What is it - hyperthyroidism is a clinical syndrome, which is caused by an elevated content of thyroid hormones.
Another medical name for this condition is thyrotoxicosis.
It develops as a result of either pathological processes of the thyroid gland, or exposure to unfavorable environmental factors.
Possible causes of hyperthyroidism
The causes that can lead to hyperthyroidism are diverse. They can be divided into three main groups, which include:
1) Pathological processes in which there is an increased synthesis of these hormones;
2) Pathological processes in which tissue destruction of the thyroid gland is observed with the release of hormones contained in it;
3) Hyperthyroidism due to iatrogenic factors.
The first group of causal factors is the most numerous. It is associated with the following diseases:
1) Diffuse toxic goiter - common endocrinopathy, which is associated with approximately 80% of cases of hyperthyroidism. Its development is associated with the formation of thyroid-stimulating antibodies that stimulate the synthesis of hormones by thyroid cells( autoimmune pathology);
4) Pituitary tumor, in which there is an increased synthesis of thyroid-stimulating hormone, which stimulates the tissue of the thyroid gland. This disease has an extremely low prevalence.
To the second group of diseases are such as:
1) Autoimmune thyroiditis Hashimoto. It develops as a result of damage to the thyroid tissue by the immune system, which is triggered by various factors( pregnancy, infection, stress, etc.);
2) Postpartum thyroiditis;
3) Hyperthyroidism, which is due to the intake of Cordarone( this is one of the side effects of this drug).
The last group of causative factors is associated with the administration of thyroid preparations at high dosages. This can occur as a result of an independent increase in the number of tablets used or in the absence of laboratory monitoring of hormones in the blood.
Patients who take thyroxine, Eutirox and analogues of these drugs are at risk.
Symptoms of hyperthyroidism
Hyperthyroidism, and its symptoms affect any system of the human body, they are represented by the following clinical signs:
nervous system - frequent mood swings, tearfulness, increased psychoemotional activity;
heart and blood vessels - tachycardia, heart rhythm disturbances, episodes of cardiac irregularities, arterial hypertension, heart failure;
digestive system - diarrhea and rumbling in the abdomen;
musculoskeletal system - muscle weakness, osteoporosis, bone fractures;
skin and its appendages - increased fragility of nails, hair loss, increased sweating, weight loss;
sexual system - decreased libido, potency( in men), delayed menstrual, as well as infertility in women.
The course of hyperthyroidism can be of three degrees:
1) Easy degree. It is characterized by a slight decrease in body weight, the frequency of heart contractions ranges from 80-100 beats per minute, their rhythm is regular, all other endocrine glands except the thyroid function normally.
2) Medium-heavy current. He is diagnosed on the basis of a sufficiently significant decrease in body weight, the heart is contracted with a frequency of 100 to 120 beats per minute, there are occasional episodes of heart rhythm disturbances, diarrhea, and adrenal insufficiency gradually increases.
3) Heavy current is characterized by indicators that exceed the above.
Also read the symptoms of hypothyroidism.
Diagnosis of hyperthyroidism
When suspected of hyperthyroidism involves carrying out both laboratory and instrumental research methods. They have the following objectives:
1) Confirmation of the diagnosis;
2) Identification of the background disease that led to this condition;
3) Identification of complications from target organs.
The main methods used are:
the content of thyroid-stimulating hormone in the blood;
the content of thyroxine and triiodothyronine in the blood;
definition of antibodies to thyroglobulin and thyroid peroxidase;
ultrasound examination of the thyroid gland( reveals inflammatory infiltration, nodal formations, cysts, etc.);
ultrasound examination of the heart with dopplerometry( necessary to estimate the fraction of the ejection of the left ventricle);
electrocardiographic study;
ophthalmoscopy and other ophthalmic diagnostic tests.
Treatment of hyperthyroidism
Hyperthyroidism, treatment of which can be carried out by one of the three listed methods or a combination thereof, depending on the situation.
1) Surgical intervention;
2) Conservative therapy;
3) Use of radioactive iodine.
The choice of this or that treatment strategy will depend on the following factors:
the nature of the underlying pathological process that manifests itself as hyperthyroidism;
of the patient's age;
the presence of an allergic reaction to a particular pharmacological drug;
severity of hyperthyroidism;
presence of concomitant diseases.
Conservative therapy is aimed at reducing the production of thyroid hormones. The main mechanism of their action is suppression of the accumulation of iodine in this glandular organ, and it is necessary for the synthesis of hormones.
It is clear that in its absence, the endocrine function will be disrupted.
Surgical treatment of hyperthyroidism is performed according to the following indications:
thyroid cancer;
jagged shape of the goiter with increasing nodes in the dynamics or with their large dimensions.
The operation can be both radical( complete removal of the organ) and organospore( the part of the organ is removed).In the postoperative period, the determination of the level of thyroid hormones is shown, since the condition of hypothyroidism is not excluded.
In the latter case, it is shown to carry out hormone replacement therapy with thyroxine preparations. Also conservative therapy implies the conduct of symptomatic therapy, which depends on the presence of target organ damage.
Radioiodine therapy is based on the destructive effect of radioactive iodine on thyroid cells. The preparation can be administered both in tablet form and in the form of an aqueous solution. Reception is made once. Radioactive iodine is particularly effective against thyroid cells, which are the most active.
Its therapeutic effect is for two to four weeks. As a result, it is possible to reduce the size of the endocrine organ, reducing its ability to synthesize hormones. Radium therapy should be used in conjunction with other medications. However, it is very rare to achieve full recovery. Sometimes there are indications for another treatment course.
Prognosis and prevention of hyperthyroidism
The main preventive measures for hyperthyroidism are as follows:
regular passage of ultrasound examination of the thyroid and examination of the level of hormones if the patient is at risk;
sufficient iodine content in the diet and water;
prevention of infections that can lead to the development of autoimmune processes;
rational stay in the sun and refusal to visit tanning salons;
vitaminized nutrition.
The prognosis for hyperthyroidism depends on the timely correction of this condition. This allows you to prevent the negative impact of increased levels of thyroid hormones on the target organs.
Therefore, patients with thyrotoxicosis should be on the dispensary account of an endocrinologist. It involves monitoring once every six months the level of hormones, and according to the indications and more often, as well as the dynamic carrying out of ultrasound examination of the thyroid gland for the purpose of early detection of the progression of the pathological process.
Effects of thyroid hyperthyroidism
Complications of hyperthyroidism develop when there is no timely treatment of background diseases. The main complications are:
thyrotoxic heart, in which its hypertrophy and rhythm disturbances are observed;
thyrotoxic crisis, which is characterized by a sharply elevated level of thyroid hormones. It is characterized by fever, impaired consciousness, increased heart rate, etc. All these symptoms appear acutely.
atrial fibrillation;
increased blood pressure;
thyrotoxic psychosis;
progression of chronic diseases.
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