Hyperthyroidism and its treatment

Jul 10, 2012 , Tereza Kratochvílová

hypertyreoza-lecba.jpg - kopie
hypertyreoza-lecba.jpg - kopie
The treatment of hyperthyroidism is absolutely vital for the patient's health, mainly due to its severe symptoms. Hyperthyroidism is treated by drugs called thyrostatics and in some cases by a surgical removal of the gland, known as a thyroidectomy. Untreated hyperthyroidism can lead to a thyrotoxic crisis a condition endangering the patient's life.

Hyperthyroidism

Hyperthyroidism is a medical term for an increased function of the thyroid gland, which then produces an excessive amount of hormones. A thyroid gland is an organ found the the front of the neck, specialized for hormone production. The most common cause of hyperthyroidism is a Graves-Basedow disease, which is an autoimmune thyroid inflammation, forming about 60-80% of all cases. Other causes are nodes and adenomas (benign thyroid gland tumors).

Hormones

Thyroid gland hormones are absolutely indispensable for most processes in the human body. Practically all organs fall under their influence. The thyroid gland produces triiodothyronine (T3) and tetraiodothyronine (T4, thyroxine). The amount of hormones the gland releases into the bloodstream is controlled by another gland, hypophysis, using a thyrotropic hormone (TSH). In order to achieve the correct effect of the hormones on organs, their concentration in blood cannot be either too low or too high. If the level of thyroid hormones is high, we refer to this as hyperthyroidism or as thyrotoxicosis.

Hyperthyroidism diagnosis

A specialist called an endocrinologist treats diseases of the thyroid gland. In order to determine a correct diagnosis and start an effective treatment of hyperthyroidism, it is first necessary to undergo a complete examination, during which the doctor will palpate your thyroid gland. Your endocrinologist will also be interested in knowing if anyone in your family has a thyroid disease or if you suffer from an autoimmune disease yourself. The basis of the entire examination is a blood sample, which is used to determine the levels of T3 and T4, concentration of TSH and the presence of antibodies against TSH receptors. Hyperthyroidism is marked by low levels of TSH, high values of T3 and T4, antibodies against TSH receptors may be present. If we find specific antibodies in the blood, the cause is most likely the Graves-Basedow disease. After that, an ultrasound is done to determine the size and any changes of the thyroid gland. A tissue sample is taken through biopsy as well, which, in the case of a finding will clarify its origin, for example whether it is a cancerous disease or not. If needed, further examinations are done using MRI, CT, x-ray or scintigraphy.

Methods of treating hyperthyroidism

If hyperthyroidism is diagnosed, its initially needed to decrease the levels of thyroid hormones using medication. This medication is known as thyrostatics and is taken in pill form. High doses are used at first, which are then decreased based on frequent examinations. Your doctor is always the one to decide for a decreased dosage. Drugs to slow down the heart rate, beta blockers are taken together with thyrostatics. Aside from treating hyperthyroidism itself, it's also necessary to search for its cause, then treat it as well. Sometimes, hyperthyroidism can be managed by taking thyrostatics long-term. With a Graves-Basedow disease there is a good chance the situation will calm itself completely after some time of taking medication. If the disease cannot be controlled by medication however, a more radical treatment is needed, in order to remove the dangerous tissue. Surgical treatment or radioiodine treatment are used for a permanent solution of hyperthyroidism. These are mainly used for thyroid cancer. Whether it's appropriate to perform a surgery or use a radioiodine treatment is decided by the doctor based on the patient's state. After a surgical removal or destroying the gland with radioiodine the body can no longer produce T3 and T4 hormones, which then need to be supplied in pill form for the rest of life. In USA the most commonly used treatment is using radioiodine, while in Europe and the rest of the world, the focus is more on using thyrostatics or a surgical removal.

Recommendations for hyperthyroidism

If you are diagnosed with a disease causing hyperthyroidism, it's vital for you to take your doctor's advice, to keep the dosage of drugs and undergo regular examinations at your endocrinologist. It's important to avoid great physical activity, to get plenty of rest and take good care of your health. If you do not keep a healthy lifestyle, your hyperthyroidism can turn into a thyrotoxic crisis, which is a life threatening condition. To improve your overall health condition, you should avoid food with high content of iodine, black coffee and especially alcohol. Doctors also warn against excessive suntanning. Avoid overly heated places, saunas and steam baths may be detrimental to you.

Prognosis of hyperthyroidism treatment

Hyperthyroidism manifests through many unpleasant symptoms and can culminate into very serious health complications. This is why it's extremely important to cooperate with your doctor for your own sake. Keeping calm and patient is the best thing to do during treatment. The decrease of hormones is not noticeable immediately after starting the treatment, in some cases it can take months for the hormonal levels to settle. Do not despair if the results don't come instantly and keep up your treatment. Although lengthy and unpleasant, the treatment is relatively successful, with extremely low mortality. After finishing the treatment, it is however necessary to visit your endocrinologist for the rest of your life, to maintain your hormonal levels and, if your thyroid gland has been removed, to take pills with thyroid hormones. 

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