroid hormone into the blood stream which leads to hyperthyroidism. Over time the thyroid usually returns to its normal state.
Because the stored thyroid hormone has been released, patients may become hypothyroid where their thyroid gland produces too little thyroid hormone for a period of time until the thyroid gland can build up new stores of thyroid hormone.
Postpartum thyroiditis - Some women develop mild to moderate hyperthyroidism within several months of giving birth, which usually lasts 1 to 2 months. This is often followed by several months of hypothyroidism.
Most women recover and have normal thyroid function. Excessive Iodine ingestion - Some food sources with high concentrations of iodine, such as over the counter supplements, kelp tablets, some expectorants, amiodarone a medication used to treat certain heart rhythm problems and x-ray dyes, may occasionally cause hyperthyroidism in some patients.
In most cases, the hyperthyroidism usually resolves when the supplement is discontinued. This treatment may cause thyroid activity to slow enough to be considered underactive hypothyroidism , and you may eventually need to take medication every day to replace thyroxine. Anti-thyroid medications. These medications gradually reduce symptoms of hyperthyroidism by preventing your thyroid gland from producing excess amounts of hormones. They include methimazole Tapazole and propylithiouracil.
Symptoms usually begin to improve within several weeks to months, but treatment with anti-thyroid medications typically continues at least a year and often longer.
For some people, this clears up the problem permanently, but other people may experience a relapse. Both drugs can cause serious liver damage, sometimes leading to death. Because propylthiouracil has caused far more cases of liver damage, it generally should be used only when you can't tolerate methimazole. A small number of people who are allergic to these drugs may develop skin rashes, hives, fever or joint pain.
They also can make you more susceptible to infection. Surgery thyroidectomy. If you're pregnant or you otherwise can't tolerate anti-thyroid drugs and don't want to or can't have radioactive iodine therapy, you may be a candidate for thyroid surgery, although this is an option in only a few cases.
In a thyroidectomy, your doctor removes most of your thyroid gland. Risks of this surgery include damage to your vocal cords and parathyroid glands — four tiny glands situated on the back of your thyroid gland that help control the level of calcium in your blood. In addition, you'll need lifelong treatment with levothyroxine Levoxyl, Synthroid, others to supply your body with normal amounts of thyroid hormone.
If your parathyroid glands also are removed, you'll need medication to keep your blood-calcium levels normal. If Graves' disease affects your eyes Graves' ophthalmopathy , you can manage mild signs and symptoms by using artificial tears and lubricating gels and by avoiding wind and bright lights. If your symptoms are more severe, your doctor may recommend treatment with corticosteroids, such as prednisone, to reduce swelling behind your eyeballs.
Two drugs — rituximab Rituxan and teprotumumab — are being used to treat Graves' ophthalmopathy, even though there isn't a lot of definitive evidence yet to prove that they're effective. Teprotumumab received fast-track approval from the Food and Drug Administration based on one small study. More study of both drugs as a treatment for Graves' ophthalmopathy is needed. Once you begin treatment, symptoms of hyperthyroidism should subside and you should start feeling much better. However, your doctor may recommend that you watch out for iodine in your diet because it can cause hyperthyroidism or make it worse.
Kelp, dulse and others types of seaweed contain a lot of iodine. Cough syrup and multivitamins also may contain iodine.
If you have Graves' ophthalmopathy or dermopathy, the following suggestions may help your eyes or skin:. If you've been diagnosed with hyperthyroidism, the most important thing is to receive the necessary medical care. After you and your doctor have decided on a course of action, there are some things you can do that will help you cope with the condition and support your body during its healing process.
You'll likely start by seeing your primary care doctor. However, in some cases, you may be referred immediately to a doctor who specializes in the body's hormone-secreting glands endocrinologist. Cause Graves' disease is the most common cause of hyperthyroidism. Other common causes include: Thyroid nodules. Thyroid nodules are abnormal growths in the thyroid gland that can make too much thyroid hormone. For more information, see the topic Thyroid Nodules. Thyroiditis occurs when your body makes antibodies that damage your thyroid gland.
