Hyperthyroidism During Pregnancy Overt hyperthyroidism Subclinical hyperthyroidism.
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Transcript of Hyperthyroidism
HyperthyroidismOveractive thyroid
Last reviewed: April 19, 2010.
Hyperthyroidism is a condition in which the thyroid gland makes too much thyroid hormone. The condition is often referred to as an "overactive thyroid."Causes, incidence, and risk factorsThe thyroid gland is an important organ of the endocrine system. It is located in the front of the neck just below the voice box. The gland produces the hormones thyroxine (T4) and triiodothyronine (T3), which control the way every cell in the body uses energy. This process is called your metabolism.Hyperthyroidism occurs when the thyroid releases too much of its hormones over a short (acute) or long (chronic) period of time. Many diseases and conditions can cause this problem, including:
Getting too much iodine
Graves disease (accounts for most cases of hyperthyroidism) Inflammation (thyroiditis) of the thyroid due to viral infections or other causes Noncancerous growths of the thyroid gland or pituitary gland Taking large amounts of thyroid hormone Tumors of the testes or ovaries
Related topics:
Factitious hyperthyroidism Hypothyroidism Painless (silent) thyroiditis
Symptoms
Difficulty concentrating
Fatigue
Frequent bowel movements
Goiter (visibly enlarged thyroid gland) or thyroid nodules Heat intolerance Increased appetite Increased sweating
Irregular menstrual periods in women
Nervousness
Restlessness Weight loss (rarely, weight gain)
Other symptoms that can occur with this disease:
Breast development in men
Clammy skin
Diarrhea
Hair loss Hand tremor Weakness High blood pressure
Itching - overall
Lack of menstrual periods in women
Nausea and vomiting
Pounding, rapid, or irregular pulse
Protruding eyes (exophthalmos) Rapid, forceful, or irregular heartbeat (palpitations)
Skin blushing or flushing
Sleeping difficulty Signs and testsPhysical examination may reveal thyroid enlargement, tremor, hyperactive reflexes, or an increased heart rate. Systolic blood pressure (the first number in a blood pressure reading) may be high.Subclinical hyperthyroidism is a mild form of hyperthyroidism that is diagnosed by abnormal blood levels of thyroid hormones, often in the absence of any symptoms.Blood tests are also done to measure levels of thyroid hormones.
TSH (thyroid stimulating hormone) level is usually low
T3 and free T4 levels are usually high
This disease may also affect the results of the following tests:
Cholesterol test
Glucose test Radioactive iodine uptake T3RU Triglycerides Vitamin B12 (in rare cases)
Treatment
How the condition is treated depends on the cause and the severity of symptoms. Hyperthyroidism is usually treated with one or more of the following:
Antithyroid medications
Radioactive iodine (which destroys the thyroid and stops the excess production of hormones)
Surgery to remove the thyroidIf the thyroid must be removed with surgery or destroyed with radiation, you must take thyroid hormone replacement pills for the rest of your life.
Beta-blockers such as propranolol are used to treat some of the symptoms, including rapid heart rate, sweating, and anxiety until the hyperthyroidism can be controlled.
Expectations (prognosis)
Hyperthyroidism is generally treatable and only rarely is life threatening. Some of its causes may go away without treatment.
Hyperthyroidism caused by Graves disease usually gets worse over time. It has many complications, some of which are severe and affect quality of life.
ComplicationsThyroid crisis (storm), also called thyrotoxicosis, is a sudden worsening of hyperthyroidism symptoms that may occur with infection or stress. Fever, decreased mental alertness, and abdominal pain may occur. Immediate hospitalization is needed.
Other complications related to hyperthyroidism include:
Heart-related complications including:
Rapid heart rate Congestive heart failure Atrial fibrillation
Increased risk for osteoporosis, if hyperthyroidism is present for a long time
Surgery-related complications, including:
Scarring of the neck
Hoarseness due to nerve damage to the voice box
Low calcium level due to damage to the parathyroid glands (located near the thyroid gland)
Treatments for hypothyroidism, such as radioactive iodine, surgery, and medications to replace thyroid hormones can have complications.
