Hyperthyroidism: When the Thyroid Runs Amok

The Draining Symptoms of Hyperthyroidism

The thyroid is a butterfly-shaped gland weighing between 15 and 25 grams, located in the neck below the Adam's apple. It produces hormones regulating the body – T3 (triiodothyronine) and T4 (thyroxine) – and any thyroid disorder can affect heart health, menstrual cycles, concentration, muscles, intestines, and mood.

This post explains thyroid disorders, their mental health implications, and the symptoms prompting testing and treatment. Because proper thyroid function is crucial for various bodily organs and tissues, abnormalities can manifest in numerous symptoms.

Overproduction of thyroid hormones, called hyperthyroidism (also hyperthyroxemia or thyrotoxicosis), leads to symptoms such as:

• Changes in heart rhythm (arrhythmia, tachycardia, or palpitations);
• Insomnia;
• Excessive sweating;
• Fatigue;
• Anxiety;
• Irritability;
• Muscle weakness;
• Irregular menstruation (sometimes very short or light);
• Diarrhea;
• Increased appetite;
• Hair loss;
• Hand tremors;
• Weight loss;
• Warm skin and heat intolerance;
• Difficulty reasoning and concentrating;
• Visible enlargement of the gland (goiter) or nodules;
• Agitation and hyperactivity;
• Swollen or protruding eyes;
• Brittle nails;

The Varied Origins of Hyperthyroidism

Main causes of hyperthyroidism include:

• Graves' Disease: An autoimmune disease (the body attacks itself) causing thyroid enlargement and hyperthyroidism. It can cause swollen eye muscles (bulging eyes, discomfort, double vision) and is more common in women, often affecting multiple family members.
• Toxic Multinodular Goiter: Multiple nodules in an enlarged thyroid can cause overproduction of hormones. It's often diagnosed after age 50, affecting heart rhythm, and may be present for years before becoming hyperfunctional.
• Toxic Nodule: A single nodule producing excess hormones, not hereditary.
• Subacute Thyroiditis: A disease of unknown cause, with significant thyroid inflammation, painful enlargement, and hormone release into the bloodstream. Usually resolves spontaneously.
• Postpartum Thyroiditis: 5-10% of women develop mild to moderate hyperthyroidism months after delivery, often followed by hypothyroidism. May become permanent, requiring lifelong hormone replacement.
• Silent Thyroiditis: Transient hyperthyroidism resembling postpartum thyroiditis but unrelated to pregnancy and painless.
• Excessive Iodine Intake: High-iodine substances (kelp, some expectorants, amiodarone) can sometimes cause hyperthyroidism.
• Thyroid Hormone Overdose: Excessive thyroid hormone medication. Dosage should be checked annually; never self-medicate.

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Treatment to Calm Things Down

Hyperthyroidism treatment varies depending on cause and symptom severity.

Therapies and remedies include:

• Antithyroid Medications: Reduce hormone production. Methimazole is preferred; propylthiouracil (PTU) may be used for pregnant or breastfeeding women (though it has side effects and isn't routinely used outside of pregnancy). These control, but don't cure, hyperthyroidism.
• Radioactive Iodine Uptake: Cures hyperthyroidism but usually destroys the thyroid, requiring lifelong hormone replacement.

Surgical removal or radiation necessitates lifelong hormone replacement. Other medications may treat specific symptoms (rapid heart rate, sweating, anxiety) until hyperthyroidism is controlled.

Hyperthyroidism is generally treatable and rarely life-threatening. Some causes may resolve without treatment but still require monitoring. Graves' disease hyperthyroidism worsens over time, leading to serious complications affecting quality of life, requiring prompt treatment.

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