Hyperthyroidism

Running Head : HYPERTHYROIDISM

Hyperthyroidism : Bigger May Not Always Be Better

John McKain

University of South Alabama

Key words : hyperthyroidsim , thyrotoxicosis , Graves ' disease , toxic goiter , thyroidectomy

Abstract

Hyperthyroidism is defined as the excessive function of the thyroid gland . This is a very common dis that is said to be present in 1 .5 to 2 .0 of women in the United States . Patients with this condition has clinical manifestations that include hyperactivity , irritability nervousness , muscle weakness , weight loss increased appetite , heat intolerance and sweating , diarrhea , warm moist skin , fine

tremor of the hand , and variable enlargement of the thyroid gland The most common etiology is Graves ' disease or diffuse toxic goiter . It has a peak incidence between the ages of 20 and 40 , with women being affected up to seven times more commonly than men . The three primary methods in the management of hyperthyroidism include the use of antithyroid drug therapy , surgical removal of the thyroid gland and the destruction of the thyroid tissue with radioactive iodine . The purpose of this is to provide information regarding hyperthyroidism and to discuss some aspects about its management

Hyperthyroidism : Bigger May Not Always Be Better

Hyperthyroidism is defined as the excessive function of the thyroid gland (Braunwald , et al , 2001 . It is commonly used interchangeably with the medical condition known as thyrotoxicosis which is the hypermetabolic state brought about by elevated levels of thyroid hormones (Cotran , et al , 1999 . However , both terms are not synonymous to each other . When the hormone excess is secondary to the hyperfunction of the thyroid gland , such as in the case of Graves disease , the thyrotoxicosis may be correctly called hyperthyroidism However , since other conditions can lead to elevated hormone levels other than a hyperactive thyroid gland , any increase in thyroid hormone is properly referred to as thyrotoxicosis (Cotran , et al , 1999 Whatever the case may be , both conditions have similar clinical manifestations . These include hyperactivity , irritability , nervousness muscle weakness , weight loss increased appetite , heat intolerance and sweating , diarrhea , warm moist skin , fine tremor of the hand , and variable enlargement of the thyroid gland (Braunwald , et al , 2001

Causes of hyperthyoidism

There are several diss associated with hyperthyroidism . The most common etiology is Graves ' disease or diffuse toxic goiter which accounts for 60 to 80 of thyrotoxicosis in general . It has a peak incidence between the ages of 20 and 40 , with women being affected up to seven times more commonly than men (Braunwald , et al , 2001 . This is a very common dis that is said to be present in 1 .5 to 2 .0 of women in the United States (Cotran , et al , 1999 . Other causes of hyperthyroidism include toxic multinodular goiter , toxic adenoma functioning thyroid carcinoma metastases , excessive intake of iodine and secondary diss outside the thyroid such as certain pituitary gland tumors , tumors that secrete chorionic gonadotropin hormone and gestational thyrotoxicosis in pregnancy (Braunwald , et al , 2001

Management of hyperthyroidism

The three primary methods in the management of hyperthyroidism include the use of antithyroid drug therapy , surgical removal of the thyroid gland and the destruction of the thyroid tissue with radioactive iodine Drug therapy is most useful in children with small glands and mild disease . This is the only therapy that leaves an intact thyroid gland but it does require a long period of treatment (Katzung , 2001 . Surgery is the treatment of choice in patients under age 35 with severe thyrotoxicosis and large goiters . The main advantage of thyroidectomy is immediate cure of the disease (Schwartz , et al , 1999 . In addition about 80 to 90 of patients will require lifetime thyroid supplementation following surgery to avoid hypothyroidism (Katzung 2001 . Older patients in the United States undergo radioiodine treatment . It is the treatment in patients without underlying heart diseases . However , it is contraindicated in pregnant or nursing women . The key objective in any of these treatments is controlling the increased level of the thyroid hormone released into the blood

Summary

Hyperthyroidism is a common disease affecting mostly women . Emphasis should be given to its cardiac manifestations which could lead to severe complications . The diagnosis of hyperthyroidism should cause concern to its underlying etiology which could be a primary tumor or a metastasis from a distant tumor . Several treatment options are available to thyroid patients . Careful selection of the treatment modality and good patient compliance to medication should lead to a favorable treatment outcome

References

Braunwald , E , Fauci , A .S , Kasper , D .L , Hauser , S .L , Longo , D .L Jameson , J .L

(2001 . Harrison 's Principles of Internal Medicine (15th ed . New York

Mcgraw-Hill Health publishing division

Cotran , R , Kumar , V , Collins , T (1999 . Robbins Pathologic Basis of Disease (6th ed

Philadelpia : W .B . Saunders Company

Katzung , B .G (2001 . Basic Clinical Pharmacology (17th ed . New York

Lange Medical Books /Mcgraw-Hill Medical Publishing Division

Schwartz , S .I , Shires , G .T , Spencer , F .C , Daly , J .M , Fisher , J .E Galloway , A .C

(1999 . Principles of Surgery Companion Handbook (17th ed . New York

Mcgraw-Hill Health publishing division

Hyperthyroidism - PAGE 5 - ...