Hyperthyroidism
Hyperthyroidism
Hyperthyroidism is a condition where the thyroid gland becomes overactive and produces an excess of hormones. This accelerates metabolism and may lead to various symptoms and complications.
Causes of Hyperthyroidism
Graves' disease – The most common cause of hyperthyroidism.
Toxic multinodular goiter
Silent (lymphocytic) thyroiditis
Postpartum hyperthyroidism – A transient hyperthyroidism that may develop after childbirth and sometimes leads to a hypothyroid phase.
Subacute (granulomatous) thyroiditis – Inflammation of the thyroid gland, often occurring after upper respiratory infections.
Excessive dosage of levothyroxine
Symptoms of Hyperthyroidism
Rapid, strong, and irregular heartbeat
Anxiety, irritability, and insomnia
Weakness and tremors
Heat intolerance
Weight loss despite increased appetite
Frequent bowel movements
Diagnosis
Hyperthyroidism is diagnosed through blood tests measuring TSH, FT4/TT4, and FT3/TT3 levels. Additionally, thyroid scintigraphy or antibody tests may be required to determine the cause (Graves' disease, toxic multinodular goiter, or thyroiditis).
Treatment
1. Medication
Antithyroid drugs – Methimazole and propylthiouracil reduce thyroid hormone production. Methimazole is preferred due to fewer side effects.
Beta-blockers – (e.g., atenolol, propranolol) do not reduce hormone production but help manage symptoms.
2. Radioiodine Therapy
Destruction of the thyroid gland using a small dose of radioactive iodine. This often leads to hypothyroidism, requiring lifelong hormone replacement therapy. Radioiodine therapy is contraindicated during pregnancy and breastfeeding.
3. Surgery (Total Thyroidectomy)
Recommended if:
A large goiter obstructs the airway
Severe side effects occur with medication
A thyroid nodule is suspected to be cancerous
Worsening Graves' orbitopathy (eye disease)
A radical treatment is needed before pregnancy
Hyperthyroidism and Pregnancy
If you are taking antithyroid medication and planning pregnancy, consultation with an endocrinologist is essential. Managing hyperthyroidism during pregnancy requires frequent monitoring. Pregnancy should not be planned for at least six months after radioiodine therapy.