Hyperthyroid stories: Patient stories | British Thyroid Foundation
Natasha – hyperthyroidism | British Thyroid Foundation
Natasha completed the London Marathon in 2019 after undergoing a total thyroidectomy (removal of thyroid gland) 18 months earlier to treat her Graves’ disease. In her candid blog, Natasha recounts the highs and lows of her journey with what she refers to as her ‘now non-existent thyroid.’
Tash’s Marathon 2019
As I awoke to the noise of my alarm, I pushed snooze as fast as I could to get back to that all important sleep as if it were just another normal day. Although this was not another normal day this was Marathon day.
Months of training, running in all weathers rain or shine. Trying out new classes to make sure that every muscle had a had a work out. Making sure that not only I could run but I was strong enough to do the distance. As the distances increased, the new aches and pains, and worry if they would last, or if in fact I had done some damage and would not be able to get to the start, also increased. The feeling of being so far away from home on foot with the “what if feeling”. The over analysing of whether I had done enough, was I doing the right training and was I eating the right foods to fuel my running? And the constant pressure of can I really do this.
Here is my story in brief to explain how I got to this point. I know we are all different but just maybe someone else may have had the same battles. It all started with my hairdresser telling that she would no longer cut my hair, the day I realised I had collected enough hair to make a voluptuous wig. And the day I went to the doctors and all they did was take my heart rate and before I knew it, I was off for my first blood test. But what I didn’t know was that this would be the first of many, many, many more to come. I don’t know about you but I had no idea we had a pretty little butterfly shaped gland in our throats that had huge control over our very existence.
As the months, and then years, went by with the weight gain and the weight loss, the levels of energy fluctuated between non-existent and very low. The mood, and the new emotions – fear, anxiety and depression; all things I had never felt before and now had to try and learn how to deal with them, and this new Tash that was appearing. I was used to feeling fear and anxiety when pushing my boundaries but not when just leaving home for work in the morning.
So four years had now passed with the medication’s (carbimazole) levels being adjusted every couple of months to accommodate my thyroid levels, praying that the dose would decrease to zero and I would become normal again. To so much joy my levels had become normal and I no longer had to take those little tiny pills. However this did not last long and before I knew it I was back at the GP picking up my prescription as before. Here we were back to the beginning; starting on the same journey, but this time I now had to consider my future treatment, did I have my thyroid removed or did I undergo the radioiodine which was far less invasive although this was not so straight forward as I had been suffering from Graves’ disease. That feeling of looking in the mirror and not recognising your own face, my eyes had changed shape so dramatically and not even recognising the person within.
I had always been a very active person, enjoying the outdoors and exploring. My main passion was scuba diving, and I used to do some quite deep technical dives. This was all a thing of the past as the fear and anxiety had taken over and now I was too scared to get in the water I had lost doing what I loved the most. My current level of activity was back and forth to the sofa for a cuppa or a dry tissue, and even at times this felt like too much. Oh and just to clarify, I had never done any running at this point.
My mind was made up: I just wanted this thing to be out of my body, and eventually my levels were right to get me booked in and under the knife. The fear on the run up was immense; in fact in describable. Not only was I dealing with that but also trying to understand which feelings were real and which were being driven by the thyroid. I have never felt so scared and alone despite having a boyfriend and a loving family. I knew that this had to be done.
I had been on a mindfulness course to try and learn how to deal with these new emotions, and as I sat outside the operating theatre, I can truly say it was a massive help. I just focussed on my breathing and all my fears and anxieties were swept away.
Up until then, I was so ignorant about anxiety or depression. I can now, hand on my heart ,say that I can sympathise and actually go so far as to say that I have helped some of my friends affected by this.
I am now thyroid-less and my new journey begins. I naively thought that once it had been removed, it would have all been a distant memory. However, this is not strictly true, this is where the challenges started. I was determined to get back to being Tash: Tash before she had thyroid issues, fun, outgoing, worry free, adventurous and up for anything.
Every day was a new challenge, but I grabbed all of them by the horns and decided to try new ones.
Once I was well enough, I really wanted to shift the weight so the obvious one for me was running, as my boyfriend is a runner so why not. I signed up for Park Run and within a couple of months I had shaved minutes off my time and I went from being able to run 100 yards to being able to run 5k. The Park Run community is amazing, everyone was so encouraging, and it gave me something to get out of bed for, otherwise sleep was always at the top of my list if I had any spare time.
From here I tried pushing myself and increasing the distances and even entered couple of races. I had one goal and that was to not be last, and I succeeded. One thing led to the next and one day at work my colleagues said the ballot is open for the London Marathon, why don’t we enter. My first thought was it’s like winning the lottery, right? A one in a million chance. By this time, I had run 10k so thought well why not I won’t get a place and I didn’t want to be a party pooper.
Your place in the London marathon – yup I got in!
The shock, the horror and I was in denial. I got a place!
Well best get running. This was a challenge that felt like it had been handed to me by someone ‘up there.’ It did not cross my mind to not do it. It was another challenge and another pair of horns to grab, and what an achievement to say that I had run the London Marathon.
The emotions up to the marathon were incredible, I couldn’t talk about the “M” word without shedding a tear or two and I couldn’t tell you why.
Praying that I had done enough and I would make it round, I am now fast approaching the start line again unable to explain my feelings I can only say I think I had all of them. Fear, joy, worry, elation, in trepidation and excitement all I had to do was get over the start line and keep running.
The crowds are truly amazing and to now finally understand when people say the crowd carries you they certainly do.
A boyfriend’s point of view
When you think you’re having a tough time and can’t see an end, think of your partner as they are going through change that you can’t understand, comprehend or sympathise with. Is it all really happening? YES IT IS.
Supporting someone through anything can be tough and misunderstood sometimes. One person’s idea of support does not necessarily support the other person’s needs. This is something I have learnt the hard way.
I haven’t always understood problems associated with thyroid disease. I can’t say I understand it now. But what I have started to learn are the struggles that come with it, not only for the person involved, but their nearest and dearest in close surroundings. The tough times we have been through; we have drifted apart through no fault of our own, but the changes Tash has been through. The anxiety, the nervousness, the depression Tash has been through. It has been such a struggle without being able to prevent it. I, on the other hand, have not changed to accommodate this and understand her troubles. The challenges she has been facing are beyond anything I can comprehend.
Tash has set goals which, in my eyes, have given her focus, determination and proof that whatever happens to you, you can fight back. The only problem is I have only seen it now and not whilst I have been pushing her to do some of these things. I know she can do them but have pushed so hard it created issues instead of support. None of this was realised by me until the emotional week leading up to the marathon Tash had chosen to conquer. My lack of support for her led Tash to decide she didn’t want me to be at the marathon to support and help. It was devastating news to me and one that brought me to back down to reality with a big thump. I haven’t been as supportive as I could have been. I haven’t realised all the struggles and strains going on. In fact I hadn’t realised a lot of things: I hadn’t asked.
The big day arrived and to my wonderful surprise Tash had asked me to head to London to help. So with an early start on Sunday morning I made my journey to London to support Tash in her biggest challenge yet.
I never believed I would be the one stressing so much on a run I wasn’t taking part in. I was trying to make sure I could get myself to so many different places out on the route to give as much encouragement over the run, cheer her on and make sure she knew support was there for her all of the way.
The mere 14 miles I covered running backwards and forwards hoping to grab that glimpse of Tash as she ran past was so joyful. Her big smile appeared through the crowd every time. 26.2 miles covered Tash’s longest ever distance run. I’m sure this challenge for her is over but the next challenge is only around the corner. I will be there for her to support her on her next challenge and hopefully every other challenge after that. All I wish is that I understood that thyroid challenge in the first place.
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A personal story of the pain and anguish of thyroid disease — hoping to help others who are suffering
By Lyn Hacker
Special to NKyTribune
A friend of mine has challenged me to write about something I deal with on a daily basis. It is my thyroid. He challenged me because January was Thyroid Awareness Month. He has also suffered from this condition, and nearly gone into congestive heart failure because of it. He wants me to state categorically, it is very serious and affects men as well as women.
That said, my old friend, there’s not enough room to write about it here as extensively, or as medically, as is needed to explain it all. There are so many intricacies to the condition, and it affects different people in different ways. But here is something to take note of: According to LifeWorks Wellness Center: “On a global scale, a staggering 200 million people have problems with their thyroid glands, with over 50 percent remaining undiagnosed. In the US alone, the instance of thyroid disease is running close to epidemic levels and equally as worrying is the number of undiagnosed or misdiagnosed cases.”
Take home lesson– if you are feeling any of the following: weight issues, bone-crushing fatigue, depression, hair loss/thinning hair, muscle aches, heart palpitations, dry/itchy skin, anxiety, brain fog, problems conceiving or carrying pregnancies, and/or chronic pain – see a good doctor and ask for a thyroid panel.
My friends on Facebook have noticed I’ve substituted a thyroid ribbon for my usual profile photo. This is because January was National Thyroid Month, and I’ve shared bits and pieces of articles about thyroid problems on my status all month long, including some helpful articles from thyroidchange.org.
But I’ve not really written about what it’s like to deal with this on a daily basis. I hesitate to write about it – I’m embarrassed by it, although I don’t know why. It wasn’t my fault. It wasn’t brought on by bad living. I’m not seeking pity. But I’m becoming more and more aware of what an epidemic it’s becoming, and how people are suffering from its affects. I feel compelled to speak up, so that maybe I can help someone else.
It’s not ‘in your head’
This disease also affects men on a large scale. But if you are a woman, prepare to meet obstacles getting the correct diagnosis and treatment, including being sent to a psychiatrist. It is sad but true, many doctors still feel it is “all in your head. ”
I am over 60 now, and beyond such foolishness.
When I was in my early 40’s, I developed Graves Disease, which is an acute form of hyperthyroidism. Manifesting in “thyroid storms,” it was a walk through Hell. My heart raced and jumped around like it was going to explode. I couldn’t sleep and my hands, (and at times my whole body), shook so badly that even strangers noticed and commented on it. (“Honey, are you okay?”).