Calling your health care providerCall your health care provider if you have symptoms that could be caused by too much thyroid hormone production. Go to an emergency room or call the local emergency number (such as 911), if you have:
Change in consciousness
Dizziness
Rapid, irregular heartbeat
Call your health care provider if you are being treated for hyperthyroidism and you develop symptoms of underactive thyroid, including:
Depression
Mental and physical sluggishness
Weight gain
Prevention
There are no known ways to prevent hyperthyroidism.
Hyperthyroidism
What is hyperthyroidism?
Hyperthyroidism means overactivity of the thyroid gland, resulting in too much thyroid hormone in the
bloodstream. The oversecretion of thyroid hormones leads to overactivity of the body's metabolism.
Thyroid Gland - Click to Enlarge
What are the symptoms of hyperthyroidism?
The following are the most common symptoms of hyperthyroidism. However, each individual may
experience symptoms differently. Symptoms may include:
Nervousness
Irritability
Increased perspiration
Thinning of the skin
Fine, brittle hair
Weak muscles, especially in the upper arms and thighs
Shaky hands
Fast heartbeat
High blood pressure
Increased bowel movements
Weight loss
Sleeping difficulty
Prominent eyes
Sensitivity to bright light
Confusion
Irregular menstrual cycle
The symptoms of hyperthyroidism may resemble other conditions or medical problems. Always consult
your doctor for a diagnosis.
Types of hyperthyroidism
There are several forms of hyperthyroidism, including:
Graves' disease (diffuse toxic goiter). Graves' disease is most often associated with
hyperthyroidism. Researchers believe Graves' disease is caused by an antibody which stimulates the
thyroid too much. This overstimulation causes the excess production of thyroid hormone. Graves'
disease is categorized as an autoimmune disorder (a dysfunction of the body's immune system). The
disease is most common in young to middle-aged women and tends to run in families.
Symptoms of Graves' disease are identical to hyperthyroidism, with the addition of three other
symptoms. However, each individual may experience symptoms differently. The three additional
symptoms include:
Goiter (enlarged thyroid which may cause a bulge in the neck)
Bulging eyes (exophthalmos)
Thickened skin over the shin area
Toxic nodular goiter (also called multinodular goiter). Hyperthyroidism caused by toxic nodular
goiter is a condition in which one or more nodules of the thyroid becomes overactive. The overactive
nodules actually act as benign thyroid tumors. Symptoms of toxic nodular goiter do not include
bulging eyes or skin problems, as in Graves' disease. The cause of toxic nodular goiter is not known.
Thyroiditis. Thyroiditis causes temporary hyperthyroidism, usually followed with hypothyroidism (an
underactive thyroid). Thyroiditis is an inflammation of the thyroid gland. There are three types of
thyroiditis:
Hashimoto's thyroiditis
Subacute granulomatous thyroiditis
Silent lymphocytic thyroiditis
In addition, if a person takes too many thyroid hormone tablets, hyperthyroidism may occur.
How is hyperthyroidism diagnosed?
In addition to a complete medical history and medical examination, diagnostic procedures for
hyperthyroidism may include:
Measurement of thyroid hormone in the bloodstream
Thyroid ultrasound. A test to evaluate the thyroid gland for evidence of any nodules.
Thyroid scan. A test that uses a radioactive substance to create an image of the thyroid.
Treatment for hyperthyroidism
Treatment for hyperthyroidism is very specific for each patient. The goal of treatment is to restore the
thyroid gland to normal function, producing normal levels of thyroid hormone. Specific treatment for
hyperthyroidism will be determined by your doctor based on:
Your age, overall health, and medical history
Type of hyperthyroidism
Extent of the disease
Your tolerance for specific medications, procedures, or therapies
Expectations for the course of the disease
Your opinion or preference
Treatment may include:
Use of antithyroid drugs that help lower the level of thyroid hormones in the blood.
Use of radioactive iodine, in the form of a pill or liquid, which damages thyroid cells so that production
of thyroid hormones is slowed down.
Surgery to remove part of the thyroid (the overactive nodule).
Use of beta-blocking agents, which block the action of thyroid hormone on the body; (These drugs do
not change the levels of thyroid hormone in the blood, but may make the patient feel better.)
--
Facts about hyperthyroidism:
Less than 1 percent of people in the US have hyperthyroidism.
Hyperthyroidism usually occurs between the ages of 30 and 50.