You can also get thyroiditis from a viral or bacterial infection. At first, thyroiditis may cause your thyroid levels to rise as hormone leaks out from the damaged gland. Later, levels may be low hypothyroidism until the gland repairs itself.
Symptoms You may have hyperthyroidism if you: Feel nervous, moody, weak, or tired. Have hand tremors, or have a fast or irregular heartbeat, or have trouble breathing even when you are resting. Feel very hot, sweat a lot, or have warm, red skin that may be itchy. Have frequent and sometimes loose bowel movements. Have fine, soft hair that is falling out.
Lose weight even though you are eating normally or more than usual. Specific symptoms of Graves' disease People with Graves' disease often have additional symptoms, including: Goiter , which is an enlarged, painless thyroid gland.
Thickened nails that lift off the nail beds. Pretibial myxedema, which is lumpy, reddish, thick skin on the front of the shins and sometimes on top of the feet. Clubbing fingers with wide tips.
Graves' ophthalmopathy , which causes bulging, reddened eyes , among other symptoms. Complications Graves' ophthalmopathy is a possible complication of hyperthyroidism. If you do not treat your hyperthyroidism, you may: Lose weight because your body's metabolism is faster.
Have heart problems such as rapid heart rate, atrial fibrillation , and heart failure. Have trouble replacing calcium and other minerals in your bones, which can lead to osteoporosis. What Happens If your thyroid gland makes too much thyroid hormone , you may have symptoms of hyperthyroidism. You have a family history of thyroid problems.
People who have close relatives with Graves' disease or other thyroid problems are more likely to develop hyperthyroidism. You have an autoimmune disease, such as Addison's disease or type 1 diabetes. You smoke cigarettes. People who smoke are more likely to have Graves' disease and are more likely to have Graves' ophthalmopathy. When should you call your doctor? Call your doctor immediately if you have been diagnosed with hyperthyroidism and: You feel very irritable.
You have unusually high or low blood pressure compared to your normal blood pressure. You feel nauseated, are throwing up, or have diarrhea. Your heart is beating very fast or you have chest pain. You have a fever. You are confused or feel sleepy. You cannot breathe well or you feel very tired, which can be symptoms of heart failure. You should also call your doctor if: You develop symptoms of Graves' ophthalmopathy , such as bulging, reddened eyes.
You feel very tired or weak. You are losing weight even though you are eating normally or more than usual.
Your throat is swollen or you are having trouble swallowing. Watchful waiting Watchful waiting is a period of time during which you and your doctor observe your symptoms without using medical treatment. Who to see Health professionals who are qualified to diagnose and treat hyperthyroidism include: Internists. Family medicine physicians. Nurse practitioners. Physician assistants.
For further treatment, your primary doctor may refer you to one of the following specialists: Endocrinologist Surgeon Nuclear medicine specialist Ophthalmologist. Exams and Tests Your doctor will ask questions about your medical history, do a physical exam, and order medical tests to diagnose hyperthyroidism. If your doctor thinks you may have hyperthyroidism, he or she may order: A thyroid-stimulating hormone TSH test , which is a blood test that measures your levels of TSH.
If your TSH level is low, your doctor will want to do more tests. Thyroid hormone tests , which are blood tests to measure your levels of two types of thyroid hormones, called T3 and T4. If your thyroid hormone levels are high, you have hyperthyroidism. After you are diagnosed with hyperthyroidism, your doctor may also want to do: An antithyroid antibody test to see if you have the kind of antibodies that attack thyroid tissue.
This test can help diagnose Graves' disease and autoimmune thyroiditis. A radioactive thyroid scan and radioactive iodine uptake tests , which use radiation and a special camera to find out the cause of your hyperthyroidism.
