Hyperthyroidism

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Definition

Hyperthyroidism is a clinical syndrome caused by excessive production of thyroid hormones. The affected person very often develops significant alterations to the metabolism, nervous system and heart.

Symptoms

To learn more: Hyperthyroidism symptoms

Hyper-ionicity causes an increase in oxygen consumption and metabolic heat production. Thyroid hormones are indeed thermogenic and, while their defect is often the basis of a pathological overweight, an excess correlates to disorders such as hyper-sweating, tremors, heat intolerance and excessive thinness.

The clinical picture of hyperthyroidism is quite varied and, in addition to the symptoms described above, includes numerous disorders, mostly related to increased metabolic activity. The skin of a hyperthyroid patient is hot due to increased blood flow and peripheral vasodilation, with which the body tries to disperse the excess thermal energy.

Hyperthyroidism, like hypothyroidism, is often associated with goiter, that is, with a significant increase in volume and weight of the thyroid.

An excess of thyroid hormones increases protein catabolism and can cause fatigue (muscle weakness). Even the scalp suffers from this condition and the fragile and thin hair tends to lose its natural undulations becoming smooth; frequent alopecia.

Hyperthyroidism influences the activity of the central nervous system, causing psychological disorders such as nervousness, agitation and insomnia, to the point of causing a real psychosis.

With regard to the repercussions on the cardiovascular system, hyperthyroidism is associated with an increase in heart rate (tachycardia), and the strength of contraction of the heart. Hypertension, often associated with hypertrophy of the left ventricle, is also observed.

Other minor signs of hyperthyroidism include: irregular menstruation, infertility in both male and female, decreased libido, gynecomastia in 5% of males, conjunctivitis, thin but not atrophic epidermis, periorbital edema and dysfunction of extra ocular musculature. The most obvious symptom associated with eye disorders is exophthalmos, which is the protrusion of the eyeballs which gives the patient an apprehensive and frightened expression.

Causes

Hyperthyroidism is one of the most frequent endocrine-metabolic disorders. It mainly affects women between the ages of 20 and 40, although it can occur at any age.

The main causes of origin are due to:

diffuse primitive hyperplasia or Graves-Basedow disease. The body produces antibodies called thyroid-stimulating immunoglobulins or IST which, combining with specific TSH receptors, mimic its action, stimulating hormone production, with consequent goiter and the appearance of the symptoms described above. After diabetes, Graves-Basedow's hyperthyroidism is the most common endocrinological disease. It mainly affects women between the ages of 20 and 40.
Toxic multinodular goiter: less frequent than Graves-Basedow's disease and with less predilection for the female sex, it generally occurs after 50-60 years. Sneaky onset, caused by protracted thyroid stimulation due to insufficient synthesis of thyroid hormones. It is widespread in areas of reduced iodine intake and is characterized by the presence of an increased thyroid gland (goiter) in which there are functionally more active nodules than the remaining parenchyma.
Toxic nodular goiter: in this case hyperthyroidism is the result of a localized and not widespread hormonal hyperproduction as in the previous case. A more or less wide area of the thyroid "goes crazy" and starts producing an excess of thyroid hormones regardless of TSH stimulation
Hyperfunctional adenoma (toxic adenoma): causes an asymmetric increase in the thyroid gland (widely affected, with a lobulated or cocooned appearance).
Excessive production of TSH, a pituitary hormone that stimulates the thyroid to produce thyroid hormones (rare)
Abuse of thyroid preparations (subjects taking these hormones for weight loss); accidental ingestion of thyroid tissue in food ("toxic burger"); iodine uptake: generally causes hyperthyroidism in subjects predisposed (with previous episodes of thyroid dysfunction), sometimes even in subjects with normal thyroid function (be careful not to abuse iodized salt and supplements such as fucus or laminaria).

Therapy

To learn more: Drugs for the treatment of hyperthyroidism - Thyroidectomy - Therapy with marked iodine

The therapy of hyperthyroidism is closely linked to its cause of origin. Partial or total removal of the glandular body ( thyroidectomy ) or the use of marked iodine therapy (able to selectively destroy abnormal thyroid cells) may be necessary. The pharmacological treatment is based on the use of thyrostatic medicinal products, capable of blocking hormone synthesis (substances related to thiourea) or blocking the peripheral conversion of T4 (inactive form) to T3 (active form).