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What is hyperthyroidism?

One of the hormones produced by the thyroid gland is called thyroxine, which is released into your blood circulation and is transported to your tissues. This hormone ensures that your metabolism runs smoothly by regulating energy use, temperature and the functioning of your organs. But what happens when too much thyroxine is produced?

‘Hyperthyroidism, also known as an overactive thyroid, is caused by an autoimmune condition called Graves’ Disease. It may also be due to overactive nodules (fluid-filled lumps) or occasionally a viral infection called thyroiditis,’ says Dr Wayne May, an endocrinologist at Life Kingsbury hospital. 

Hyperthyroidism symptoms

Common symptoms of hyperthyroidism include:

  • A fast heart rate
  • Hand tremors
  • Weight loss
  • Hair loss
  • Tiredness and insomnia
  • Increased bowel movements
  • Itchiness
  • Sweating

‘A sore throat may also be a symptom, as thyroiditis can cause inflammation, which mimics a sore throat,’ explains Dr May. ‘Nodules may be prevalent in areas with low iodine in the diet.’

How is hyperthyroidism diagnosed?

Since some of the symptoms of hyperthyroidism (unexpected weight loss, excessive hunger, heat intolerance, fatigue) are similar to other conditions, a blood test helps with accurate diagnosis.

‘Diagnosis of suspected thyroid issues is via blood tests. Your TSH (thyroid-stimulating hormone) levels will be measured, including T4 (thyroxine) and T3 (triiodothyronine). If necessary, sometimes a scan like an ultrasound is also done. This helps to pick up nodules and inflammation,’ shares Dr May.

‘Thyroid uptake scans may also be used, which are done by the nuclear medicine department. For Graves’ Disease, we can also measure the responsible antibody causing the problem (anti-TSH receptor antibody),’ he explains.

If your results show a high level of the thyroid hormone and a low level of TSH, then it’s likely that you have hyperthyroidism. 

What are the risk factors for hyperthyroidism?

Since Graves’ Disease is autoimmune, there is a very strong genetic link, with other members in the family often having a thyroid problem as well. Other triggers include stress and infection that affects the thyroid.

Thyroid problems tend to affect women more than men and can occur at any age (including newborn babies). Secondary triggers in women include puberty, pregnancy and menopause. Fluctuating oestrogen levels may be the reason why women are more susceptible, coupled with a family history of the condition. 

What is the best treatment for hyperthyroidism?

‘Treatment can be in the form of tablets called Neo-Mercazole (for Graves’ Disease). Radioactive iodine and surgery are generally used for nodules but are also sometimes used in the treatment of Graves’ Disease if the nodules fail medical treatment,’ advises Dr May.

Here’s how each treatment option works:

Neo-Mercazole tablets (oral treatment): Works by reducing the amount of thyroid hormones that your thyroid gland produces.

Surgery: Involves the removal of a part of or the whole thyroid gland.

Radioactive iodine: Capsules containing radioactive iodine are taken orally and help to destroy thyroid cells that make the thyroid hormones. This causes the thyroid to shrink and the level of thyroxine in the blood is stabilised. If the thyroid gland is completely destroyed during this treatment, the missing hormone can be replaced with medication called Eltroxin or Euthyrox.

‘Cases of thyroiditis usually settle within a few weeks. The consequence of radioactive iodine treatment and surgery is often hypothyroidism (when the body produces too little thyroxine). Patients will require lifelong treatment for this condition,’ he concludes.

Note: If you suspect you might have hyperthyroidism, speak to your doctor and share your concerns.

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