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Hyperthyroidism

Hyperthyroidism refers to the condition resulting from excess production of thyroid hormones.

Symptoms
Tiredness, anxiety, nervousness, emotional over sensitivity, restlessness, easy distractibility, compulsive purposefulness, decreased sleep, warm and moist skin, easy falling of hair, weight loss, change in appetite, feeling of warmth, ill–formed stools, changes in menstrual flow, repeated abortions, goiter, enlargement/bulging and reddening of eyes with excess watering, double vision etc. may result from hyperthyroidism in adults. In children, in addition, growth and sexual development as well as school performance may be affected. All complaints need not be present in a given patient. In fact, sometimes, the patient (especially if elderly) may not have any complaint.

Causes
  1. The commonest cause of hyperthyroidism is a condition called Graves’ disease (named after a physician), in which the patient has a smooth (i.e., no nodules) goiter and typical eye complaints (see above). The condition is caused by the production in the body of certain substances called antibodies which stimulate the thyroid and cause increase in its size and/or function. In such an individual, antibodies against other body tissues may be produced leading to other disorders.
  2. Certain drugs and iodine–containing water filters may cause the thyroid to function excessively. It is important to tell us details of all drugs (‘Allopathic’, ayurvedic etc.) that the patient is taking.
  3. One or more nodules present in the thyroid gland may function excessively and lead to hyperthyroidism.
  4. Inflammation of the thyroid gland, as after infection or delivery releases thyroid hormones which are already present inside the thyroid into the blood in large quantities and cause complaints described above. It must be stressed that in these situations, the production of thyroid hormones is not increased.
Diagnosis
Hyperthyroidism is diagnosed by estimating the blood level of thyroid hormones and TSH. As the levels in blood are extremely minute, accurate and reliable methods of estimation are of utmost importance.

Treatment
Different causes of hyperthyroidism have different treatment. It is therefore very important to find the cause before starting treatment.
  1. For treatment of graves disease, there are three treatment options, namely anti–thyroid tablets to be taken by mouth, radioactive iodine (or radio iodine) or surgery.
  2. For treatment of single or multiple nodules causing hyperthyroidism, radio iodine or surgery are the treatment options.
  3. For hyperthyroidism caused by drugs, the drug in question is withdrawn if possible.
  4. For inflammation of thyroid leading to high blood levels of thyroid hormones, treatment is aimed only at providing relief from complaints.



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