What is hyperthyroidism and how is it diagnosed?
Hyperthyroidism is a condition that leads to excessive production of thyroid hormones. These hormones increase the activity of most of the body's organs and tissues: heart rate, fat consumption, heat production... The most common cause (90%) of hyperthyroidism is an autoimmune disease called "Graves' disease" or "Basedow's disease". Antibodies directed against the thyroid stimulate it too much: the gland then produces an excess of hormones, leading to hyperthyroidism.
For every man with hyperthyroidism, there are 8 women with the condition and for every man with the hypothyroidism, there are 3 to 10 women with the condition. The disease most commonly affects people between the ages of 20 and 40, but can occur at any age.
What are the symptoms of the disease?
- Difficulty sleeping;
- Excessive sweating and hot flashes;
- Weight loss, despite an increased or unchanged appetite;
- Increased heart rate;
- Nervousness and mood swings;
- Muscle weakness;
- Diarrhea, frequent bowel movements; and
- Red, shiny and warm skin.
How is the diagnosis made?
To diagnose hyperthyroidism, the doctor often takes the patient's medical history and performs a physical exam, which generally includes an inquiry into the symptoms the individual is experiencing and a palpation and examination of the individual's thyroid gland, located at the base of the neck.
Blood tests are often used in confirming the diagnosis by measuring thyroxine and thyroid-stimulating hormone (TSH). TSH's role in the body is to stimulate the thyroid to secrete thyroid hormones, with the main thyroid hormone being thyroxine. In the common case of hyperthyroidism, the thyroid is overactive, causing the thyroid hormones to be secreted in excess. This ultimately leads to a reduction in the TSH level because the excess thyroid hormone production is interpreted by the body to mean that the production of the TSH hormone is not neccessary. Dysthyroidism is often an autoimmune disease. For this reason, antibodies are sometimes searched for in order to know the cause of the condition.
Treatments for hyperthyroidism
Physical and mental rest is a first step in recovery as the body becomes exhausted quicker with hyperthyroidism. Caffeine should also be avoided.
In order to limit weight loss, it is necessary for those diagnosed with hyperthyroidism to have an increased number of meals during the day. The individual's diet should be increased in calories when too much weight loss is experienced.
Intense physical activity is not recommended. However, when the individual is undergoing treatment, exercise, especially weight bearing exercise or sports, is recommended as it limits bone demineralization, which is a complication of hyperthyroidism.
In the case of Grave's disease, the eyes may be irritated, swollen and dry. It is therefore advisable for individuals to avoid certain factors such as wind, sun, and tobacco. Dry eyes can be soothed with eye drops. Finally, raising the head at night limits the pressure on the eyes.
In the case of Graves-Basedow disease, treatment is based on the use of drugs called synthetic antithyroid drugs. Unlike hypothyroidism, treatment is started at high doses for one to two months, then the dosage is gradually decreased until normal thyroid function is achieved. It is advisable to take them with meals.
Antithyroid drugs (carbimazole, etc.) are very effective but can cause rare and potentially serious side effects. For this reason, extreme caution should be exercised when fever, angina or infection occurs under antithyroid drugs. In case of relapse or intolerance to medication, possible treatments are surgery, preferred in young women, and radioactive iodine 131, preferred in the elderly.
Sources: Article written under the supervision of Professor Philippe Touraine, Head of the Endocrinology and Reproductive Medicine Department at the Pitié Salpêtrière in Paris
Published May 2, 2018