I was working at a horse farm then. It was during foaling season and I was on the foaling crew and assisted the veterinarians with the mares and foals as needed. One vet noticed and remarked on the fact that I was unable to connect IV tubing due to my hands shaking. Jokingly he asked if I was suffering from DTs, but later pulled me aside, and in private, told me I should see a physician (he knew I didn’t drink that much!). He had recognized the signs.
I did, and that is where my problems got so much worse, because the doc wasn’t a good one. He did the first part of everything properly. He tested me for antibodies and diagnosed the Graves Disease, but that is where things went south. Without educating me at all about the condition, or offering me any other options, he recommended radiation ablation of my thyroid gland, which killed it. I did it because he had convinced my mother I could die and she was freaking out. He then sent me back to work with a dying thyroid, and finally prescribed synthroid for me without taking any blood tests. I was advised to return in a year.
Unbeknownst to me, my life had changed forever. There is this thing called TSH, thyroid stimulating hormone, that your body secretes, which tells the thyroid gland exactly how much thyroid hormones (T3/T4) your body needs to do its thing. The medication is supposed to replace that. How does the doctor know? He/she tests the TSH and hopefully some other markers. Most of the time when a person develops hyperthyroid problems (Graves Disease, Hashimoto Syndrome, etc. ), the thyroid ablation and supplemental hormone solves the problem.
But there are a few of us who have TSHs that “swing,” and by swinging, I mean swing from one extreme to the other, for absolutely no reason that I, or my “new” doctor, in the 20 years hence, have been able to figure out.
Looking for a solution
In the meantime I’ve seen three specialists, who also couldn’t offer an explanation. I’ve spent entire years hypothyroid, (dull, foggy, gaining weight, itchy, cold, apathetic), being routinely tested (more often than once a year, I might add), and having medication changes that didn’t get me back to “normal.” I’d then become hyperthyroid, (heart racing and jumping, shaky, hot, insanely hungry, brain flying through hyperspace, sleepless) and spend the next year trying to get “normal” again. 2014 was another of those years – hypothyroid from January to October, where I evened out for two months, then went hyper.
Used by permission of www. thyroidchange.org
It’s truly too painful to describe how this darkens your mind, heart and soul, how it “changes” you. I find I’m always second guessing myself, and my confidence has truly suffered. I feel like I have dissociation episodes and at times truly wonder who I am, and not in an existential sense. In a way, when you’re hypo, it is like you are slowly dying. (Without your medication, you will become comatose). Hyper, you wonder which next run of tachycardia will be your last. Worst of all is you can’t control any of it. You’re hopefully working with a doctor who truly cares, but you’re tied to a blood test and that comes down once every two months, if you’re lucky. Imagine spending a year like that. Or 20.
Lots of people do, and it’s not in their heads.
Before the ablation, when I had a problem, I solved it. Didn’t like the situation? Got out or changed it. Got fat? Lost weight. I had control over my life. For better or worse, it was up to me.
Now that most basic control has been wrenched out of my hands, and I’ll never have it again. I can gain weight on 1,000 calories a day. Or I can do every relaxation exercise I know and still shake like a leaf.
Hypo, an insidious apathy takes over, because it seems you need some sort of metabolic activity in your body and brain to actually care about things. There is the horrible brain fog you have to fight through over the tiniest little things – times when you leave a place and think you are turning one way, but instead turn another, and wind up two towns away. There is not being able to remember the name of a street where you used to live. There is not being able to remember a word you need – you plug in synonyms on Google Search to find it. Bills and appointments must be posted on a calendar, and the phone alarm has to remind you to check the calendar every day.
It’s like you’ve become one of the most inadequate, incapable people you can possibly think of, totally unable to handle or do the simplest things. Hyper, you become hyper vigilant about everybody and everything. Worrying and anxiety becomes nonstop. In short, everything you thought you were, or could be, has vanished via the next round of tests.
There is no second wind.
My doctor now would laugh at me for saying this, but I swear it’s true. It’s like you take a little pill of energy in the morning, and when it’s gone, it’s gone. As in kaput. You tire easily, and you’ll remain that tired till the next morning. There’s no spending one moment longer, nor adding one more thing in. There’s never going one more mile nor one more minute. When it’s spent, it’s spent, and you don’t recover until after you take your next dose of Synthroid.
I’m not prone to talking about my problems, especially in a public forum, but this has affected me for so long, I can’t stand the thought of others suffering in silence with it. That’s why I partnered with thyroidchange.org to help get the word out.
If any of this sounds like you, male or female, check with a doctor and get those panels done. If the doctor isn’t willing, go to another one. If your insurance doesn’t cover it, pay for it out of pocket. Find a way. Find someone who will work with you to get the answers you need, and to make the changes to regain your life. Because it is your life that’s wasting away, adrift in a sea of confusion, pain, fatigue and guilt spent over not being able to be who others think you should be, or who you think you should be.
I am so thankful for the wonderful doctor I have now, who has brought me as close as I have been, in the past 20 years, to “euthyroid, or “normal.” Good doctors are out there, though you may have to look for them.
For assistance, check out www.thyroidchange.org, which has many ways to help, including an interactive section that enables you to find the right doctor for you. These doctors have been chosen for their willingness to order full thyroid labs as well as take into account patient symptomatology.
They can help you figure it out. It’s a whole, new world.
Lyn Hacker is a Lexington native raised by Appalachian parents to be not only educated but proficient in the living arts – working very hard, playing music, growing gardens, hog farming, orchard management and beekeeping. The UK graduate has been a newspaper staff writer and production manager, a photography lab manager, a Thoroughbred statistics manager, a Bluegrass singer and songwriter, a registered respiratory therapist, a farmer, a Standardbred horsewoman, a Red Barn Radio promoter and a beekeeper. She lives on a farm in Sadieville.
My Thyroid Story
I didn’t realize I had Graves disease, because nothing really felt wrong.
Graves is an autoimmune disease that causes hyperthyroidism, a.k.a. an overproduction of thyroid hormones. It results because of an overproduction of an antibody called TSI, Thyroid-stimulating immunoglobulin, that has a similar effect to TSH, thyroid stimulating hormone. TSI antibodies cause the thyroid gland to produce excess thyroid hormone.
You may have heard of Hashimoto’s Syndrome – this is the exact opposite (hypothyroidism and the underproduction of thyroid hormones.)
I was in high school when I was diagnosed. I also have had the autoimmune disease Type 1 diabetes since I was 7 years old. Like T1D, the exact cause of Graves disease is unknown, but one of the theories around the onset of Graves is that it surfaces due to stress or an infection. An infection can trigger antibodies that cross-react with the TSH receptor. It is similar to the theory about Type 1 diabetes surfaces after an infection.
Before my Type 1 diabetes diagnosis, I had strep throat … so maybe it’s true? I was also diagnosed with Celiac about the same time I was diagnosed with Graves – I can’t remember which came first – and perhaps the stress of one caused my body to trigger the other.
I do recall being so. hot. all. the. time! I would sweat profusely every single day for no reason – it was actually super embarrassing because no matter what I did, it wouldn’t stop. Heat intolerance is one of the big symptoms of a thyroid problem, so that suddenly all made sense.
I went on methimizole, an anti-thyroid drug, and went about my merry way, not really thinking of my thyroid that much. No one ever explained to me what a thyroid does or why it’s important, so I just assumed it was no big deal. I was pretty wrong.
In January of 2013, my junior year in college, I was in New York City studying at Parsons School of Design, and I went to a new endocrinologist at the Naomi Berrie Center. In her office we talked about diabetes. When I brought up my thyroid, she gasped, reached across her desk and felt my elbows. She stood up and said, “Come with me.” She marched me out of the room and down the hall to the thyroid specialist.
“Look at this girl!” she exclaimed as she busted into the doctor’s office. “She is the PERFECT example of hyperthyroidism! Look at her eyes bulging out, how much she is sweating, her skin is very warm. She should be in front of medical students!” I was so confused as they prodded at me. They pointed out that my thyroid felt enlarged, and explained that you are only supposed to be on an anti-thyroid medication for a few years, tops. After that, if you don’t reverse back to normal, drastic action is required.
Think of your thyroid like a pendulum. Your thyroid should sit perfectly in the middle. Your body needs thyroid hormone to function – the thyroid is the boss, the car engine in your body. The little guy is what keeps your cells moving and healthy, making sure they have enough nutrients and oxygen to keep going. The thyroid hormones help with muscle and nerve function in your heart, your breathing and oxygen usage, body temperature and nervous system. It increases the utilization of nutrients, ensures normal cell growth, and keeps your body’s calcium and cholesterol levels in check. So if the pendulum is stuck one way or another, instead of in the middle, your body gets thrown off. And if you are hyperthyroid, your thyroid is eventually supposed to swing back to the middle. Mine did not.
Back in the doctor’s office, I was nervous. They were talking about radioactive iodine and surgery. Surgery?! Radioactive what?! I left shaken and immediately called my mother to tell her I’d need surgery on my neck or to drink radioactive thyroid poison. I was terrified as I stood in the windy street near the 168th Street Subway Station in Washington Heights. I felt alone and scared. I had never heard of this happening to anyone, except those with cancer. Did I have cancer?!
At home in California, I went to a surgeon at Stanford Hospital who specialized in Thyroid surgery. I had decided to get the surgery because A) My thyroid was lumpy and had nodules, and I was worried they were cancerous, and B) because I was only 21 at the time and didn’t want the extra radioactivity in my body. The doctor’s confidence and impeccable record definitely made me feel better; he explained that he would cut right in the crinkle lines of skin on my neck, so the scar would be small. He assured me that my vocal cords wouldn’t be damaged, though of course, that was a risk. All in all, I really wasn’t all that nervous for the actual surgery.
The morning of surgery I woke up covered in hives at 4 a.m. I didn’t know why (usually they result from eating gluten, but I hadn’t had any recently) and I couldn’t take any allergy meds because I needed to have an empty stomach. So I tried my best not to scratch away my skin as we went to the hospital a few hours later.