Early detection Experts do not agree on whether adults who don't have symptoms should have a thyroid test.
Treatment Overview There are three treatments for hyperthyroidism. Initial treatment Initial treatment for hyperthyroidism usually is antithyroid medicine or radioactive iodine therapy.
Antithyroid medicines work best if you have mild hyperthyroidism, if this is the first time you are being treated for Graves' disease, if you are younger than 50, or if your thyroid gland is only swollen a little bit small goiter.
Radioactive iodine is often recommended if you have Graves' disease and are older than 50, or if you have thyroid nodules toxic multinodular goiter that are releasing too much thyroid hormone.
Radioactive iodine is not used if: You are pregnant or you want to become pregnant within 6 months of treatment. You are breastfeeding. You have thyroiditis or another kind of hyperthyroidism that is often temporary. Ongoing treatment During and after treatment for hyperthyroidism, you will have regular blood tests to check your levels of thyroid-stimulating hormone TSH. If you have Graves' disease and have been taking antithyroid medicine but your hyperthyroidism has not improved, you can continue to take antithyroid medicine or you can try radioactive iodine therapy.
If you have lots of side effects from antithyroid medicines and radioactive iodine is not an option for you, you may need surgery to remove all or part of your thyroid gland thyroidectomy. Treatment if the condition gets worse If radioactive iodine or antithyroid medicines are not working well, you may need: Another treatment of radioactive iodine. Surgery to remove all or part of your thyroid gland thyroidectomy. Prevention Hyperthyroidism caused by Graves' disease is a genetic disease that you cannot prevent.
Home Treatment Be sure to see your doctor regularly so he or she can be sure that your hyperthyroidism treatment is working, that you are taking the right amount of medicine, and that you are not having any side effects. If you are taking antithyroid medicine, take it at the same time every day.
To help reduce the symptoms of hyperthyroidism, you can: Lower stress. This helps relieve symptoms of anxiety and nervousness. Stress Management Avoid caffeine. Caffeine can make symptoms worse, such as fast heartbeat, nervousness, and difficulty concentrating. Quit smoking. If you have Graves' disease and you are a smoker, you are more likely to develop Graves' ophthalmopathy.
Quitting Smoking. Medications Antithyroid medicine is often used for hyperthyroidism, because it works more quickly than radioactive iodine therapy. You have to take the medicine for at least 1 year. Your symptoms may come back after you stop taking it. And then you have to start taking antithyroid medicine again or try a different treatment.
There are some rare side effects from the medicine, ranging from a rash to a low white blood cell count, which can make it hard for your body to fight infection. What to think about Antithyroid medicine may or may not make your hyperthyroidism symptoms go away.
The medicine is much more effective in people who have mild disease. Up to 30 out of people in the United States will have their hyperthyroidism go away go into remission after taking antithyroid medicine for 12 to 18 months.
It is not used for thyroiditis. Antithyroid medicine is used instead of radioactive iodine if you are pregnant, breastfeeding, or trying to become pregnant. Children are treated with antithyroid medicine, because experts do not know if radioactive iodine treatment is safe for children.
Treating children with antithyroid medicine is challenging. It is hard to know how much medicine they need when they are growing so quickly.
Your doctor may prescribe low doses of thyroid hormone medicine to take with your antithyroid medicine so that your thyroid hormone levels do not get too low. Surgery Surgery for hyperthyroidism thyroidectomy removes part or all of the thyroid gland. You may need surgery if: Your thyroid gland is so big that it is hard for you to swallow or breathe. You have thyroid cancer or your doctor suspects you have thyroid cancer.
For more information, see the topic Thyroid Cancer. You had serious side effects from taking antithyroid medicines. And radioactive iodine is not an option for you. You have a large goiter that radioactive iodine treatment did not shrink. You have a single, large thyroid nodule that is making too much thyroid hormone, and radioactive iodine did not effectively treat the nodule.
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