High levels of thyroid hormone can cause hyperthyroidism, thyroid storm, and Graves disease. An excessive amount of thyroid hormones can cause symptoms that range from mild to highly toxic, which can lead to illness and death in the patients who are affected.
Hyperthyroidism
When thyroid function is too high, this is called hyperthyroidism. Hyperthyroidism is characterized by increased thyroid hormone synthesis and secretion from the thyroid gland.
Thyrotoxicosis
Though frequently referred to interchangeably, the word thyrotoxicosis, refers to the clinical condition of excess circulating thyroid hormones, no matter what the source. For example, thyrotoxicosis caused by toxic drugs or radiation (Inflammation and release of stored hormone in the body); Or excessive thyroid levels due to taking large doses of thyroid medications (Extra-thyroidal source of hormone)
Graves disease
The most common type of noticeable hyperthyroidism is Graves disease, also known as Diffuse Toxic Goiter. It is an autoimmune disease in which autoantibodies attack the thyroid-stimulating hormone (TSH) receptor. As a result, the thyroid gland is triggered in the wrong way, which causes the gland to get bigger and make more thyroid hormones.
Graves disease is more likely to happen if you smoke, take a lot of iodine, are stressed, or have a family history of hyperthyroidism or other inflammatory diseases. The three typical signs of Graves disease are: goiter, exophthalmos, and pretibial myxedema.
Thyroid storm
Thyroid storm is a rare complication of hyperthyroidism that can be deadly. People who have untreated or partly treated thyrotoxicosis, and then have surgery, an infection, or a physical injury, are more likely to get it.
Thyroid storm must be diagnosed and treated based on symptoms alone, since lab proof isn’t always possible quickly. People who have this condition usually have high fevers, tachycardia, nausea and vomiting, tremors, restlessness, and psychosis. Patients may become drowsy or unconscious with low blood pressure as the disease gets worse.
How to tell if someone has Hyperthyroidism
These are some of the signs and symptoms of hyperthyroidism:
Weight loss
Palpitations
Chest pain (Occurs in the absence of heart disease)
Psychosis (Hallucinations)
Menstrual irregularity
Disorientation (Confusion)
Tremor
Nervousness, anxiety, or emotional lability
Heat intolerance
Increased perspiration
Fatigue
Weakness – (Affects proximal muscles- (face, shoulders, hips)
Edema
Dyspnea/ Difficulty of breathing
Diarrhea/ Frequent bowel movements
How to Diagnose High Thyroid Levels
Thyrotoxicosis can be diagnosed by high levels of free thyroxine (T4) and low to undetectable levels of thyroid-stimulating hormone (TSH).
Hyperthyroidism can also be shown by the following lab results:
Hyperglycemia/ High Blood Sugar
Hypercalcemia/ Too much calcium
Hepatic problems/ Abnormal liver function
Low serum cortisol
Leukocytosis / Increased White Blood cells
Hypokalemia / Low Blood Potassium
A chest x-ray can show if someone has congestive heart failure or a lung infection, which are often signs that thyroid storm is getting worse.
In Graves disease, a nuclear thyroid scan can show widespread uptake, and in toxic nodular thyroiditis, it can show focal uptake.
Managing High Thyroid Hormones
Your doctor may prescribe Anti-thyroid drugs like propylthiouracil (PTU) and methimazole (MMI) stop the production of T4.
However, the US Food and Drug Administration (FDA) added a boxed warning to the prescribing information for propylthiouracil. There is a high chance of serious liver damage and acute liver failure, and the recommendation is to use propylthiouracil on people who can’t handle other treatments, like surgery, methimazole, or radioactive iodine.
Radioactive iodine treatment is the preferred therapy for hyperthyroidism and is administered orally as a single dose, in capsule or liquid form. This causes fibrosis and destruction of the thyroid over weeks to many months, resulting to hypothyroidism.
Thyroidectomy or Thyroid Surgery is reserved for special circumstances, such as severe hyperthyroidism in children, or pregnant women who can’t tolerate antithyroid medication.
Symptomatic Management
Oral rehydration for patients who are dehydrated.
Beta-blockers to treat palpitations and tremors.
Saline eye drops as needed and form-fitting sunglasses when going outside are recommended for moderate ophthalmopathy.
For vision-threatening eye problems, high-dose steroids is prescribed, with an option for orbital decompression surgery.
Takeaway
In most cases, hyperthyroidism necessitates medical intervention and supervision by a qualified physician.
Good nutrition, regular exercise, self-care, and stress reduction techniques can all be beneficial. Thyroid function can return to normal when it is controlled with medical treatments and a balanced lifestyle.
References
PubMed Central. Hyperthyroidism. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5014602/
Medscape. Hyperthyroidism and Thyrotoxicosis. https://emedicine.medscape.com/article/121865-overview
Medscape. Hyperthyroidism, Thyroid Storm, and Graves Disease. https://emedicine.medscape.com/article/767130-overview