Once I got into my waiting bed at the hospital, the hives had calmed down a bit. A nurse had put some special socks on me to help my skin splints that had inexplicably also decided to join the party. But I smiled through it as I showed the doctors and nurses my Dexcom CGM and explained how to watch it during surgery. My blood sugar was doing okay but I was worried I would go low. I thought, how would they wake me up to get me to eat? (Duh Mary, they would just inject you with something to get you BG up … but my brain wasn’t thinking too clearly at 7 a.m.) I smiled and waved to my mom and they wheeled me out of the room and down the hall.
All I remember from the surgery were the moments before the anesthesiologist put me to sleep, and the moments after when I woke up groggy to a sea of concerned faces. What was going on? I wondered as they pushed a clipboard towards me and told me to sign my insulin release paperwork, which would state that I wanted to keep control over my own insulin and keep my pump on. I signed it and they looked relieved as the nurse scuttled away. Apparently, this was a document I should have signed before the anesthesia. Oops?
The doctors explained to me that as soon as I was asleep, they found me covered in hives. They gave me a steroid shot, which made my BG skyrocket to the upper 400s, and only after that did they call the endocrinologist. My surgeon had done an amazing job in spite of the other issues. He told me that they had taken the entire thyroid and para-thyroid glands out. He seemed pleased with the cut and size the scar would be, and gave me good tips for recovery. He even said I could leave the next day! Dermatology had other plans though, and kept me for another 48 hours to observe me and show the medical students my weird body.
Recovery from the surgery took awhile. I had to have lots of testing to monitor my thyroid level as they started me on a thyroid hormone, which takes awhile to get to work. I can’t remember a lot of the physical symptoms, only the visual ones, a.k.a. the scar on my neck. Again, I didn’t think a lot about how important your thyroid is.
I didn’t think about it until late 2016 / early 2017. I had been sick with a general cold, but there were days I was so exhausted I could hardly get out of bed, or where I was so dizzy upon standing, I’d almost fall over (among a host of other symptoms). My doctors weren’t doing a great job, and no one told me to check my thyroid levels. For months I continued like this, barely making it through the day. Finally, a doctor mentioned that when you get sick, your body needs extra thyroid hormone to help get it back to normal. Funny thing, that doesn’t happen when you don’t have a thyroid. So guess what? At the time I was actually dangerously hypothyroid – apparently, you should go to the hospital if you can’t get out of bed, or are dizzy upon standing. No one had told me that until now!
Fast forward to earlier this year – it happened again. I got a cold, then the flu, then an infection in my foot because my immune system was so down. I had even been taking my thyroid medicine regularly! But your body needs fluctuate, and sometimes you need more or less thyroid hormone. I ended up then getting too much hormone before finally balancing it out again. My endocrinologist and I work closely now to get my thyroid tested regularly and make medication adjustments as needed. She is the one who first told me, ten years after being diagnosed with Graves disease, that your thyroid hormone affects your insulin sensitivity! I’m grateful to work with a great doctor now, but the road here has not been smooth. Who would have thought I was at increased risk for other autoimmune diseases with having Type 1 diabetes. It’s the trifecta I never wanted, but I am learning to manage!
Learn more about Thyroid diseases.
Over Active Thyroid?? Rhian’s Story
What is hyperthyroidism?
Hyperthyroidism, or overactive thyroid disease, means your thyroid gland makes and releases too much thyroid hormone. The thyroid gland is located in the front of your neck, just below your Adam’s apple. It makes hormones that control your metabolism. Metabolism is the pace of your body’s processes and includes things like your heart rate and how quickly you burn calories.
Symptoms of hyperthyroidism include weight loss, increased perspiration (sweatiness), rapid heart rate, hand tremors, difficulty sleeping, irritability and feelings of anxiety.
In October 2016, owner of One 2 One Therapy Rhian Davies started having palpitations, rapid heart rate and anxiety. Assuming it was down to stress due to relocating her business, she didn’t see a doctor about it. By January she started to notice that she was losing weight for no apparent reason, and struggled to do her normal exercise routine of running 30-60 mins. Her heart rate would exceed 180bpm even on a gentle plod around the block, and she felt like she had nothing in the tank. It wasn’t until she almost collapsed whilst out running that she went to see her G.P who sent her for blood tests. The tests revealed she had an overactive Thyroid, which was being caused by Graves disease.
Rhian has always loved running to keep her mind and body healthy. She has previously completed 2 marathons and several half marathons for charity and the news of her condition was very hard to accept when she’s always been fit and strong. After seeing an Endocrynologist and being prescribed Carbimazole for her condition, Rhian’s rapid heart rate and palpitations are now under control. Unfortunately for her, new symptoms have arisen since being on the medication including joint pain, muscle weakness and fatigue which means that she has had to find new gentler ways to keep fit, such as Yoga and swimming. One of her new symptoms is a frozen shoulder, something that she is used to treating regularly in the clinic and is now undergoing physiotherapy treatment herself. A frozen shoulder is a common complication with thyroid conditions.
The reason for this blog is simply because the symptoms can often be mistaken for stress and Rhian wanted to share her story to make people aware of what to look out for. If you haven’t seen Rhian doing her usual events recently, you now know why. We all hope that she gets better soon so she can get back to her usual healthy and happy self and back to treating her clients as soon as possible.
She is currently under the care of an Endocrinologist at Royal Glamorgan Hospital and is hoping the medication will solve her problem. If the medication doesn’t help, they are looking at options to use radioactive Iodine, or to surgically remove her Thyroid. We have listed below some of the symptoms and causes, and hope it is helpful to anyone that thinks these issues sound familiar.
What are the symptoms of hyperthyroidism?
Hyperthyroidism usually begins slowly, so its symptoms can be mistaken for stress or other health problems. It can cause a variety of symptoms, including:
- Weight loss
- Rapid heartbeat, irregular heartbeat or pounding of the heart
- Nervousness, anxiety or irritability
- Tremors (trembling of the hands and fingers)
- Changes in menstrual patterns (usually lighter flow, less frequent periods) in women
- Increased sensitivity to heat
- Increased perspiration
- Changes in bowel patterns
- An enlarged thyroid gland (called a goiter), which can appear as a swelling at the base of the neck
- Muscle weakness
- Difficulty sleeping
- Increased appetite
Older adults may have subtle symptoms, such as increased heart rate, increased perspiration and a tendency to become more tired during normal activities.
If your hyperthyroidism is caused by Graves’ disease, you may also have Graves’ opthalmopathy, a disorder that affects your eyes. These symptoms may show up before, after or at the same time as your symptoms of hyperthyroidism. In Graves’ opthalmopathy, the muscles behind the eyes swell and push the eyeballs forward. Often, the eyeballs will actually bulge out of their normal position. The front surfaces of the eyeballs become can dry, red and swollen. You may notice excessive tearing or discomfort in your eyes, sensitivity to light, blurry or double vision, and less eye movement.
What causes hyperthyroidism?
In more than 70% of cases, hyperthyroidism is caused by an autoimmune disorder called Graves’ disease. Normally, antibodies produced by the immune system help protect the body against viruses, bacteria and other foreign substances. An autoimmune disease is when your immune system produces antibodies that attack your body’s tissues and/or organs. With Graves’ disease, antibodies produced by the immune system stimulate the thyroid, making it produce too much hormone. Doctors think Graves’ disease may run in families. It is most common among young women.
Two other common causes for hyperthyroidism include:
- Hyperfunctioning thyroid nodules. One or more nodules or lumps in the thyroid grow and increase their activity so that they make too much hormone.
- Thyroiditis. A problem with the immune system or a viral infection causes the thyroid gland to become inflamed and produce extra thyroid hormone that leaks into the bloodstream.
If you think you could have Hyperthyroidism, make an appointment with your G.P.
Patient Stories | GDATF
The following stories were graciously shared via e-mail and social media to let other patients know that they are not alone! Would you like to share your own experience with Graves’ disease, Hashimoto’s thyroiditis, thyroid nodules, or other issues? E-mail us at [email protected]!
NEW! Five Years Later: Reflections and Celebrations of a Former Graves Girl, contributed via email by Christina Aragon
I hope you are all staying safe and well during these challenging times. If you are struggling with Graves Disease/Hyperthyroidism, I wish you the very best. There is light and life at the end of the tunnel, and I hope you find my positive story uplifting. Feel free to contact me with any questions.
My story begins back in the Winter of 2011 at the age of 36. At the time, I was just starting out in my career as a school counselor, had just bought my first home and was in a new relationship. I felt like I had everything going for me. As you begin to read my story, it may initially sound like many other stories, but its not. I hit many unusual and unfortunate bumps in the road before I came to a place of wellness, peace and acceptance.
As the winter progressed, it felt like my health was starting to digress. I had trouble sleeping, I had elevated an elevated heart rate/blood pressure, my hands would constantly shake, I started having frequent panic attacks and problems with my eyes. After some extensive lab work, my general practitioner diagnosed me with Hyperthyroidism caused by Graves Disease (based on my autoimmune antibody blood work). I knew thyroid problems ran in my family, but mostly Hypothyroidism, as far as I could recall. My grandmother battled with an underactive thyroid for years.
My doctor then referred me to a well-known endocrinologist who specialize in complex cases of Graves Disease. My case was considered complex as I had an unusually high antibody count and a huge goiter that sometimes had the tendency to choke me. The right side of my thyroid was like three times the size of the left side. I was also diagnosed with Thyroid Eye Disease. Fortunately, I didnt get the bulging you sometimes see with Graves, but I had blurred vision, a gritty feel in my eyes and frequent eye infections.
My new endo and his team of course offered me the usual three choices of treatment: medication, Radioactive Iodine (RAI) and surgery. Although none of these options seemed appealing to me, I started out taking Methimazole, accompanied by beta blockers and anti-anxiety medications. When I was first diagnosed, my condition was so bad that I was taking between 12-15 pills a day and I was on 60 MG of Methimazole. This dosage is unheard of unless you are on the verge of a Thyroid Storm.which was the dark road I was headed towards. At this time, my doctors were really pushing for me to do RAI as soon as possible. The thought of RAI just didnt sit well with me this early on in the condition. The story of course gets better!