Hyperthyroidism is more common in women than in men.--
Incidence (annual) of Congenital hypothyroidism:
about 1 in 4000 babies
Incidence Rate for Congenital hypothyroidism: approx 1 in 272,000 or 0.00% or 1,000 people in
USA [about data]Extrapolation of Incidence Rate for Congenital hypothyroidism to Countries and
Regions: WARNING! EXTRAPOLATION ONLY. NOT BASED ON COUNTRY-SPECIFIC DATA
SOURCES. The following table attempts to extrapolate the above incidence rate for Congenital
hypothyroidism to the populations of various countries and regions. As discussed above, these
incidence extrapolations for Congenital hypothyroidism are only estimates and may have very limited
relevance to the actual incidence of Congenital hypothyroidism in any region:
Country/Region Extrapolated Incidence Population Estimated Used
Congenital hypothyroidism in North America (Extrapolated Statistics)
USA 1,079 293,655,4051
Canada 119 WARNING! (Details) 32,507,8742
Mexico 385 WARNING! (Details) 104,959,5942
Congenital hypothyroidism in Central America (Extrapolated Statistics)
Belize 1 WARNING! (Details) 272,9452
Guatemala 52 WARNING! (Details) 14,280,5962
Nicaragua 19 WARNING! (Details) 5,359,7592
Congenital hypothyroidism in Caribbean (Extrapolated Statistics)
Puerto Rico 14 WARNING! (Details) 3,897,9602
Congenital hypothyroidism in South America (Extrapolated Statistics)
Brazil 676 WARNING! (Details) 184,101,1092
Chile 58 WARNING! (Details) 15,823,9572
Colombia 155 WARNING! (Details) 42,310,7752
Paraguay 22 WARNING! (Details) 6,191,3682
Peru 101 WARNING! (Details) 27,544,3052
Venezuela 91 WARNING! (Details) 25,017,3872
Congenital hypothyroidism in Northern Europe (Extrapolated Statistics)
Denmark 19 WARNING! (Details) 5,413,3922
Finland 19 WARNING! (Details) 5,214,5122
Iceland 1 WARNING! (Details) 293,9662
Sweden 33 WARNING! (Details) 8,986,4002
Congenital hypothyroidism in Western Europe (Extrapolated Statistics)
Britain (United Kingdom) 221 WARNING! (Details) 60,270,708 for UK2
Belgium 38 WARNING! (Details) 10,348,2762
France 222 WARNING! (Details) 60,424,2132
Ireland 14 WARNING! (Details) 3,969,5582
Luxembourg 1 WARNING! (Details) 462,6902
Monaco 0 WARNING! (Details) 32,2702
Netherlands (Holland) 59 WARNING! (Details) 16,318,1992
United Kingdom 221 WARNING! (Details) 60,270,7082
Wales 10 WARNING! (Details) 2,918,0002
Congenital hypothyroidism in Central Europe (Extrapolated Statistics)
Austria 30 WARNING! (Details) 8,174,7622
Czech Republic 4 WARNING! (Details) 1,0246,1782
Germany 303 WARNING! (Details) 82,424,6092
Hungary 36 WARNING! (Details) 10,032,3752
Liechtenstein 0 WARNING! (Details) 33,4362
Poland 142 WARNING! (Details) 38,626,3492
Slovakia 19 WARNING! (Details) 5,423,5672
Slovenia 7 WARNING! (Details) 2,011,473 2
Switzerland 27 WARNING! (Details) 7,450,8672
Congenital hypothyroidism in Eastern Europe (Extrapolated Statistics)
Belarus 37 WARNING! (Details) 10,310,5202
Estonia 4 WARNING! (Details) 1,341,6642
Latvia 8 WARNING! (Details) 2,306,3062
Lithuania 13 WARNING! (Details) 3,607,8992
Russia 529 WARNING! (Details) 143,974,0592
Ukraine 175 WARNING! (Details) 47,732,0792
Congenital hypothyroidism in the Southwestern Europe (Extrapolated Statistics)
Azerbaijan 28 WARNING! (Details) 7,868,3852
Portugal 38 WARNING! (Details) 10,524,1452
Spain 148 WARNING! (Details) 40,280,7802
Georgia 17 WARNING! (Details) 4,693,8922
Congenital hypothyroidism in the Southern Europe (Extrapolated Statistics)
Italy 213 WARNING! (Details) 58,057,4772
Greece 39 WARNING! (Details) 10,647,5292
Congenital hypothyroidism in the Southeastern Europe (Extrapolated Statistics)
