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Encyclopedia > Hyperthyroidism
Hyperthyroidism
Classification & external resources
Triiodothyronine (T3, pictured) and thyroxine (T4) are both forms of thyroid hormone.
ICD-10 E05.
ICD-9 242, 775.3
DiseasesDB 6348
MedlinePlus 000356
eMedicine med/1109 

Hyperthyroidism (or "overactive thyroid gland") is the clinical syndrome caused by an excess of circulating free thyroxine (T4) or free triiodothyronine (T3), or both. Image File history File links Triiodothyronine. ... The thyroid hormones, thyroxine (T4) and triiodothyronine (T3), are tyrosine-based hormones produced by the thyroid gland. ... Thyroxine, or 3:5,3:5 tetra­iodothyronine (often abbreviated as T4) is the major hormone secreted by the follicular cells of the thyroid gland. ... The thyroid hormones, thyroxine (T4) and triiodothyronine (T3), are tyrosine-based hormones produced by the thyroid gland. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // E00-E35 - Endocrine diseases (E00-E07) Disorders of thyroid gland (E00) Congenital iodine-deficiency syndrome (E01) Iodine-deficiency-related thyroid disorders and allied conditions (E02) Subclinical iodine-deficiency hypothyroidism (E03) Other hypothyroidism (E030) Congenital hypothyroidism with diffuse goitre (E031) Congenital hypothyroidism without goitre (E032) Hypothyroidism due to medicaments and other... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... In medicine, the term syndrome is the association of several clinically recognizable features, signs, symptoms, phenomena or characteristics which often occur together, so that the presence of one feature alerts the physician to the presence of the others. ... Thyroxine, or 3:5,3:5 tetra­iodothyronine (often abbreviated as T4) is the major hormone secreted by the follicular cells of the thyroid gland. ... The thyroid hormones, thyroxine (T4) and triiodothyronine (T3), are tyrosine-based hormones produced by the thyroid gland. ...

Contents

Causes

Hyperthyroidism is the result of excess thyroid hormone production, causing an overactive metabolism and increased speed of all the body's processes.


Thyroid hormone generally controls the pace of all of the processes in the body. This pace is called one's metabolism. If there is too much thyroid hormone, every function of the body tends to speed up. The thyroid gland regulates the body temperature by secreting two hormones that control how quickly the body burns calories and energy. If the thyroid produces too much hormone, the condition is called hyperthyroidism, but if too little is produced, the result is hypothyroidism. This article or section does not cite its references or sources. ...


Major causes in humans are:

Other causes of hyperthyroxinemia (high blood levels of thyroid hormones) are not to be confused with true hyperthyroidism and include subacute and other forms of thyroiditis (inflammation) and struma ovarii (a teratoma). Thyrotoxicosis (symptoms caused by hyperthyroxinemia) can occur in both hyperthyroidism and thyroiditis. When it causes acutely increased metabolism, it is sometimes called "thyroid storm", a life-threatening event characterized by tachycardia, hypertension, and fever. Graves disease is a thyroid disorder characterized by goiter, exophthalmos, orange-peel skin, and hyperthyroidism. ... A Hurthle cell is a large cell often associated with follicular thyroid cancer. ... Toxic multinodular goitre (also known as toxic nodular goitre, toxic nodular struma) is a form of hyperthyroidism - where there is excess production of thyroid hormones. ... A teratoma is a type of tumor that derives from pluripotent germ cells. ... Look up teratoma in Wiktionary, the free dictionary. ... This article or section does not cite any references or sources. ... For other forms of hypertension, see Hypertension (disambiguation). ... This article needs additional references or sources for verification. ...


Excess thyroid hormone from pills can also cause hyperthyroidism. Amiodarone, a heart medication, can sometimes cause hyperthyroidism. Hamburger toxicosis is a condition that occurs sporadically and is associated with ground beef contaminated with thyroid hormone. Amiodarone belongs to a class of drugs called Vaughan-Williams Class III antiarrhythmic agent. ...


Postpartum thyroiditis occurs in about 7% of women during the year after they give birth. PPT typically has several phases, the first of which is hyperthyroidism. Many times, the hyperthyroidism corrects itself within weeks or months without any treatment necessary. Postpartum thyroiditis is usually a transient phenomenon observed following pregnancy and may involve hyperthyroidism, hypothyroidism or the two sequentially. ...