After just a couple of weeks of taking the Methimazole (60 MG), my poor body rebelled and broke down by developing severe allergic reaction of extreme joint pain in just about every joint in my body. I could barely move or walk even a short distance because my body was in so much pain. I limped when I walked and needed a cane as a walking aide. As much as I just wanted to get off the meds, I couldnt as I was warned against the possibility of going into Thyroid Storm. As all of this was happening, my mental health was getting worse (Graves Rage) along with frequent panic attacks, and an overall decline of my health was persisting. I was forced to resign at my job and pursue disability. Additionally, I lost my relationship as well as I felt I had nothing to give to anyone during my health crisis. All I could think of was trying to survive without extreme bodily pain.
Around this time, I got into a disagreement with my endo as they were pushing RAI constantly, and I just didnt feel ready for it. So, me and my poor painful body secretly searched for a new endocrinologist. By the time I met with my new endo, she was like a breath of fresh air. She didn’t push RAI and recommended I try Propothyrocil (PTU) for a few months to see if remission was possible within two years.
Over the next year, my health improved while taking the PTU. I was living a healthier lifestyle by exercising more and eating healthier. Like I said, things were great for about a year and a half until we started to decrease my PTU. Upon decreasing my PTU, my Graves flared up with a vengeance. PTU has a black box warning and its not meant to be taken long-term at higher dosages. For the first time, I seriously started thinking of submitting to RAI. I completed the uptake scan (RAI 123) with the nuclear medicine doctor. We discovered that my TSH, T3 and anti-body count were so abnormally high, I was at risk for Thyroid Storm again. So, I submitted to the RAI treatment (131) at 15 mc, and didnt really have a reaction. I had nightmare stories about RAI and its side effects, but it felt like nothing to me. I didnt turn bright neon green/yellow and none of my electronics sparked from nuclear contact. I spent a week home alone mostly reading and watching Netflix while I wondered what was occurring in my newly radiated body.
Fast forward six months and the RAI hasnt worked. Im still on PTU and my thyroid levels are up and down. I could sense my doctors frustration, so she recommended another round of RAI. This idea wasnt sitting well with me so I went for a second opinion. I actually went back to my original endo with some slight embarrassment considering I didnt really leave on the best terms. They welcomed me back with open arms and ran some blood work. Interesting enough, I have developed Hashimotos Disease and my liver enzymes are elevated (possibly due to the prolonged use of PTU). Now I will need block replacement therapy (which is complicated in itself) and I might have to get off of PTUwhich I cant live without. My endo then surprised me and said based on my high antibody count and extremely large goiter, he didnt believe that another dose of RAI would be appropriate. In fact, if I did it again, I might be looking at doses in the amount given to thyroid cancer patients. He then recommended a Total Thyroidectomy surgery with one of the best endocrine surgeons in the state. The thought of this surgery just terrified me!! I remember being a child/teenager and watching action/horror movies watching people get their throats slashed and thinking this is the worst way to die, and nobody will ever be able to place a sharp object near my neck. Although it was my worst fear, I was comforted in the fact that I have exhausted all treatment options for this disease. I had literally reached the end of my rope, and desperately needed this surgery to improve the quality of my life, lengthen my life and possibly save it! The pressure this disease was putting on my heart and liver was no longer worth it.
Over the next couple of months, I prayed about this impending surgery and interviewed various surgeons for the job. I ended up hiring my endos recommendation for a surgeon. I felt instantly comfortable with him and he had a ton of experience with complex cases of Graves Disease. Unfortunately, two weeks prior to my surgery I got really ill and ended up in the ER when my thyroid was swelling up and choking me, not allowing me to clear my lungs. I knew then I needed to have the surgery as soon as possible despite my fear of going under the knife. I had just turned 40 years old and wanted a brand new lease on life so I had the surgery on March 9th, 2015 at St. Josephs Hospital in Phoenix, AZ. It was an instant success with no surgical complications and a pleasant hospital stay. I was placed on hormone replacement (Synthroid) right away. I had minimal scarring post-surgery. I would highly recommend my surgeon over and over again. So, if anyone needs thyroid surgery I the Phoenix area, please PM me and I can refer you to this excellent surgeon.
Post-surgery, it has taken me a few years between trying Synthroid and natural thyroid meds (e.g. Armour Thyroid, etc.) to get stabilized. Im finally stabilized and at a point where I feel pretty good or lets say I have found my new norm. Although Ive gained about 10 lbs. since being thyroid less, and my weight still seems to fluctuate a bit. I think my biggest grip since being hypothyroid is how easily I tire sometimes as some days/nights are worse than others. I continue to eat well, exercise regularly, get plenty of rest and keep my stress levels down, which really helps. Overall, I’m feeling pretty good now and if I had to do it all over again, I dont think I would have done anything differently. Educating myself on thyroid disease, acknowledging, understanding and accepting the disease has helped me tremendously during the healing process both physically and mentally. I have lived and learned (sometimes the hard way), but I feel like there are no what ifs or bargaining thoughts as I have taken every appropriate route and crazy turn to end up where Im at alive and healthy thank be to God. Here I am 5 years later as happy and healthy as can be. Here’s to 5 years of being thyroidless and overcoming Graves Disease!!
The Journey to Thyroid Surgery
November 2015, I was diagnosed with Graves’ disease. Before that, I never put that much thought into the enlarged gland in my neck, which I thought was a result from my high metabolism and my vigorous physical activities. I kept telling myself, “I’ve been playing sports since I was 4 years old. I’m fine”. Last year when I noticed a visibly large lump and that my energy levels were low while doing my offseason football training in Atlanta, I made a quick phone call to my mother. She lovingly demanded all the way from the DMV area [DC/Maryland/Virginia] to stop what I was doing and to go get a full physical. Thank goodness for Urgent Care facilities.
As a former athlete, getting physicals was of the norm to be able to play sports…to this day I still live and breathe football. I’ve sustained injuries along the way that required surgeries, a collapsed lung, torn ACL and Meniscus. The latter, hindering my promising opportunity to play in the NFL. The post-surgery recovery and leadership adversities going into my senior year of college football proved to be a trying and dark time in my life.
Adversity for most is perceived as a hindrance, however in my life, it has been a constant motivation. A humble and grateful product of a single mother household that endured some harsh avenues, being a father figure and role model to my little sister, and having a father (a former 12 year NFL veteran and current NFL Coach) choosing not to have a relationship with me…adversities have only made me stronger along the way.
Just as being diagnosed with Graves’ disease, it is a health adversity, and one that I embrace. This season of my life will afford me the opportunity to learn more about the disease, the most common cause of hyperthyroidism. In turn, I have the amazing opportunity to become a unique advocate in bringing awareness of Graves’ disease not only for my generation, but for all people who have been diagnosed or know someone who has.
I was initially prescribed methimazole to see if my levels would decrease. In almost a year that I’ve been on the medication and a few ultrasounds along the way, my levels have not decreased. Per my pre-consult with Dr. Shatul L. Parikh of Northwest ENT and Allergy, my surgery for thyroid removal will take place on Thursday, September 29, 2016.
We all endure adversities, no one’s journey is easy. Graves’ disease is the 5th quarter in my game of life, and all I can do is win.” – Jamal Londry-Jackson. Pictured above with his mother Kathryn, aka “Mama Kat”.
My Diagnosis Story, contributed by Emma, age 17. Click here to read.
“After I was out of a 5 night stay in the hospital, including a night in an ICU setting, and once I was on my feet again, I was told that I could have died, if I didn’t get any treatment when I did. I would either have a stroke or a heart attack from my heart going so fast.”
Living with Myasthenia Gravis and Graves Disease, contributed by Judy Sonkin – Click Here to Read
“I don’t know why I have this disease and I never will. I must not question that, as it won’t bring me to a better place.”
Gravely Ill, contributed by Nancy Austin – Click Here to Read
“I am now more assertive with doctors, and no longer see myself as a recipient of healthcare, but rather a partner in my health care.”
My Graves’ Story, contributed by Christine Althaus – Click Here to Read
“The next day I received a call from my Dr.’s nurse, and she flat out told me “we think you have Graves’ disease”. Imagine my shock! A disease, what are you talking about? Graves, who names something that?”
“Being diagnosed was actually a little bit of a relief after a year of hospital trips and being misdiagnosed as having anxiety. That is, until you google the disease and find a whole bunch of scary information and quickly realize the severity of a chronic illness. I found it very hard to find any blogs, sites, support groups that focused more on the coping, managing, and encouraging rather than a lot of complaining and negativity. After living with Graves for three years, I can see both sides of this very well. It is chronic, it is hard to “manage”, and even more hard to explain to others, especially those closest to you, why you are so damn easily irritated. Not “looking” sick but feeling terrible…it’s tough. Very. The cardiac problems seem to be the worst for me and week to week is a roller coaster, a long list of other chronic bothersome issues are always with me but I have come to terms with it for the most part (this is me being positive). It could always be worse, I like to say.
Stress is a major trigger and managing that is my new life project. Keep your thoughts positive and your peace close. Be gentle with yourself. Best to us all…”
K.C.T. (via Facebook)
“I was diagnosed last year. Thyroid levels are now in control but eyes are red and hurt. Pressures are normal. Doc says to use drops and ointment. I am going thru the active inflammation phase of graves eye disease. It is a horrible experience!”
T.P.M. (via Facebook)
“I had first symptoms at 27 but not diagnosed until 40…. Because I’m not skinny. Finally they diagnosed me as Parkinsons because tremors were beyond bad. Then a new doctor ran some bloods just for interest. My levels where off the charts, specialist had never seen such high levels. They were amazed I hadn’t gone in to Cardiac Arrest. 2 years on levels are still extremely high and can not get heart rate under 120 p/m. What fun. My symptoms are tremors and high heart rate, eyes are good but I’m not skinny, wouldn’t mind the skinny bit. And sleep is very rare.”