Albania 13 WARNING! (Details) 3,544,8082
Bosnia and Herzegovina 1 WARNING! (Details) 407,6082
Bulgaria 27 WARNING! (Details) 7,517,9732
Croatia 16 WARNING! (Details) 4,496,8692
Macedonia 7 WARNING! (Details) 2,040,0852
Romania 82 WARNING! (Details) 22,355,5512
Serbia and Montenegro 39 WARNING! (Details) 10,825,9002
Congenital hypothyroidism in Northern Asia (Extrapolated Statistics)
Mongolia 10 WARNING! (Details) 2,751,3142
Congenital hypothyroidism in Central Asia (Extrapolated Statistics)
Kazakhstan 55 WARNING! (Details) 15,143,7042
Tajikistan 25 WARNING! (Details) 7,011,556 2
Uzbekistan 97 WARNING! (Details) 26,410,4162
Congenital hypothyroidism in Eastern Asia (Extrapolated Statistics)
China 4,775 WARNING! (Details) 1,298,847,6242
Hong Kong s.a.r. 25 WARNING! (Details) 6,855,1252
Japan 468 WARNING! (Details) 127,333,0022
Macau s.a.r. 1 WARNING! (Details) 445,2862
North Korea 83 WARNING! (Details) 22,697,5532
South Korea 177 WARNING! (Details) 48,233,7602
Taiwan 83 WARNING! (Details) 22,749,8382
Congenital hypothyroidism in Southwestern Asia (Extrapolated Statistics)
Turkey 253 WARNING! (Details) 68,893,9182
Congenital hypothyroidism in Southern Asia (Extrapolated Statistics)
Afghanistan 104 WARNING! (Details) 28,513,6772
Bangladesh 519 WARNING! (Details) 141,340,4762
Bhutan 8 WARNING! (Details) 2,185,5692
India 3,915 WARNING! (Details) 1,065,070,6072
Pakistan 585 WARNING! (Details) 159,196,3362
Sri Lanka 73 WARNING! (Details) 19,905,1652
Congenital hypothyroidism in Southeastern Asia (Extrapolated Statistics)
East Timor 3 WARNING! (Details) 1,019,2522
Indonesia 876 WARNING! (Details) 238,452,9522
Laos 22 WARNING! (Details) 6,068,1172
Malaysia 86 WARNING! (Details) 23,522,4822
Philippines 317 WARNING! (Details) 86,241,6972
Singapore 16 WARNING! (Details) 4,353,8932
Thailand 238 WARNING! (Details) 64,865,5232
Vietnam 303 WARNING! (Details) 82,662,8002
Congenital hypothyroidism in the Middle East (Extrapolated Statistics)
Gaza strip 4 WARNING! (Details) 1,324,9912
Iran 248 WARNING! (Details) 67,503,2052
Iraq 93 WARNING! (Details) 25,374,6912
Israel 22 WARNING! (Details) 6,199,0082
Jordan 20 WARNING! (Details) 5,611,2022
Kuwait 8 WARNING! (Details) 2,257,5492
Lebanon 13 WARNING! (Details) 3,777,2182
Saudi Arabia 94 WARNING! (Details) 25,795,9382
Syria 66 WARNING! (Details) 18,016,8742
United Arab Emirates 9 WARNING! (Details) 2,523,9152
West Bank 8 WARNING! (Details) 2,311,2042
Yemen 73 WARNING! (Details) 20,024,8672
Congenital hypothyroidism in Northern Africa (Extrapolated Statistics)
Egypt 279 WARNING! (Details) 76,117,4212
Libya 20 WARNING! (Details) 5,631,5852
Sudan 143 WARNING! (Details) 39,148,1622
Congenital hypothyroidism in Western Africa (Extrapolated Statistics)
Congo Brazzaville 11 WARNING! (Details) 2,998,0402
Ghana 76 WARNING! (Details) 20,757,0322
Liberia 12 WARNING! (Details) 3,390,6352
Niger 41 WARNING! (Details) 11,360,5382
Nigeria 65 WARNING! (Details) 12,5750,3562
Senegal 39 WARNING! (Details) 10,852,1472
Sierra leone 21 WARNING! (Details) 5,883,8892
Congenital hypothyroidism in Central Africa (Extrapolated Statistics)
Central African Republic 13 WARNING! (Details) 3,742,4822
Chad 35 WARNING! (Details) 9,538,5442
Congo kinshasa 214 WARNING! (Details) 58,317,0302
Rwanda 30 WARNING! (Details) 8,238,6732
Congenital hypothyroidism in Eastern Africa (Extrapolated Statistics)
Ethiopia 262 WARNING! (Details) 71,336,5712
Kenya 121 WARNING! (Details) 32,982,1092
Somalia 30 WARNING! (Details) 8,304,6012
Tanzania 132 WARNING! (Details) 36,070,7992
