Symptoms and Causes of Hyperthyroidism - Essay Example

Hyperthyroidism The purpose of this report is to define what Hyperthyroidism is, what the symptoms are, what the causes are, how hyperthyroidism is diagnosed, and what the available treatments for hyperthyroidism are. Upon great deal of research, Hyperthyroidism is found to be not only symptoms of other organic diseases, but it could also be caused by some hereditary factors. Typically, early symptoms include feeling overheated, hand tremors, and weight loss. As hyperthyroidism persists, a fast heart rate, anxiety, frequent soft bowel movements, and a lack of stamina are often noted (What happened 2005). There are two thyroid hormones, thyroxine and tri-iodothyronine. Tri-iodothyronine is the sole mediator of the action of thyroid hormone in the cell. Thyroid hormone regulates energy and heat production; facilitates healthy development of the central nervous system, somatic growth, and puberty; and regulates synthesis of proteins important in hepatic, cardiac, neurological, and muscular functions. These diverse effects account for the numerous and varied symptoms of hyperthyroidism. (Cooper 2003). The proper treatment of hyperthyroidism depends on recognition of the signs and symptoms of the disease and determination of the etiology (Ried and Wheeler 2005). Treatment for hyperthyroidism includes; radioactive iodine, antithyroid medication, and rarely surgery to get rid of the thyroid gland and all its parts. However, some less serious cases require only continuous monitoring by the physician. Definition and progression of Hyperthyroidism The term hyperthyroidism is used to broadly describe a clinical syndrome caused by either acute or chronic excess production or release of thyroid hormones and the accompanying clinical manifestations (Blackwell 2004). Hyperthyroidism develops when the thyroid gland produces too much thyroid hormone. Thyroid hormones regulate metabolism and influence all of body processes, including heart rate, digestion, muscle and bone strength, and cholesterol levels (Topic overview 2005). Hyperthyroidism will cause the increase in thyroid hormone production. The spectrum of possible signs and symptoms depends on the cause of the hyperthyroidism, but typically, symptoms include those of a hyper metabolic state (Blackwell 2004). Hyperthyroidism can also be due to hereditary factors. People with a family history of thyroid disease have an increased chance of developing it themselves. Age and sex are also factors, with most cases occurring after age 50 and women more likely than men to develop thyroid dysfunction (Holcomb 2003). Hyperthyroidism usually begins slowly. At first, the symptoms may be mistaken for simple nervousness due to stress. If the patient has been trying to lose weight by dieting, he may be pleased with his initial success until he found out that he has hyperthyroidism, which has quickened the weight loss, however, causes other problems (What is Hyperthyroidism 2003). In Graves' disease, which is the most common form of hyperthyroidism, the eyes may look enlarged because the upper lids are elevated. Sometimes, one or both eyes may bulge. Some patients have swelling of the front of the neck from an enlarged thyroid gland (a goiter) (What is Hyperthyroidism 2003). Historical perspective of hyperthyroidism One of the first references to the thyroid gland in Western medicine is in 1656, when it was thought that the main function of the thyroid gland was to lubricate the trachea (Hamdy 1995). It was also believed to have a cosmetic function in women. Paintings going back to ancient Egypt often emphasize the size of the thyroid gland in women. In the early 1800s, the thyroid was thought to be a vascular shunt to divert the blood flow from the brain. In 1811, cancer of the thyroid was the first disease of the thyroid to be described (Hamdy 1995). Anatomy and physiology associated with hyperthyroidism In patients with the syndrome of hyperthyroidism, tissues are exposed to overlarge amounts of thyroid hormones. Thyrotoxicosis was originally a clinical term that described the appearance of affected patients, who have tachycardia, warm moist skin, and raised body temperature (Cooper 2003). Thyrotoxicosis is used to refer to any condition in