P.P. (via Facebook)
“I started having symptoms at 17 and was told by countless doctors that there was nothing wrong with me – a few even told my mom I was faking and to take me to a counselor. Finally diagnosed at 21, took meds for a while until the heart palpitations and eye issues became overwhelming, then had RAI. It was tough for the first year with levels and symptoms all over the place but I’m stable now unless I get really stressed. It’s so nice to read other’s stories and know that you are not alone, which is how most of us feel when we go so long being misdiagnosed and then are diagnosed with a disease we’ve never even heard of.”
S.R.S. (via Facebook)
Graves’ Disease in a Young Boy: Kade’s story
All those things started happening to Kade gradually over the spring and summer of 2015. His mother, Kate, says she thought, “He’s 4 and running all over the place. That’s what little boys do. And he’s always hot, even in air conditioning, but it’s summertime. He’s eating an unbelievable amount of food, but he’s probably having a growth spurt.”
Kade’s heart was beating fast even when he was watching TV or playing quietly with toys. But his mother thought it was his asthma medication, which has a potential side effect of rapid heartbeat. Then he began misbehaving, which wasn’t like him. And he started barely being able to make it to the bathroom, even though he was a kid who never had accidents. Kate became concerned this was more than just typical preschooler stuff.
At Kade’s 5-year well visit at CHOP Primary Care, High Point, his pediatrician, Richard Santos, MD, ran a urine test and, later, some blood tests to try and figure out if there was a medical explanation for the changes in Kade’s behavior.
“He called me at 7:30 Monday morning,” Kate says. “He told me, ‘Kade is going to be OK, but his thyroid is out of control.’” The moment Kade’s blood test results came in, Santos had called the Pediatric Thyroid Center at Children’s Hospital of Philadelphia to make an appointment. “Dr. Santos knew he had to get Kade seen ASAP,” she says, “and the Thyroid Center fit him in quickly.”
Kade is a bit of an anomaly. The truth is, if those symptoms had happened to a teenage girl, it wouldn’t be a leap to consider hyperthyroidism as a potential diagnosis. Females are five to 10 times more likely than males to have Graves’ disease, the autoimmune form of hyperthyroidism. Onset of Graves’ disease is much more common during adolescence, although the number of children under 10 years at the time of diagnosis has increased over the last decade.
Graves’ disease, which affects approximately 1 in 10,000 children in the United States, is the most common type of hyperthyroidism. It occurs when a person’s immune system develops antibodies that attach to the thyroid cells, causing them to produce an overabundance (the “hyper” in the name) of thyroid hormone.
Interestingly, several members of both Kate’s extended family, and her husband’s, Mike’s, family, had been diagnosed with autoimmune thyroid disease. But they all had hypothyroidism, known as Hashimoto’s thyroiditis, a condition where their thyroid doesn’t produce enough thyroid hormone.
For now, disease is under control
Once Kade was diagnosed with Graves’ disease, Andrew Bauer, MD, Director of the Thyroid Center, spent time explaining how the disease works and the course of treatment. The initial step is to start a medication, which works by lowering the amount of thyroid hormone.
As Kade’s thyroid hormone production returned to normal, so did his gentle personality and (mostly) good behavior. Most patients will see a return to baseline, with the majority of their symptoms, including attention difficulties, anxiety, increased appetite, weight loss, fatigue and others, resolving.
For some, the course of the disease is very predictable; however, for some there are ups and downs even when the child follows the treatment plan.
“I can tell in a hurry,” says Kate, when his thyroid hormone levels have increased. “He gets hot, and he gets very naughty and doesn’t listen. He’ll be doing really well for a while and then the numbers spike and the symptoms come back.”
During those periods, Kade musters his self-control while he’s in school and then lets loose once he’s home for the day. “He’s bouncing off the walls,” Kate says. “He tells me, ‘I try so hard to be a good boy at school.’ He really wants to please his teacher, so I understand.”
For the last six months or so, Kade’s Graves’ disease has been under control and so have his symptoms. That’s a huge relief for the family.
When Graves’ can’t be managed with medication
Although Kade is doing well, it has been more than three years since his diagnosis, and his thyroid stimulating antibody levels are still elevated. During each quarterly clinic visit, Dr. Bauer reviews the chances that Kade’s Graves’ disease will go into remission, an event that happens in approximately 20 percent of patients.
“Unfortunately, even with the best of care, there are no medications or changes in the diet that increase the chances for a patient to achieve remission,” Dr. Bauer says. “People have tried supplements and even gluten-free diets, but — as of now — no data shows these efforts increase the chances for remission. It is a matter of luck.”
Remission is most likely within five years of diagnosis. So, if the child is well- managed, it’s reasonable to wait to see if they go into remission. However, if there are frequent ups and downs in thyroid hormone levels and the associated adjustment in medication dosing disrupts a patient’s daily activities, the medical team will consider moving toward definitive therapy sooner rather than later.
Options for definitive treatment include either surgically removing of the thyroid (thyroidectomy) or destruction of the thyroid using radioactive iodine (radioactive iodine ablation). The choice for if, when and which form of definitive treatment is individualized for each patient.
Energy level still high; kind heart returns
The medication hasn’t zapped Kade’s energy. He is constantly playing sports with his 6-year-old brother Alec. The boys stay busy with street hockey, basketball, soccer, flag football, karate, tennis and golf. Little sister Noelle, 3, tries to keep up with her brothers. “It’s busy around here, but a lot of fun,” Kate says.
Kade sees school as a learning adventure. “He loves reading and loves math,” his mom says. “He loves everything and wants to do everything. He wants to learn guitar and piano and Mandarin. That’s just how he is.”
He has handled having Graves’ disease with a maturity well beyond his 8 years, and his family remains cautiously optimistic remission is possible.
“He acts like it’s not a big deal,” Kate says. “He doesn’t think about it or talk about it. He takes his medicine every morning in some applesauce. He’s sweet and kindhearted. That’s when I know his Graves’ disease is under control, when my sweet boy with his heart of gold is back.”
Thyroid Cancer: My Story | Columbia University Department of Surgery
In the fall of 2011, three months after my wedding, I began to experience some strange health issues including an irregular heartbeat and panic attacks. I was just 31 at the time, and I have always exercised regularly, eaten a well balanced diet, and have been very healthy. Since we had just recently moved to New York from Maine, my husband and I had not yet found a new doctor, so it was not until January 2012 that I saw my new primary care provider. He could not find anything via physical examination or testing to cause my symptoms. Fortunately, he did not give up looking. Although the results of my thyroid blood test had been normal, he observed that my thyroid felt perhaps a little bit swollen, so he sent me for an ultrasound of my neck. To my great surprise, my thyroid was enlarged and had multiple nodules growing on both sides of it. Soon after, a biopsy confirmed that I had thyroid cancer.
My initial reaction to the “C” word was panic and fear. But once I met with Dr. Lee, I was reassured that this was just going to be a bump in the road of life. I underwent a complete thyroidectomy in March 2012, and the only required treatment afterwards was a radioactive iodine pill. My symptoms completely disappeared, and a few months after surgery, my tiny 1-inch incision faded away.
I wish I could say my story ended there, as it does for many people, but mine continued. After a year of good health, regular visits to my endocrinologist, and new routine of taking my Synthroid pill each morning, it was discovered through a follow-up neck ultrasound and biopsy that the cancer had come back in one of the surrounding lymph nodes. So at the end of June 2013, Dr. Lee performed my second surgery, a Modified Radical Neck Dissection. During this procedure, he removed over 20 lymph nodes from the right side of my neck. It was a more invasive procedure than the first, but you wouldn’t know it by looking at my incision site. My scar is longer now, but already has faded so much it is virtually unnoticeable. I will again be taking a radioactive iodine pill the end of this month to complete my treatment. But I feel great and I have returned to my daily routines.
I am so thankful for all of my amazing doctors and my incredibly supportive husband, family, and friends. They all made this experience much easier for me to get through. Dr. Lee was a large part of the reason I have gotten through this twice, knowing that everything would be ok in the end. During my office visits, he would sit with my husband and me until we had run out of questions to ask, answering each one thoroughly, always patient and with a smile. With him, I truly have had the very best care!
My fingers are crossed that this will be the end of it, and the only reminders of this life event I will hopefully have are my faded scar and the pill I take each morning.
Learn about thyroid cancer and its treatment at the Columbia Thyroid Center.
90,000 Hyperthyroidism – why it develops, how it manifests itself, general principles of treatment
Symptoms and treatment of hyperthyroidism of the thyroid gland
Excessive hormonal activity of the thyroid gland – when the organ produces too much of the hormones thyroxine and triiodothyronine – in medicine is called hyperthyroidism. The second name of the disease is thyrotoxicosis or diffuse toxic goiter. It is characterized by an accelerated metabolism and requires long-term therapy.
Causes and symptoms of pathology
The disease develops due to the progression of any pathology. Hyperthyroidism in men and women can be caused by:
- the formation of nodules in the tissues of the thyroid gland;
- benign and malignant tumors of the pituitary gland;
- inflammation of the thyroid gland – thyroiditis;
- hormonal diseases of the ovaries;
- Dysfunction of the prostate gland.
Hyperthyroidism can develop with prolonged use of drugs containing iodine. Separately, the congenital form of the disease is considered, which can develop due to problems with the thyroid gland in a pregnant woman or due to a hereditary factor.
Symptoms of thyroid hyperthyroidism in women and men are quite intense:
- constant trembling of the upper limbs;
- violation of the psycho-emotional background – irritation, tearfulness, mood swings;
- heart rhythm disturbance;
- amenorrhea – absence of menstruation without pregnancy;
- decreased sex drive in men;
- Gynecomastia – swelling of the mammary glands in men.
Signs of hyperthyroidism in children are more pronounced – newborns immediately have a characteristic facial expression with bulging eyes, a slightly open mouth, and an enlarged tongue. But in old age, the clinical picture of the disease may be absent altogether – hyperthyroidism occurs in a latent form.
No endocrinologist can make a diagnosis based on patient complaints. To confirm the verdict, the patient must undergo a full examination.As part of the diagnosis of hyperthyroidism, the following is carried out:
- laboratory blood test;
- ultrasound and computed tomography of the thyroid gland;
- assessment of the activity of individual parts of the organ – scintigraphy;
- thyroid biopsy.
