Hyperthyroidism is an autoimmune disease in which the thyroid gland over produces hormones in the body. Graves’ disease, which is more likely to affect women than men, is amongst the most common forms of hyperthyroidism and in some cases can be the underlying cause of hyperthyroidism.
What Does the Thyroid do
The thyroid gland is a butterfly-shaped gland in the front of the neck located below the Adam’s apple and surrounding the trachea. The thyroid not only plays a role in growth, metabolism, body temperature, heart rate, menstrual cycles, and weight, but also regulates many bodily functions by releasing hormones into the bloodstream. The release of hormones directed by the brain. When thyroid levels become low, the hypothalamus triggers the production of a hormone called thyrotropin, which then tells the pituitary gland to stimulate the thyroid by releasing THS (thyroid stimulating hormone). Once triggered the thyroid gland then releases the needed level of Thyroxin, or T4, which is delivered into the body and then converted into the hormone triiodothyronine (T3). These systems are all dependent upon each other.
What is Hyperthyroidism and Graves Disease
Hyperthyroidism is a condition in which the thyroid gland over produces thyroxine. This condition is classified as an autoimmune problem. Studies do not completely explain the cause of autoimmune disease other than there is a genetic connection. Other known causes include excess iodine which is an ingredient in the hormones the thyroid produces, tetraiodothyronine (T4) and triiodothyronine (T3).
According to the Mayo Clinic symptoms of hyperthyroidism may include:
- Unintentional weight loss, even when your appetite and food intake stay the same or increase
- Rapid heartbeat (tachycardia) — commonly more than 100 beats a minute
- Irregular heartbeat (arrhythmia)
- Pounding of your heart (palpitations)
- Increased appetite
- Nervousness, anxiety and irritability
- Tremor — usually a fine trembling in your hands and fingers
- Changes in menstrual patterns
- Increased sensitivity to heat
- Changes in bowel patterns, especially more frequent bowel movements
- An enlarged thyroid gland (goiter), which may appear as a swelling at the base of your neck
- Fatigue, muscle weakness
- Difficulty sleeping
- Skin thinning
- Fine, brittle hair
Hyperthyroidism and Graves disease usually appears between ages 30 and 50, although it may occur at any age.
There are a number of disorders that impact the immune system and cause hyperthyroidism, but Graves decease is a common cause. In Graves’ disease, the immune system creates antibodies known as thyroid-stimulating immunoglobulins. These antibodies then attach to healthy thyroid cells. They can cause the thyroid to create too much of the aforementioned thyroid hormones.
According to the Mayo Clinic common signs and symptoms of Graves’ disease include:
- Anxiety and irritability
- A fine tremor of your hands or fingers
- Heat sensitivity and an increase in perspiration or warm, moist skin
- Weight loss, despite normal eating habits
- Enlargement of your thyroid gland (goiter)
- Change in menstrual cycles
- Erectile dysfunction or reduced libido
- Frequent bowel movements
- Bulging eyes (Graves’ ophthalmopathy)
- Thick, red skin usually on the shins or tops of the feet (Graves’ dermopathy)
- Rapid or irregular heartbeat (palpitations)
Treatments for Hyperthyroidism and Graves Disease
There are several treatments for Hyperthyroidism which range from medications to surgery. Possible treatments include:
- Radioactive iodine. A safe and effective treatment used since the 1940s for both Hyperthyroidism and Graves disease. It is a pill that gradually shrinks the thyroid over time.
- Anti-thyroid medications. There are two commonly used forms of Antithyroid drugs (also called thionamides). Methimazole, a tablet taken up to three times a day which rapidly reverses. Propylthiouracil does the same as Methimazole, but at a slower rate but requires closer monitoring because of the potential for liver damage.
- Beta blockers. These drugs may include Propranolol (Inderal), Atenolol (Tenormin), Metoprolol (Lopressor, Toprol-XL) Nadolol (Corgard). These drugs block the effects the hormone has on the body. They do not work to inhibit hormone production in the thyroid.
- Surgery (thyroidectomy). Surgery may be the final resort, or in cases where the patient is pregnant or having negative reactions to the available medications. A thyroidectomy is a procedure in which part of your thyroid gland is removed. While this is a common surgery, all surgeries are risky, especially around such a sensitive area. Generally a lifetime of medication is required to help supply the body with the correct levels of hormones. This surgery can also be rather invasive, so scarring in the neck area is almost inevitable.
Graves treatments are much the same other than treatments mean to fix or relieve ophthalmopathy. Mild symptoms can be treated with over the counter drugs and medications, but in more serious cases steroids, corrective lens glasses, surgery, and in some cases orbital radiotherapy (a series of targeted X-rays) may be used to help.