Uganda 97 WARNING! (Details) 26,390,2582
Congenital hypothyroidism in Southern Africa (Extrapolated Statistics)
Angola 40 WARNING! (Details) 10,978,5522
Botswana 6 WARNING! (Details) 1,639,2312
South Africa 163 WARNING! (Details) 44,448,4702
Swaziland 4 WARNING! (Details) 1,169,2412
Zambia 40 WARNING! (Details) 11,025,6902
Zimbabwe 13 WARNING! (Details) 1,2671,8602
Congenital hypothyroidism in Oceania (Extrapolated Statistics)
Australia 73 WARNING! (Details) 19,913,1442
New Zealand 14 WARNING! (Details) 3,993,8172
Papua New Guinea 19 WARNING! (Details) 5,420,2802
About extrapolations of prevalence and incidence statistics for Congenital hypothyroidism:
WARNING! EXTRAPOLATED STATISTICS ONLY! Not based on data sources from individual
countries. These statistics are calculated extrapolations of various prevalence or incidence rates against
the populations of a particular country or region. The statistics used for prevalence/incidence of
Congenital hypothyroidism are typically based on US, UK, Canadian or Australian prevalence or
incidence statistics, which are then extrapolated using only the population of the other country. This
extrapolation calculation is automated and does not take into account any genetic, cultural,
environmental, social, racial or other differences across the various countries and regions for which the
extrapolated Congenital hypothyroidism statistics below refer to. The extrapolation does not use data
sources or statistics about any country other than its population. As such, these extrapolations may
be highly inaccurate (especially for developing or third-world countries) and only give a general
indication (or even a meaningless indication) as to the actual prevalence or incidence of Congenital
hypothyroidism in that region. These statistics are presented only in the hope that they may be
interesting to some people.
About prevalence and incidence statistics in general for Congenital hypothyroidism:
The word 'prevalence' of Congenital hypothyroidism usually means the estimated population of people who are managing Congenital hypothyroidism at any given time (i.e. people with Congenital hypothyroidism). The term 'incidence' of Congenital hypothyroidism means the annual diagnosis rate, or the number of new cases of Congenital hypothyroidism diagnosed each year (i.e. getting Congenital hypothyroidism). Hence, these two statistics types can differ: a short disease like flucan have high annual incidence but low prevalence, but a life-long disease like diabetes has a low annual incidence but
hANATOMY AND PHYSIOLOGY OF THE THYROID GLAND
A normal adult thyroid gland usually weighs 10 to 20 g. It receives its nourishment from bilateral superior and inferior thyroid arteries and a small artery called thyroid ima.
The thyroid gland secretes two thyroid hormones (THs). Thyroxine (T4) represents 90% of thyroid hormone production, whereas triiodothyronine (T3) comprises 10%. Peripheral tissues convert T4 to T3 and most T3 is derived from T4. TH secretion is regulated by the hypothalamus-pituitary-thyroid axis through the actions of thyroid-releasing hormone (TRH) and thyroid-stimulating hormone (TSH).
Thyroid hormones are transported in serum bound to carrier proteins and only 0.03% to 0.04% of T4 and 0.3% to 0.4% of T3 exist as a free hormone. Thyroid-binding globulin (TBG) is the main carrier, accounting for 75% of bound T4 and all bound T3. Thyroxine-binding prealbumin (TBPA) accounts for 15% of T4binding, and albumin …
-igh prevalence. For more information see about prevalence and incidence statistics.