The most informative diagnostic method is a blood test for TSH – with hyperthyroidism, the level of hormones will be very high. If there is a suspicion of a benign or malignant tumor in the thyroid gland, then more complete information about neoplasms can be obtained only after a histological examination of fragments of pathologically altered cells.
Treatment of hyperthyroidism of the thyroid gland
If the disease is diagnosed at an early stage of development, then the patient is selected nutrition and diet – with mild hyperthyroidism, this is the main method of restoring thyroid function. It is necessary to reduce the amount of iodine-rich foods in the menu, and in some cases they are completely excluded. Diet food is selected on an individual basis – much depends on the patient’s weight, concomitant pathologies, age.
Of the medications, thyrostatic drugs are prescribed, which reduce the activity of the production of hormones by the thyroid gland.With the right combination of diet and drug therapy, positive dynamics can be achieved in a short time. If hyperthyroidism was diagnosed at a late stage of development, then the patient will be recommended to take specific medications for life.
Treatment of hyperthyroidism of the thyroid gland takes place on an outpatient basis. In case of severe intoxication of the body with hormones, the patient is hospitalized. In severe cases, the doctor prescribes radioiodine therapy – the use of iodine preparations that can destroy abnormal cells of the thyroid gland.This therapy has many side effects, it is poorly tolerated by patients and requires constant monitoring by endocrinologists.
If drug therapy does not give positive results, the doctor may prescribe a surgical intervention. A malfunctioning part of the thyroid gland is excised for the patient. If you had to remove a large part of the organ, then there is a high risk of developing hypothyroidism – insufficient intake of hormones into the body. In this case, the patient is prescribed lifelong substitution therapy.
How to treat hyperthyroidism during pregnancy is determined only by a gynecologist. If the endocrinologist does not see a threat to a woman’s health, then it will be possible to get by with a diet. The choice of drugs is carried out after assessing the real risks for the expectant mother and fetus.
How is subclinical hyperthyroidism diagnosed, what are the features of the course of the disease in the elderly and adolescents – you can find out about this on our website https://www.dobrobut.com/.
Hyperthyroidism from uncontrolled intake of large amounts of thyroid hormones or iodine
The clinical picture of the disease consists of a triad of main symptoms.These include tachycardia, goiter, and exophthalmos. Patients complain of increased irritability, difficulty swallowing, interruptions in the heart area, constant diffuse sweating. Symptoms also include a feeling of heat, trembling hands, sudden weight loss, changes in handwriting, shortness of breath, and muscle weakness. Lacrimation and photophobia may also occur.
Changes in the emotional state are characteristic. Patients complain of irritability, a tearful state, poor sleep, worse tolerance to high temperatures in the external environment, general weakness, a rapid degree of fatigue, tremors of the limbs.Frequent pain in the cardiac region.
A patient with hyperthyroidism also has characteristic external signs. Human skin is warm and moist, there is an angry look. The subcutaneous fat layer is poorly expressed.
Disorders caused by the thyroid gland stimulate the development of tachycardia and increased systolic pressure. The volume of the heart per minute can increase up to 30 liters per minute. At the same time, the heart sounds are loud, and a systolic murmur is clearly heard at the apex. In the case of severe forms of hyperthyroidism, there may be disruptions in cardiac activity.These factors can cause heart failure, as well as tachycardia and atrial fibrillation. In addition, it is also possible to enlarge the liver, the appearance of an edematous syndrome, reaching up to the anasarca, as well as moist and fine bubbling rales.
In almost half of the cases, the disease affects the digestive system. In the case of mild to moderate severity, appetite increases. In the course of the development of the severity of the disease, the stool becomes liquid, since peristalsis increases, achilia occurs, and the exocrine function of the pancreas decreases.In addition, spastic contractions of the stomach and intestines are possible, provoking pain syndromes. Such conditions can be easily confused with an attack of acute appendicitis, pancreatitis, gastric ulcer or renal colic.
With the disease, all basic functions of the liver are also impaired. The development of toxic hepatitis begins, turning into cirrhosis of the liver and liver failure. Often the reproductive system is also affected. Women often suffer from menstrual dysfunction, manifested in the form of amenorrhea.This can often lead to infertility. In men, the level of libido decreases and the development of impotence begins.
Violations manifested by the organs of vision, the so-called exophthalmos. Its signs are glitter in the eyes, as well as a wide opening of the eye slits with the formation of a white strip located between the iris and the upper eyelid itself. The flashing becomes infrequent and incomplete. The ability to fix the gaze on a separate object located at a close distance from the patient is violated.There is a lag of the upper eyelid from the eye iris during fixation of the object with a gaze. It is necessary to correctly distinguish between disturbances on the part of the organs of vision in the case of hyperthyroidism and in other endocrine pathologies. The extreme degree of development of hyperthyroidism is a thyrotoxic crisis. This condition is severe and can be fatal.
Conservative therapy includes taking antithyroid drugs, beta-blockers, as well as tranquilizers, sedatives and iodine preparations.In the absence of the effectiveness of therapy, surgical treatment is used.
Medicines that block the synthesis of thyroid hormones include 0.01 gram mercazolil, used two to four times a day. You should strive to achieve an euthyroid state in which the pulse has a normal frequency and filling, and body weight is stable. In addition, cardiac abnormalities and neurological disorders should disappear. Upon reaching this state, maintenance doses of 0.005 grams are taken once every 2 days, or once every three days for two years.If the patient’s condition has not improved, surgical treatment is used.
The implementation of treatment with antithyroid drugs should be correctly combined with the appointment of beta-blockers, due to which the clinical recovery of the patient can be brought closer. Beta-blockers are indicated for patients with persistent tachycardia, extrasystole and atrial fibrillation.
For greater stabilization of the healing effect and protection against thyroid-stimulating antibodies, as well as to reduce the content of thyroxine and triiodothyronine, lithium carbonate is used at 0.9-1.9 grams per day.
A positive effect is also given by the appointment of tranquilizers, such as sibazone, phenazepam, tazepam or nosepam, as well as various sedatives.
Surgical treatment of the disease requires specialized training for two or more weeks before reaching the euthyroid state. In particular, thyrostatic drugs are used for this. Improvement of cardiac activity is carried out with the use of digitalis drugs and beta-blockers. Contraindications to surgical treatment are: decompensation of the system of internal organs, severe diffuse toxic goiter, violation of the cardiovascular system, chronic renal and hepatic failure, various types of mental disorders.
During the operation, the following complications are possible: opening of bleeding, air embolism in case of damage to large veins, damage to the recurrent nerve, removal or damage of the parathyroid glands, which leads to the further development of a hypoparathyroid state.
In case of trauma to two recurrent nerves, acute asphyxia may occur. This acute state of respiratory failure requires immediate tracheal intubation and tracheostomy.
First of all, if you experience the symptoms described above, you should contact the endocrinologist .Even if you are confident in the diagnosis, make an appointment to clarify the most effective treatment regimen.
You can sign up for a consultation with an endocrinologist in the city of Novosibirsk at any time convenient for you!
90,000 Treatment of thyrotoxicosis – Docrates
In addition to the treatment of oncological diseases, Docrates Clinic provides treatment of thyrotoxicosis (hyperthyroidism) with encapsulated radioactive iodine (I-131) .
Radioiodine therapy is a method widely used in Finland that allows non-operative elimination of thyrotoxicosis – Graves’ disease (excessive production of thyroid hormones), which occur with diffuse or nodular toxic goiter .
When the drug is taken, radioiodine accumulates and acts in the thyroid gland itself. Beta radiation radioiodine penetrates into the thyroid tissue and suppresses its function, which leads to a decrease in the production of hormones and a decrease in the volume of the thyroid gland. The goal of treatment is to restore normal thyroid function. As a rule, to achieve the desired treatment result, it is necessary to conduct a single radioiodine therapy . In rare cases, a second course of treatment may be required.
In some cases, after radioiodine therapy , the patient may experience hypothyroidism (insufficient production of thyroid hormones), such patients are prescribed a substitute for the T4 hormone – L-thyroxine.
After completing treatment , the patient must follow the mandatory precautions. For example, refrain from communicating with children and pregnant women. Detailed recommendations and precautions are given to the patient when contacting the clinic.
Contraindications to treatment are pregnancy and breastfeeding of children.
At Docrates Clinic , treatment with radioiodine is carried out in the direction of an endocrinologist. It is also possible to make a referral in the clinic itself. Each patient is assigned an individual dose of the drug, depending on the volume of the thyroid gland, hormonal parameters and other factors.
The patient sends a request to the clinic with the necessary medical documents.The doctors of the clinic consider a clinical case, after which the patient receives an answer about the possibility of treatment, a dose of of radioiodine is prescribed and the date of arrival is agreed. Before the start of treatment , the clinic staff will send the patient additional information about the treatment, instructions for preparing for treatment and further precautions.
When the patient is discharged from the hospital, the radiation background is measured and the documents necessary for passing the border control are issued.
We would like to draw your attention to the fact that after 90,073 treatment, performed at the Docrates clinic, the patient does not need to dispose of his clothes. During the treatment, you can bring your phone, computer, etc. The patient’s personal belongings do not accumulate radiation and remain safe.
Cost of treatment with radioiodine
90,000 Subclinical hyperthyroidism associated with deaths from cardiac arrest
At the 2013 Congress of Endocrinologists in Copenhagen, Denmark, the results of a large study of more than 500 thousand patients were presented, which indicate that subclinical hyperthyroidism increases the risk of death by 20% from causes related to the cardiovascular system, primarily fatal cases of cardiac arrest.
