Hyperthyroidism

The thyroid gland is mainly in charge of the internal metabolism regulation mechanism of the body. Its changes will directly affect the metabolism and function of the body. Hyperthyroidism will cause many high metabolism states, among which the patients will experience palpitation, irritability and fatigue.

Treatment begins by identifying the causes of hyperactivity, including the ingestion of food or drugs that contain thyroxine by mistake, but most of them are due to the similar symptoms of functional nodules and Graves' disease, so further detailed examination is necessary. The biggest concern is palpitations, because chronic uncontrolled hyperthyroidism is one of the leading causes of early-onset heart failure.

Related symptoms

Diagnostic process

• The examination will vary from person to person, with some requiring only blood drawn and ultrasound, and others requiring further arrangement of absorption photography for evaluation, which will require further discussion with the physician.
• Whether there is exogenous thyroxine uptake or temporary hyperthyroidism caused by infection should be excluded before treatment.
• The treatment after diagnosis is also the part that patients are most worried about and want to know. According to different causes, the treatment is generally divided into three types: antithyroid drugs, surgical resection, radioiodine therapy, etc. Which treatment option is better or worse can be discussed with doctors.

Treatment

Once Graves’ disease is clinically diagnosed, treatment options include radioactive iodine therapy, anti-thyroid drugs, or thyroidectomy. Radioactive iodine is more commonly used in the United States, but the current trend is for the use of antithyroid drugs to gradually increase, and in the absence of other complications, the three treatment options do not differ significantly in quality of life after long-term treatment.

However, there are still some special clinical conditions that make a certain type of treatment more appropriate.

1. Radioiodine: women of childbearing age who are expected to be pregnant for more than half a year, patients who are at high risk of other surgical complications, who have had neck surgery or radiation therapy, who are lack of experienced thyroid surgeons, who have contraindications for the use of antithyroid drugs or who are unable to maintain normal thyroid function effectively when using drugs. In addition, if the patient has hypokalemic periodic paralysis, right heart failure pulmonary hypertension, or heart failure, it is also suitable for radioiodine therapy.
2. Antithyroid drugs: For patients with high recovery probability, such as women, with minor diseases, small goiter, negative or low concentration of thyrotropin receptor antibodies (TRAb), pregnancy, older age, or high risk of surgery and a short expected life span, alongside moderate to severe Graves' ophthalmopathy, which need a quick correction of biochemical abnormalities, antithyroid drugs may be considered.
3. Operation: women of childbearing age who are expected to be pregnant for less than half a year have normal thyroid function, compression symptoms or large goiter (more than 80g), relatively low radioiodine absorption, together with suspected or determined to have malignant tumor, the size of thyroid nodules  more than 4cm, hyperparathyroidism required by operation, high concentrations of TRAb and severe active Graves' ophthalmopathy.