Signs and symptoms

Major clinical weight loss (often accompanied by a ravenous appetite), intolerance to heat, fatigue, weakness, hyperactivity, irritability, apathy, depression, polyuria, and sweating. Additionally, patients may present with a variety of symptoms such as palpitations and arrhythmias (notably atrial fibrillation), shortness of breath (dyspnea), loss of libido, nausea, vomiting, and diarrhea. In the elderly, these classical symptoms may not be present and they may present only with fatigue and weight loss leading to apathetic hyperthyroidism. This article needs additional references or sources for verification. ... The appetite is the desire to eat food, felt as hunger. ... For other uses, see Heat (disambiguation) In physics, heat, symbolized by Q, is energy transferred from one body or system to another due to a difference in temperature. ... The word fatigue is used in everyday living to describe a range of afflictions, varying from a general state of lethargy to a specific work induced burning sensation within muscle. ... This article does not cite any references or sources. ... Clinical depression (also called major depressive disorder, or unipolar depression when compared to bipolar disorder) is a state of intense sadness, melancholia or despair that has advanced to the point of being disruptive to an individuals social functioning and/or activities of daily living. ... Polyuria is the passage of a large volume of urine in a given period. ... A palpitation is an abnormal, rapid beating of the heart, brought on by overexertion, disease or drugs. ... A cardiac arrhythmia, also called cardiac dysrhythmia, is a disturbance in the regular rhythm of the heartbeat. ... Atrial fibrillation (AF or afib) is a cardiac arrhythmia (abnormal heart rhythm) that involves the two upper chambers (atria) of the heart. ... Dyspnea (R06. ... For other uses, see Libido (disambiguation). ... For other uses, see Nausea (disambiguation). ... Vomiting (also throwing up or emesis) is the forceful expulsion of the contents of ones stomach through the mouth and sometimes the nose. ... Types 5-7 on the Bristol Stool Chart are often associated with diarrhea Diarrhea (in American English) or diarrhoea (in British English) is a condition in which the sufferer has frequent watery, loose bowel movements (from the Greek word διάρροια; literally meaning through-flowing). Acute infectious diarrhea is a common cause...


Neurological manifestations are tremor, chorea, myopathy, and periodic paralysis. Stroke of cardioembolic origin due to coexisting atrial fibrillation may be mentioned as one of the most serious complications of hyperthyroidism. For the film see Tremors (film). ... // Chorea sancti viti (Latin for St. ... In medicine, a myopathy is a neuromuscular disease in which the muscle fibers do not function for any one of many reasons, resulting in muscular weakness. ... Periodic paralysis is a rare group of genetic diseases that lead to weakness or paralysis (rarely death) from common triggers such as cold, heat, high carbohydrate meals, not eating, stress or excitement and physical activity of any kind. ... For other uses, see Stroke (disambiguation). ... Atrial fibrillation (AF or afib) is a cardiac arrhythmia (abnormal heart rhythm) that involves the two upper chambers (atria) of the heart. ...


As to other autoimmune disorders related with thyrotoxicosis, an association between thyroid disease and myasthenia gravis has been well recognized. The thyroid disease, in this condition, is often an autoimmune one and approximately 5% of patients with myasthenia gravis also have hyperthyroidism. Myasthenia gravis rarely improves after thyroid treatment and the relationship between the two entities is as yet unknown. Some very rare neurological manifestations that are reported to be dubiously associated with thyrotoxicosis are pseudotumor cerebri, amyotrophic lateral sclerosis and a Guillain-Barré-like syndrome. Myasthenia gravis (sometimes abbreviated MG; from the Greek myastheneia, lit. ... Benign intracranial hypertension (BIH), also known by the obsolete term pseudotumor cerebri is a neurologic disease that is caused by increased intracranial pressure in the subarachnoid space surrounding the brain without any indication of intracranial pathology. ... Amyotrophic lateral sclerosis (ALS, sometimes called Lou Gehrigs Disease, Maladie de Charcot or motor neurone disease) is a progressive, fatal, neurodegenerative disease caused by the degeneration of motor neurons, the nerve cells in the central nervous system that control voluntary muscle movement. ... Guillain-Barré syndrome (GBS) or acute inflammatory demyelinating polyradiculoneuropathy is an acute, autoimmune disease that affects the peripheral nervous system and is usually triggered by an acute infectious process. ...


Minor ocular signs, which may be present in any type of hyperthyroidism, are eyelid retraction ("stare") and lid-lag. These "fear-like" eye-signs result from thyroid hormone's exacerbation of the action of norepinephrine. In hyperthyroid stare (Dalrymple sign) the eyelids are retracted upward more than normal (the normal position is at the superior corneoscleral limbus, where the "white" of the eye begins at the upper border of the iris). In lid-lag (von Graefe's sign), when the patient tracks an object downward with their eyes, the eyelid fails to follow the downward moving iris, and the same type of upper globe exposure which is seen with lid retraction occurs, temporarily. These signs disappear with treatment of the hyperthyroidism, or treatment by certain anti-adrenergic drugs. The introduction to this article provides insufficient context for those unfamiliar with the subject matter. ... Albrecht von Gräfe (May 22, 1828 - July 20, 1870), German oculist, son of Karl Ferdinand von Gräfe, was born at Berlin. ...