Dr. Christian Zelmer of Gentofte University Hospital, Hellerup, Denmark, received the Young Researcher Award for his research on April 29, 2013, and in an interview he stated: “The main finding is a 20% increase in the risk of death at all levels of hyperthyroidism, including overt and subclinical as well as in euthyroid patients, those in the lower thyroid stimulating thyroid stimulating hormone group. ”
Zelmer hopes that treating therapists and family doctors will take this issue into account.“I think there is a growing awareness that this is a factor that plays an important role and that many of these patients will be referred to endocrinologists for specialist evaluation,” he said. “It should be remembered that if a patient in the family has any of the relatives having any thyroid problems or any signs of thyroid problems, they should be evaluated. Their therapists should be aware that any symptom of an abnormal the functioning of the thyroid gland can affect the state of the cardiovascular system, and must act accordingly. “
Zelman added that the results of his study are highly correlated with those noted earlier, but the previous studies were quite small, with a maximum patient population of 50,000; 10 times more people took part in this study. The link between overt hyperthyroidism and cardiovascular mortality has been well established in the past, but the news is the link to subclinical thyroid disease.
Zelmer and colleagues investigated the risk of cardiovascular mortality and mortality from any other cause in relation to subclinical hyperthyroidism among patients examined from 2000 to 2009 in Copenhagen, Denmark, who had a thyroid blood test.The information was obtained from a nationwide registry. Patients with a history of thyroid disease or related treatment were excluded. The risk of cardiovascular mortality was analyzed using Kaplan-Meier curves and Poisson regression models to estimate the likelihood of disease occurrence (IRRs).
Of 574,595 patients included in the study (mean age 48.7 years; 39.1% men), 95.9% were euthyroid, 1603 (0.3%) had overt hypothyroidism, 11,834 (2.1%) had subclinical hypothyroidism, 3967 (0.7%) had overt hyperthyroidism, 6264 (1.1%) had subclinical hyperthyroidism.
Zelmer explained that patients with subclinical hyperthyroidism do not necessarily have symptoms; they just need to be seen more often.
The percentage of cardiovascular mortality increased in the case of subclinical hyperthyroidism of the second level with a probability of IRR 1.24 for patients with a TSH index <0.1 mU / L and a probability of IRR 1.21 with a TSH of 0.1 to 0.2 mU / L and a normal level of free thyroxine.Patients with TSH <0.1 mU / L "were expected to be at increased risk. Even patients with" normal "TSH levels (0.2-0.4 mU / L) had an IRR of 1.21 for cardiovascular death.
The results of the study showed that the risk did not increase in patients with overt hypothyroidism and subclinical hypothyroidism.
A few months ago, Zelmer and colleagues reported that they found a 30% increased risk of atrial fibrillation associated with hyperthyroidism in the same group of study patients.
However, this study has some limitations. The study did not take into account external factors, such as whether radioiodine therapy was given. Based on the results of this study, it is impossible to predict whether more intensive therapy could reduce the risk of mortality, as the risk may be caused by a combination of factors that influence the course of the disease over a long period of time. A more definitive answer can be given by a randomized controlled trial.
In addition, no information was available on whether the study patients were smokers, and tobacco is known to promote hyperthyroidism and limit hypothyroidism.
The study took into account the socioeconomic status of the patients, which did not actually change the results. Prior to this, other studies were also conducted in which the factor of smoking was taken into account, but the correlation between hyperthyroidism and cardiovascular mortality was not found.
(Source: Selmer C, Olesen J, Madsen J, et al. Subclinical hyperthyroidism and risk of cardiovascular and all-cause mortality. 2013 European Congress on Endocrinology; April 29, 2013; Copenhagen, Denmark.Abstract OC3.6. http://www.medscape.com/medscapetoday).
I have hyperthyroidism – Wonderzine
The joy that everything cleared up quickly passed. Tons of information on the internet are not comforting
but rather they frighten an already anxious person with off-scale hormones. Doctors then
advise not to worry, then they also scare. People on forums complain that
the consequences of treatment are as unpleasant as the disease itself, and that the disease has
property to return repeatedly.The themes are launched in my head: “how is it, I’m only twenty-five years old, and I’m already with a defect”, “what if
treatment will not help “,” but is it necessary to treat anything at all? ” Obviously needed.
There are several treatment options: tablets, thyroid removal and
radioactive iodine. After removal of the gland or the use of iodine, it is necessary to replace the thyroid function by taking hormones from the outside – this is a lifelong daily medication. But in most cases they start with pills. In Russia now
two drugs are presented: thiamazole and propylthiouracil.The first is worth a penny and
is used more often, the second is prescribed for pregnant women and those who have started
intolerance of the first – and it costs many times more.
I was prescribed the first medicine. On the forums, some have complained that they are allergic to it and usually it begins on the fourteenth day of admission. I have
started on the fifteenth. Hives were all over my body, and I didn’t think to go to the allergist right away. I was hospitalized in
hospital for two days intravenously injected prednisolone, continued to give thiamazole and
frightened by swelling of the larynx and death.Then the medicine was canceled.
An elderly woman who was in the same room with me constantly
told me the same story about how her young daughter died. Later
she added that, of course, everything would be all right for me – and then again about
death of his daughter. And when on the third day I was offered to introduce prednisone again,
and grandma told about death, I packed my things, checked out and rushed to
allergist. The doctor took this day only by appointment.I
burst into tears right under the office and got to the reception – and still very
grateful to the doctor for the promptness. Hives were brought down for more than two weeks with injections, pills and ointments. Some acquaintances advised me to drink
a course of sedatives to cure urticaria – but this is not the result of stress, but an allergy to the drug, and it had to be treated adequately.
90,000 Hyperthyroidism in dogs | Veterinary clinic Zhuravlik
Hyperthyroidism in dogs is a condition of increased secretion of thyroid hormones into the blood.Hyperthyroidism occurs in both animals and humans.
There is currently no consensus among veterinarians on the frequency of hyperthyroidism in dogs. Most likely, this is due not to rare cases, but to their incomplete identification.
In order to understand why hyperthyroidism occurs, let us turn to the structure and functioning of the thyroid gland in normal conditions.
The thyroid gland in a dog is located on the right and left sides of the trachea, looks like tonsils, which can be connected by an isthmus.
Nearby is the esophagus, muscles, and most importantly the blood vessels that braid the gland, penetrate and branch out in it.
Outside, the thyroid gland of a dog is covered with a membrane of connective tissue, from which partitions extend deep into the organ (Fig. 2, No. 1), blood vessels (Fig. 2, No. 2), lymphatic vessels and nerves pass through them. The septa divide the organ into lobules, inside which there are “sacs” or follicles (Fig. 2, No. 3), filled with a complex chemical substance or colloid (Fig.2, no. 4), which is rich in iodine.
The follicle wall is built of one layer of cells (Fig. 2, No. 5), the colloid acts on them and stimulates the production of hormones. It is through the blood vessels that all these substances enter the body, therefore the thyroid gland belongs to the organs of internal (endocrine) secretion.
Normally, the thyroid gland of the dog produces thyroid hormones, which include:
- tetraiodothyronine (thyroxine, T4): it accounts for 3/4 of all iodine in the blood;
- triiodothyronine or T3: formed 5-10 times less than T4, but it is more active than the latter.
The main functions of these hormones:
- participation in the formation and development of tissues;
- stimulation of the cardiovascular system;
- participation in conducting nerve impulses to tissues and organs;
- participation in general metabolism;
- Improving the absorption of oxygen by tissues, as a result of which an excess amount of heat is released, which means that the body spends more energy on vital processes;
- influence on the activity of certain enzymes;
- effect on the genetic apparatus of the cell (for example, in triiodothyronine).
The production of thyroid glands is directly dependent on the work of other endocrine glands, in particular the hypothalamus and pituitary gland. There is an inextricable connection between these glands.
Causes of hyperthyroidism in dogs
The onset of hyperthyroidism in a dog can be congenital or acquired.
Congenital hyperthyroidism in a dog. There is experimental evidence that if during pregnancy the mother had, for example, exhaustion, which provoked metabolic disorders in her body, then this directly affects the high level of thyroid hormones in newborn puppies.However, after birth, the tissues begin to grow rapidly, which requires more thyroid hormones. Therefore, the stronger the mother’s exhaustion, the more the puppy needs more hubbubs, and by the age of about 4 months their blood level becomes below normal. In this case, another, the most common and dangerous disease of the thyroid gland in dogs occurs – hypothyroidism, that is, an insufficient amount of thyroid hormones.
Also, congenital hyperthyroidism in a dog can develop as a result of an autoimmune disease (translated from Latin “auto” means “oneself” or “one’s own”).This is a condition in which the immune system is unable to recognize the tissues of its own body, and in this case, thyroxine. In response, the body synthesizes special proteins – defenders or autoantibodies, which begin to “attack” the thyroid gland and other organs, which leads to disruption of their work.
Acquired hyperthyroidism in a dog may result from:
- Excessive administration of thyroid hormones into the body;
- development of a hormonally active malignant tumor of the thyroid gland (thyroid carcinoma).But this is a rare case, only 25% of all tumor processes in the gland;
- diseases of the pituitary gland.
An increase in the amount of thyroid hormones is also possible during pregnancy.
It is important to say that hyperthyroidism in a dog does not develop spontaneously, i.e. in itself, such a condition is always a consequence of serious disturbances in the hormonal work of the whole organism.
Symptoms of hyperthyroidism in dogs
Maximum frequency of registration of hyperthyroidism in dogs according to the following characteristics:
- breed: Keeshond, followed by Labrador Retrievers and Doberman Pinschers.All dogs have a tendency to develop the disease;
- age: from seven years and more. There is evidence that in such animals, changes in the thyroid gland begin at about 2 years.
The first signs of the disease are:
- Behavior change: anxiety, agitation or lethargy, in some cases – aggression;
- Sudden increase or decrease in weight: the dog can consume large amounts of food, but lose weight dramatically;
- heart palpitations;
- indigestion and respiration;
- trembling of the limbs;
- Hair loss and thickening of the nails.
90,011 increase in body temperature;
In very difficult cases, the most prominent symptom of hyperthyroidism in a dog may be so-called “bulging” or Graves’ disease. It is described in classical textbooks on veterinary medicine as follows: “… a special kind of” bulging “is registered in the dog, that is, the eyeball is sharply pushed out …”, and visually it seems that the animal has huge eyes.
The thyroid gland itself is enlarged on the right and left (in almost 70% of the examined animals). Processes in it can go in two directions.The first is when the iron increases by increasing the amount of the colloid itself. Second, when the gland increases due to the proliferation of connective tissue (septa). This condition of the gland is called goiter, fortunately, it rarely develops in dogs.
