What is hyperthyroidism and how is it diagnosed?
Hyperthyroidism is a condition that leads to excessive production of thyroid hormones. These hormones then increase the activity of most of the body's organs and tissues: heart rate, fat consumption, heat production... The most common cause (90%) of hyperthyroidism is an autoimmune disease called "Graves' disease" or "Basedow's disease". Antibodies directed against the thyroid stimulate it too much: the gland then produces an excess of hormones, leading to hyperthyroidism.
There are 8 women with hyperthyroidism for every man, and 3 to 10 women with hypothyroidism for every man. The disease most commonly affects people between 20 and 40 years of age but can occur at any age.
What are the symptoms of the disease?
- Difficult sleep,
- Excessive sweating, hot flashes,
- Weight loss despite appetite maintained or increased,
- Increased heart rate,
- Nervousness, mood swings,
- Muscle weakness,
- Diarrhea, frequent bowel movements,
- Red, shiny and warm skin.
How to make the diagnosis?
To detect hyperthyroidism, the doctor uses the patient's symptoms and palpation of the thyroid gland, which is located at the base of the neck.
It is also possible to determine the level of a hormone called TSH (Thyroid Stimulating Hormone). Its role is to stimulate the thyroid to produce thyroid hormones. In the general case of hyperthyroidism, the excess of these hormones reduces the TSH level because it is not necessary to produce more. Dysthyroidism is often an autoimmune disease. For this reason, antibodies are sometimes searched for in order to know the cause of the condition.
Treatments for hyperthyroidism
Physical and mental rest is a first step to getting better because the body gets tired faster. Caffeine should also be avoided. In order to limit weight loss, it is necessary to have more meals during the day. A patient's diet can be increased in calories when this weight loss is too high. Intense physical activity is not recommended. However, when the patient is undergoing treatment, sports practice is recommended because it limits bone demineralisation, which is a complication of hyperthyroidism.
In the case of Basedow's disease, the eyes may be irritated, swollen and dry. It is therefore advisable to avoid certain factors such as wind, sun, tobacco. Dry eyes can be soothed with eye drops. Finally, raising the head at night limits the pressure on the eyes.
In the case of Graves-Basedow disease, treatment is based on the use of drugs called synthetic antithyroid drugs. Unlike hypothyroidism, treatment is started at high doses for one to two months, then the dosage is gradually decreased until normal thyroid function is achieved. It is advisable to take them with meals.
Antithyroid drugs (carbimazole, etc.) are very effective but can cause rare and potentially serious side effects. For this reason, extreme caution should be exercised when fever, angina or infection occurs under antithyroid drugs. In case of relapse or intolerance to medication, possible treatments are surgery, preferred in young women, and radioactive iodine 131, preferred in the elderly.
Sources: Article written under the supervision of Professor Philippe Touraine, Head of the Endocrinology and Reproductive Medicine Department at the Pitié Salpêtrière in Paris
Published 12 Sep 2019