which there is an excessive amount of circulating thyroid hormone, irrespective of whether the hormone leaks from a damaged gland (thyroiditis), is secreted by the gland (Graves' disease), or is exogenous (factitious thyrotoxicosis). However, the difference between hyperthyroidism and thyrotoxicosis does not necessarily clarify the pathophysiology or treatment of each condition (Cooper 2003). In rare cases, hyperthyroidism can cause a serious medical condition called thyroid storm, which develops when the thyroid gland releases huge amounts of thyroid hormones in less time. Thyroid storm is mostly by a stressful event or a serious illness, such as a major infection (What happened 2005). Causes of hyperthyroidism The most common cause of Hyperthyroidism is the overproduction of thyroid hormone by the thyroid gland. This medical condition is also referred to as Graves' disease. Antibodies in the blood that stimulate the thyroid to grow and secrete too much thyroid hormone cause the Graves ' disease (What is Hyperthyroidism 2003). One or more nodules or lumps in the thyroid that may gradually grow and increase their activity so that the total output of thyroid hormone into the blood is greater than normal characterize another type of hyperthyroidism. This medical condition is also referred to as toxic nodular or multinodular goiter (What is Hyperthyroidism 2003). Other common causes include thyroiditis, toxic multinodular goiter, toxic adenomas, and side effects of certain medications (Ried and Wheler 2005). Most cases of thyroiditis occur when the body produces antibodies that damage the thyroid gland (Causes 2005). Toxic multinodular goiter (two or more nodules) or toxic thyroid adenoma (a single nodule) can cause the thyroid gland to produce too much thyroid hormone (Causes 2005). Less frequent causes of hyperthyroidism include metastatic thyroid cancer, ovarian tumors that produce thyroid hormone (struma ovarii), trophoblastic tumors that produce human chorionic gonadotrophin and activate highly sensitive TSH receptors, and TSH-secreting pituitary tumors (Ried and Wheeler 2005). Effects of hyperthyroidism to the body and patient's lifestyle Thyroid hormone generally affects the metabolism of the patient. If there is too much thyroid hormone, every function of the body tends to speed up. Thus the consequences of hyperthyroidism will be nervousness, irritability, increased perspiration, heart racing, hand tremors, anxiety, difficulty sleeping, thinning of your skin, fine brittle hair, and muscular weakness especially in the upper arms and thighs (What is Hyperthyroidism 2003). The patient may have more frequent bowel movements, but diarrhea is uncommon. The patient may lose weight despite a good appetite and, for women, menstrual flow may lighten and menstrual periods may occur less often (What is Hyperthyroidism 2003). Male patients can have reduced libido and sometimes painful gynaecomastia (Cooper 2003). Moreover, patients with elevated thyroid levels frequently suffer from psychological symptoms, and occasionally psychiatric symptoms predominate. Moreover, on occasion these patients can present with an acute psychosis (Moore 2005). Prognosis The prognosis for a patient with hyperthyroidism is good as long as the patient receives appropriate medications or treatments. Even with aggressive treatment, some manifestations of the disease may be irreversible, including ocular, cardiac, and psychological complications. Patients treated for hyperthyroidism have an increased all-cause mortality risk, as well as increased risk of mortality from thyroid, cardiovascular and cerebrovascular diseases, and hip fracture (Ried and Wheeler 2005). Morbidity can be attributed to the same causes, and patients should be screened and treated for osteoporosis and atherosclerotic risk factors. Patients who have been treated previously for hyperthyroidism have an increased incidence of obesity and insulin resistance (Ried and Wheeler 2005). Diagnosis The diagnosis Hyperthyroidism is relatively simple, and the prognosis is excellent if managed in a timely manner. Moreover, neonatal screening programs for hypothyroidism are now the standard of care, and have shown an incidence of 1 in 3,500 to 4,500 births. A large number of tests, procedures, and