Described and atypical (uncharacteristic) form of hyperthyroidism in dogs:
- poor appetite;
- exhaustion and weakness;
As the disease progresses and internal organ involvement progresses, symptoms may increase.In advanced cases, the animal may die.
Diagnosis of hyperthyroidism in dogs
- History questioning and examination of the dog.
- To understand the state of the body, a general analysis of blood and urine is prescribed.
- Blood test for hormones.
- Electrocardiography – to monitor the cardiovascular system, ultrasound (Fig. 3) and X-ray – to exclude tumor processes and metastases in the chest cavity.
- Other studies based on the general condition of the animal.
When treating hyperthyroidism, it is necessary to monitor the condition of the dog with repeated examinations, some laboratory tests (complete blood count, hormone levels) every 2-3 weeks, at least the first 3 months, then as necessary.
Treatment of hyperthyroidism in dogs
Treatment depends on the general condition of the body. If we are talking about severe or neglected cases, then treatment can only try to improve the quality of life of the dog.
As for the work of the thyroid gland itself, the primary task is to normalize the production of hormones using special or antithyroid drugs.Their choice, calculation of the dose and frequency of administration can only be prescribed by a veterinarian based on the results of the examination. The owner should be made aware of the possible side effects of each drug, and if it develops, the drug is canceled and a replacement is selected.
As an alternative method, a specialist may suggest surgical removal of the thyroid gland. It is important to know the consequences: the body needs noises anyway, which means that it is necessary to maintain their level in the blood with drugs in the form of injections or in tablets all their lives.
If the cause of hyperthyroidism in a dog is a tumor, then the tactics of treatment is determined by the oncologist.
At the same time, treatment of concomitant diseases (heart, gastrointestinal tract, etc.) is underway.
Prevention of hyperthyroidism in dogs
Prevention of hyperthyroidism in dogs has not yet been developed.
Prognosis for hyperthyroidism in dogs
With this disease, the prognosis is favorable in the case of:
- if the dog’s hyperthyroidism is not complicated by serious diseases of other organs or a tumor process;
- if the owner exactly follows all the recommendations of the veterinarian.Self-medication in such a situation is the path to the painful death of the animal.
- for malignant tumors of the thyroid gland with metastases to other organs;
- with the general grave condition of the animal.
Hyperthyroidism in a dog can develop secretly for a long time, the correct diagnosis can be made only with a comprehensive examination; the prognosis for the animal is determined by the general condition.
Source: https: // oncovet.ru
90,000 causes of occurrence, under what diseases occurs, diagnostics and methods of treatment
The information in this section cannot be used for self-diagnosis and self-medication. In case of pain or other exacerbation of the disease, diagnostic tests should be prescribed only by the attending physician. For a diagnosis and correct treatment prescription, you should contact your doctor.
Thyrotoxicosis is a clinical syndrome that occurs when the level of thyroid hormones in the blood is increased.An excess of these hormones affects the functioning of various organs and systems. Patients complain of dry skin, brittle hair, puffiness of the face, small tremors of the eyelids, fingers and even the whole body can be observed. There are small fluctuations in temperature, increased nervous excitability, sweating, a feeling of heat, fussiness. There are sudden attacks of muscle weakness. A person becomes quarrelsome, suspicious, excessively active. Sleep is disturbed.
The patient develops swelling and darkening of the skin of the upper eyelids, lacrimation, photophobia, a feeling of pressure and “sand” in the eyes, bulging (exophthalmos).With moderate or severe eye damage, there may be a decrease in visual acuity, patients cannot close their eyelids, therefore, damage to the cornea and sclera develops (ulceration, infection).
In some patients, on the anterior surface of the leg, lesions of the skin and subcutaneous adipose tissue develop – clearly delineated seals of a purple-cyanotic color (erythema nodosum). In men, thickening of the phalanges of the fingers is sometimes noted due to tissue edema.
Due to the influence of thyroid hormones on the cardiovascular system, patients are disturbed by cardiac arrhythmias (tachycardia, extrasystole, atrial fibrillation).
Disorders of the gastrointestinal tract are common. Even with increased appetite, body weight decreases due to accelerated metabolism. You may experience bouts of abdominal pain, vomiting, upset stools, and sometimes constipation. In severe cases, the liver is affected – its enlargement, soreness, and rarely jaundice are recorded.
Under the influence of provoking factors (stressful situations, physical overstrain, infectious diseases, surgery), a thyrotoxic crisis may occur.As a result of the sudden release of a large amount of thyroid hormones into the bloodstream, patients become restless, the body temperature rises significantly, tachycardia increases sharply, breathing becomes more frequent, and blood pressure rises.
Types of thyrotoxicosis
I. Thyrotoxicosis due to increased production of thyroid hormones:
- Graves’ disease (diffuse toxic goiter).
- Multinodular toxic goiter.
- Toxic thyroid adenoma.
- Thyroid cancer.
- TSH-secreting pituitary adenoma.
II. Thyrotoxicosis due to the production of thyroid hormones outside the thyroid gland:
- Struma ovarii (ovarian tumor).
- Functioning metastases of thyroid cancer.
III. Thyrotoxicosis not associated with hyperproduction of thyroid hormones:
- Medication thyrotoxicosis.
- Thyrotoxic phase of destructive thyroiditis (subacute, postpartum).
According to the severity of the course, mild, moderate and severe forms of thyrotoxicosis are distinguished.
With a mild form of thyrotoxicosis, the pulse does not exceed 100 beats per minute, the body weight loss is no more than 5 kg, the eye symptoms are absent or slightly expressed. With an average form, the pulse is 100-120 beats per minute, body weight loss is 8-10 kg, pronounced tremor (tremor), increased systolic blood pressure and lower diastolic pressure, exophthalmos.The severe form develops with long-term thyrotoxicosis without treatment. The pulse rate is 120-140 beats per minute, weight loss reaches exhaustion, damage to the cardiovascular system, liver, adrenal glands is observed.
Possible causes of thyrotoxicosis
An increase in thyroid hormones in the blood can be observed for several reasons:
- as a result of an increase in the production of thyroid hormones in the thyroid gland;
- as a result of the destruction of the thyroid gland tissue and the ingestion of a large amount of thyroid hormones into the blood;
- in case of an overdose of thyroid hormone preparations or as a result of side effects of drug therapy with amiodarone.
Diffuse toxic goiter (Graves’ disease) is the most common cause of increased thyroid hormone production. Depending on the nature of the enlargement of the thyroid gland, diffuse toxic goiter (diffuse enlargement of all parts of the gland) and nodular toxic goiter (focal enlargement of the thyroid gland) are distinguished.
If the node producing hormones in an increased amount is single, then they speak of a toxic adenoma.
Diffuse toxic goiter is an autoimmune disease in which antibodies appear to the structural components of the cells of the thyroid gland.Antibodies are special proteins called immunoglobulins (Ig) that the immune system produces in response to any foreign agent entering the body to fight it. In this case, the immune system recognizes the thyroid tissue as foreign.
These antibodies have a stimulating effect on the thyroid gland, causing its hyperfunction with an increase in the volume, mass of the gland, and, consequently, the concentration of thyroid hormones in the blood. Antibodies are able to cross the placental barrier and cause thyrotoxicosis in newborns.Therefore, the detection of antibodies in pregnant women is of great importance for the unborn child.
Thyrotoxicosis can be observed against the background of subacute thyroiditis. Subacute thyroiditis (inflammation of the thyroid tissue) occurs as a result of a viral disease and proceeds as a typical inflammation. In the period preceding the development of the disease, muscle pain, malaise, low-grade fever, general weakness, sore throat, and fatigue may occur. Then there is moderate to severe pain in the thyroid gland, often radiating to the ears, jaw, or throat.Sometimes there is pain when swallowing and turning the head. The thyroid gland is usually slightly enlarged, the growing fibrosis of the gland (proliferation of connective tissue) is manifested by an increase in its density.
There are 4 phases in the development of subacute thyroiditis. The first is thyrotoxic, which lasts 4 to 10 weeks. It develops in the acute stage of the disease due to increased vascular permeability against the background of inflammation and increased release of previously synthesized thyroid hormones. The patients have symptoms of thyrotoxicosis.When the reserves of hormones in the thyroid gland are depleted, the euthyroid phase begins, which lasts 1-3 weeks. It is replaced by a hypothyroid phase, lasting from 2 to 6 months, and then recovery begins.
The phenomena of thyrotoxicosis can manifest against the background of postpartum thyroiditis 1.5-3 months after childbirth.
Chorionepithelioma is a malignant neoplasm that forms from the epithelial cells of the chorion during or after pregnancy, more often in the uterus and produces the hormone chorionic gonadotropin.This hormone is a weak stimulant of thyroid cells. But at its high concentrations (300,000 U / L) thyrotoxicosis may occur.
Struma ovarii, or ovarian tumor – refers to teratomas (tumors from an atypical tissue for a given localization) in which thyroid tissue predominates or constitutes a significant component of the tumor. In 20-30% of cases, the tumor is represented only by the thyroid tissue. 5-6% of these tumors produce thyroid hormones in an amount sufficient for the development of thyrotoxicosis.
Large hormone-active metastases of follicular thyroid cancer are very rare causes of thyrotoxicosis.
Thyrotoxicosis can occur with an overdose of thyroid hormones, due to inadequate iodine prophylaxis or against the background of the use of amiodarone.
Amiodarone is a highly effective and widely used antiarrhythmic drug in cardiology. Thyroid dysfunction is a common side effect of amiodarone, caused by either excessive uncontrolled synthesis of hormones in response to iodine load and / or destruction of the gland.Amiodarone-induced thyrotoxicosis is of great importance because it aggravates the course of cardiovascular disease.
Which doctors should I contact with thyrotoxicosis
At the first manifestations of thyrotoxicosis, it is necessary to consult a general practitioner or general practitioner. When the diagnosis is confirmed after a complex of laboratory diagnostic measures, the endocrinologist prescribes therapy, corrects it and monitors the course of the disease.