Neither of these ocular signs should be confused with exophthalmos (protrusion of the eyeball) which occurs in one thyroid-related disease (Graves' disease), but which is not caused by the hyperthyroid state in that disease, and is unrelated to it. Exophthalmos when present may exacerbate these signs, however.[1] Exophthalmos (or proptosis) is a bulging of the eye anteriorly out of the orbit. ... Graves-Basedow disease is a form of thyroiditis, an autoimmune disorder that stimulates the thyroid gland, being the most common cause of hyperthyroidism (overactivity of the thyroid). ...


Diagnosis

A diagnosis is suspected through blood tests, by measuring the level of thyroid-stimulating hormone (TSH) in the blood. A low TSH (the job of TSH taken over by thyroid-stimulating immunoglobulin [TSI] that act like TSH) indicates increased levels of T4 and/or T3 in the blood. Measuring specific antibodies, such as anti-TSH-receptor antibodies in Graves' disease, may contribute to the diagnosis. In all patients with hyperthyroxinemia, scintigraphy is required in order to distinguish true hyperthyroidism from thyroiditis. Thyroid-stimulating hormone (also known as TSH or thyrotropin) is a hormone synthesized and secreted by thyrotrope cells in the anterior pituitary gland which regulates the endocrine function of the thyroid gland. ... Each antibody binds to a specific antigen; an interaction similar to a lock and key. ... Nuclear medicine is the branch of medicine that uses unsealed radioactive substances in diagnosis and therapy. ...


Treatment

The major and generally accepted modalities for treatment of hyperthyroidism in humans involve initial temporary use of suppressive thyrostatics medication, and possibly later use of permanent surgical or radioisotope therapy. All approaches may cause under active thyroid function (hypothyroidism) which is easily managed with levothyroxine supplementation. Levothyroxine, also known as L-thyroxine, synthetic T4 or 3,5,3,5-tetraiodo-L-thyronine, is a synthetic form of thyroxine (thyroid hormone). ...


Temporary medical therapy

Thyrostatics

Thyrostatics are drugs that inhibit the production of thyroid hormones, such as carbimazole (used in UK) and methimazole (used in US), or where these not tolerated then propylthiouracil. Thyrostatics are believed to work by inhibiting the iodination of thyroglobulin by thyroperoxidase. Carbimazole is used to treat hyperthyroidism. ... Methimazole is an antithyroid drug similar in action to propylthiouracil. ... Propylthiouracil is a thioamide drug used to treat hyperthyroidism. ...


If too high a dose is used in pharmacological treatment, patients can develop symptoms of hypothyroidism. This article or section does not cite its references or sources. ...


Beta-blockers

Beta-blockers do not treat, but rather mask, common symptoms of hyperthyroidism such as palpitations, trembling, and anxiety. Propranolol in the UK, and Metoprolol in the US, are most frequently used to augment treatment for hyperthyroid patients. Beta blockers or beta-adrenergic blocking agents are a class of drugs used to treat a variety of cardiovascular conditions and some other diseases. ... Propranolol (INN) (IPA: ) is a non-selective beta blocker mainly used in the treatment of hypertension. ... “Minax” redirects here. ...


Permanent treatments

Surgery as an option predates the use of the less invasive radioisotope therapy, but is still required in cases where the thyroid gland is enlarged and causing compression to the neck structures, or the underlying cause of the hyperthyroidism may be cancerous in origin.


Surgery

Surgery (to remove the whole thyroid or a part of it) is not extensively used because most common forms of hyperthyroidism are quite effectively treated by the radioactive iodine method. However, some Graves' disease patients who cannot tolerate medicines for one reason or another or patients who refuse radioiodine opt for surgical intervention. Also, some surgeons believe that radioiodine treatment is unsafe in patients with unusually large gland, or those whose eyes have begun to bulge from their sockets, claiming that the massive dose of iodine needed will only exacerbate the patient's symptoms. The procedure is quite safe - some surgeons even perform partial thyroidectomies on an out-patient basis. “Surgeon” redirects here. ...