algorithms are available to guide the clinician's efforts to diagnose thyroid dysfunction (qtd. from Hamdy 1995). A thorough history and physical examination are necessary to determine the definitive diagnosis. In addition to the history and physical, laboratory studies are essential (Blackwell 2004). The most frequently used medical tests are: Thyroid-stimulating hormone (TSH) test, which measures the levels of TSH in the blood stream, and Thyroid hormone tests, which are generally done at the same time as the TSH test. These tests help determine the cause of hyperthyroidism (Exams and tests 2005). Current treatments of hyperthyroidism and how they are done There is no single treatment that is suited to all patients with hyperthyroidism. There are still many factors that will influence the doctor's choice of treatment, including the patient's age, the form of hyperthyroidism, the severity of the disease and other medical conditions, which may be affecting the patient's health (Hyperthyroidism 2005). Hyperthyroidism caused by thyroiditis is often treated with aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs). Treatment with corticosteroids is sometimes necessary. Radioactive iodine and antithyroid drugs generally are ineffective. Complications of hyperthyroidism, such as Graves' ophthalmopathy, may need additional treatment, such as corticosteroid medications, radiation therapy, or in some cases, surgery. Results are mixed when using antithyroid medications for hyperthyroidism caused by Graves' disease (Hypothyroidism 2005). Moreover, Hyperthyroidism can be permanently treated by total removal of the thyroid gland by surgical means. Hyperthyroidism has to be controlled by an antithyroid drug or a beta-blocking drug before any operation. Usually for some days before surgery, the patient has to take drops of nonradioactive iodine-either Lugol's iodine or supersaturated potassium iodide (SSKI) (What is Hyperthyroidism 2003). This extra iodine lowers the blood supply to the thyroid gland making the surgery more easy and safe. After the thyroid gland is removed, the very source of hyperthyroidism is gone and the patient will likely become hypothyroid. As with hypothyroidism that develops after radioiodine treatment, thyroid hormone levels can be restored to normal by treatment once a day with a thyroid hormone supplement (What is Hyperthyroidism 2003). References Blackwell, James. (2004). Evaluation and Treatment of Hyperthyroidism and Hypothyroidism Journal of the American Academy of Nurse Practitioners.Vol.16, Iss. 10; pg. 422, 4 pgs. Causes. Hyperthyroidism. (2005). WebMD. Retrieved 26 Nov. 2005, from Healthwise, Incorporated. Web site: http://www.webmd.com/hw/thyroid_disorders/ hw149049.asp. Cooper, David S. (2003). Hyperthyroidism. The Lancet. London: Aug 9, 2003.Vol.362, Iss. 9382; pg. 459. Exams and test. WebMD. (2005). Retrieved 26 Nov. 2005, from Healthwise Inc. Web site: http://www.webmd.com/hw/thyroid_disorders/hw149131.asp Hamdy, Ronald C. (1995). The Thyroid Gland: A Brief Historical Perspective. Southern Medical Journal 95(5):471-473. Holcomb, Susan Simmons. (2003). Detecting thyroid disease, part 1Nursing. Horsham: Vol.33, Iss. 8; pg. 32CC1. Hyperthyroidism. (2005). Retrieved 26 Nov. 2005, from WorldNow and KCAU-TV. Web site: http://www.kcautv.com/global/story.asps=1230503 Moore, Elaine. (2005). Graves' Disease. Retrieved 26 Nov. 2005, from Creative Marketeam Canada Ltd. Web site: http://www.suite101.com/article.cfm/9630/107241. Ried, Jeri R., Stephen F Wheeler. (2005). Hyperthyroidism: Diagnosis and Treatment American Family Physician. Kansas City. Vol.72, Iss. 4; pg. 623, 8 pgs. Topic Overview. Hyperthyroidism. (2005). WebMD. Retrieved 26 Nov. 2005, from Healthwise Inc. Web site:http://www.webmd.com/hw/thyroid_disorders/hw149041.asp Treatment Overview. WebMD. (2005). Retrieved 26 Nov. 2005, from Healthwise Inc. Web Site: http://www.webmd.com/hw/thyroid_disorders/hw149155.asp What happened Hyperthyroisdism. (2005). WebMD. Retrieved 26 Nov. 2005, from Healthwisr Inc. Web site: http://www.webmd.com/hw/thyroid_disorders/hw149098.asp What is Hyperthyroidism (2003). Retrieved 26 Nov. 2005, from The American Thyroid Association. Web site: http://www.thyroid.org/patients/brochures/Hyper_brochure.pdf. Read More