Radioiodine

In Iodine-131 (Radioiodine) Radioisotope Therapy, radioactive iodine is given orally (either by pill or liquid) on a one-time basis to destroy the function of a hyperactive gland. The iodine given for ablative treatment is different from the iodine used in a scan. Radioactive iodine is given after a routine iodine scan, and uptake of the iodine is determined to confirm hyperthyroidism. The radioactive iodine is picked up by the active cells in the thyroid and destroys them. Since iodine is only picked up by thyroid cells, the destruction is local, and there are no widespread side effects with this therapy. Radioactive iodine ablation has been safely used for over 50 years, and the only major reasons for not using it are pregnancy and breast-feeding. Iodine-131 (131I), also called radioiodine, is a radioisotope of iodine. ... Clinac 2100 C100 accelerator Radiation therapy (or radiotherapy) is the medical use of ionizing radiation as part of cancer treatment to control malignant cells (not to be confused with radiology, the use of radiation in medical imaging and diagnosis). ...


Often, due to the difficulty of picking the correct dose, the treatment results in an opposite condition - hypothyroidism. This article or section does not cite its references or sources. ...


Veterinary medicine

In veterinary medicine, hyperthyroidism is one of the most common endocrine conditions affecting older domesticated cats. The disease has become significantly more common since the first reports of feline hyperthyroidism in the 1970s. In cats, the cause of hyperthyroidism continues to be researched. Most recently, mutations of the thyroid stimulating hormone receptor have been discovered which cause a constitutive activation of the thyroid gland cells. Many other factors may play a role in the pathogenesis of the disease such as goitrogens (isoflavones such as genistein, daidzein and quercertin) and iodine and selenium content in the diet. Veterinary medicine is the application of medical, diagnostic, and therapeutic principles to companion, domestic, exotic, wildlife, and production animals. ... Binomial name Felis catus Linnaeus, 1758 Synonyms Felis lybica invalid junior synonym The cat (or domestic cat, house cat) is a small carnivorous mammal. ... The 1970s decade refers to the years from 1970 to 1979, also called The Seventies. ...


The most common presenting symptoms are: rapid weight loss, tachycardia (rapid heart rate), vomiting, diarrhoea, increased consumption of fluids (polydipsia) and food, and increased urine production (polyuria). This article needs additional references or sources for verification. ... This article or section does not cite any references or sources. ... Vomiting (also throwing up or emesis) is the forceful expulsion of the contents of ones stomach through the mouth and sometimes the nose. ... Diarrhoea is the correct way to spell the word Diarrhoea. ... Polydipsia is a medical condition in which the patient ingests abnormally large amounts of fluids by mouth. ... Polyuria is the passage of a large volume of urine in a given period. ...


The same three treatments used with humans are also options in treating feline hyperthyroidism (surgery, radioiodine treatment, and anti-thyroid drugs). Drugs must be given to cats for the remainder of their lives, but may be the least expensive option, especially for very old cats. Radioiodine treatment and surgery often cure hyperthyroidism. Some veterinarians prefer radioiodine treatment over surgery because it does not carry the risks associated with anesthesia. Radioiodine treatment, however, is not available in all areas for cats. The reason is that this treatment requires nuclear radiological expertise and facilities, since the animal's urine is radioactive for several days after the treatment, requiring special inpatient handling and facilities.[2] Anesthesia or anaesthesia (see spelling differences) has traditionally meant the condition of having the perception of pain and other sensations blocked. ...


See also

Carbimazole is used to treat hyperthyroidism. ... This article or section does not cite its references or sources. ... Goitrogens are substances that suppress the function of the thyroid gland, and which can also cause an enlargement of the thyroid. ... Graves ophthalmopathy, also known by any of the combinations of Graves~/thyroid~/thyroid-associated~/dysthyroid~ with ~ophthalmopathy/~orbitopathy/~exophthalmos, is an autoimmune inflammatory disorder affecting the orbit, with or without thyroid disorder. ...

Footnotes

  1. ^ Faculty of Medicine & Dentistry (2006). Course-Based Physical Examination - Endocrinology -- Endocrinology Objectives (Thyroid Exam). Undergraduate Medical Education. University of Alberta. Retrieved on 2007-01-28.
  2. ^ Susan Little (2006). Feline Hyperthyroidism (PDF). Winn Feline Foundation. Retrieved on 2007-01-28.

Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... is the 28th day of the year in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... is the 28th day of the year in the Gregorian calendar. ...

External links

For Humans
For Felines

  Results from FactBites:
 
Hyperthyroidism - Wikipedia, the free encyclopedia (866 words)
Hyperthyroidism (or "overactive thyroid gland") is the clinical syndrome caused by an excess of circulating free thyroxine (T4) or free triiodothyronine (T3), or both.
Surgery (to remove the whole thyroid or a part of it) is not extensively used because most common forms of hyperthyroidism are quite effectively treated by the radioactive iodine method.
In veterinary medicine, hyperthyroidism is one of the most common endocrine conditions affecting older domesticated cats.
  More results at FactBites »

 
 

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