Hyperthyroidism

What is hyperthyroidism? Hyperthyroidism means your thyroid makes too much thyroidhormone. Your thyroid is a gland in the front of your neck . It controls your metabolism, which is how your body turns food into energy. It also affects your heart, muscles, bones, and cholesterol. Having too much thyroid hormone can make a lot of things in your body speed up. You may lose weight quickly, have a fast heartbeat, sweat a lot, or feel nervous and moody. Or you may have no symptoms at all. While your doctor is doing a test for another reason, he or she may discover that you have hyperthyroidism. Hyperthyroidism is easily treated. With treatment, you can lead a healthy life. Without treatment, hyperthyroidism can lead to serious heart problems, bone problems, and a dangerous condition called thyroid storm. What causes hyperthyroidism? Graves' disease causes most hyperthyroidism. In Graves? disease, the body's natural defense (immune) system attacks the thyroid gland. The thyroid fights back by making too much thyroid hormone. Like many thyroid problems, it often runs in families. Sometimes hyperthyroidism is caused by a swollen thyroid or small growths in the thyroid called thyroid nodules. This topic focuses on hyperthyroidism caused by Graves' disease. What are the symptoms? You may have no symptoms at all. Or: You may feel nervous, moody, weak, or tired. Your hands may shake, your heart may beat fast, or you may have problems breathing. You may be hot and sweaty or have warm, red, itchy skin. You may have more bowel movements than usual. You may have fine, soft hair that is falling out. You may lose weight even though you eat the same or more than usual. If you have any of these symptoms, call your doctor. Without treatment, hyperthyroidism can lead to heart problems, bone problems, and a dangerous condition called thyroid storm. How is hyperthyroidism diagnosed? Your doctor will ask you about your symptoms and do a physical exam. Then he or she will order blood tests to see how much thyroid hormone your body is making. Sometimes hyperthyroidism is found while you are having a test for another reason. You may be surprised to find out that you have this problem. How is it treated? If your symptoms bother you, your doctor may give you pills called beta-blockers. These can help you feel better while you and your doctor decide what your treatment should be. Hyperthyroidism can lead to more serious problems. So even if your symptoms do not bother you, you still need treatment.

Radioactive iodine and antithyroid medicine are the treatments doctors use most often. The best treatment for you will depend on a number of things, including your age. Some people need more than one kind of treatment. Radioactive iodine is the most common treatment. Most people are cured after taking one dose. It destroys part of your thyroid gland, but it does not harm any other parts of your body. Antithyroid medicine works best if your symptoms are mild. These pills do not damage your thyroid gland. But they do not always work, and you have to take them at the same time every day. If they stop working, you may need to try radioactive iodine. After treatment, you will need regular blood tests. These tests check to see if your hyperthyroidism has come back. They also check to see if you are making enough thyroid hormone. Sometimes treatment cures hyperthyroidism but causes the opposite problem-too little thyroid hormone. If this happens, you may need to take thyroid hormone pills for the rest of your life.

Treatment Overview
There are three treatments for hyperthyroidism. Antithyroid medicine and radioactive iodine are the ones doctors use most often. In rare cases, surgery may be done. Hyperthyroidism can lead to more serious problems. So even if your symptoms are not bothering you, you still need treatment. The kind of treatment you have depends on your age, what is causing your hyperthyroidism, how much thyroid hormone your body is making, and other medical conditions you may have. Each kind of treatment has benefits and risks. Discuss the benefits and risks of each kind of treatment with your doctor. For some people, more than one kind of treatment may be needed. Initial treatment Initial treatment for hyperthyroidism usually is antithyroid medicine or radioactive iodine therapy. If you have a lot of symptoms, your doctor may recommend you take antithyroid medicine first to help you feel better. Then you can decide whether to have radioactive iodine therapy. Antithyroid medicines work best if you have mild hyperthyroidism, if this is the first time you are being treated for Graves' disease, if you are younger than 50, or if your thyroid gland is only swollen a little bit (small goiter). Radioactive iodine is often recommended if you have Graves' disease and are older than 50, or if you have thyroid nodules (toxic multinodular goiter) that are releasing too much thyroid hormone. Radioactive iodine is not used if: You are pregnant or you want to become pregnant within 6 months of treatment. You are breast-feeding. You have thyroiditis or another kind of hyperthyroidism that is often temporary.

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Hyperthyroidism: Should I Use Antithyroid Medicine or Radioactive Iodine? If you have symptoms such as a fast heartbeat, tremors, sweating, nervousness, or dry eyes, you may take some additional medicines to treat those symptoms. Surgery is not usually part of initial treatment. You may need surgery if your thyroid gland is so big that you have a hard time swallowing or breathing. Or you may need surgery if a single large thyroid nodule is releasing too much thyroid hormone.

Sometimes treatment cures your hyperthyroidism but may cause hypothyroidism.Hypothyroidism is the opposite of hyperthyroidism-instead of making too much thyroid hormone, your body is now making too little thyroid hormone. Hypothyroidism is most common after treatment with radioactive iodine. But it can also occur after surgery and sometimes after taking antithyroid medicine. Be sure to call your doctor if you start to gain weight, feel tired, or feel cold more often than usual. These symptoms may mean you have hypothyroidism and you need to take a different medicine called thyroid hormone medicine. For more information, see the topic Hypothyroidism. Treatment if the condition gets worse If radioactive iodine or antithyroid medicines are not working well, you may need: Another treatment of radioactive iodine. Surgery to remove all or part of your thyroid gland (thyroidectomy). After treatment with radioactive iodine, you may develop hypothyroidism (too little thyroid hormone). Call your doctor if you have any of the symptoms of hypothyroidism such as gaining weight, feeling tired, or feeling cold more often than usual. If you do have hypothyroidism, you may need to take thyroid hormone medicine for the rest of your life.

Ongoing treatment During and after treatment for hyperthyroidism, you will have regular blood tests to check your levels of thyroid-stimulating hormone (TSH). You will also have regularthyroid hormone tests to check your levels of hormones called T4 and T3. These tests are a good way to know how well your treatment is working. If your symptoms do not go away after your initial treatment, you may need to repeat the treatment or try a different treatment. If you have Graves' disease and have been taking antithyroid medicine but your hyperthyroidism has not improved, you can continue to take antithyroid medicine or you can try radioactive iodine therapy. If you have lots of side effects from antithyroid medicines and radioactive iodine is not an option for you, you may need surgery to remove all or part of your thyroid gland (thyroidectomy).

Medications
Antithyroid medicine is often used for hyperthyroidism, because it works more quickly than radioactive iodine therapy. Radioactive iodine therapy destroys part or all of the thyroid gland depending on the dosage used. But antithyroid medicine does not cause permanent thyroid damage. You may take antithyroid medicine before you have radioactive iodine treatment or surgery-to bring your metabolism to normal, to make you feel better, or to reduce the chances of more serious problems. Antithyroid medicine does control hyperthyroidism in many people. But the medicine does have some drawbacks. You have to take the medicine for at least 1 year.

Your symptoms may come back after you stop taking it. And then you have to start taking antithyroid medicine again or try a different treatment. There are some rare side effects from the medicine, ranging from a rash to a low white blood cell count, which can make it hard for your body to fight infection. Your doctor may prescribe additional medicines to treat symptoms caused by hyperthyroidism, such as rapid heartbeat or dry eyes. These medicines can help you feel better while you wait for another treatment to begin to work. Medication choices Antithyroid medicines Additional medicines What to think about

Antithyroid medicine may or may not make your hyperthyroidism permanently go away. The medicine is much more effective in people with mild disease. Up to 30 out of 100 people in the United States will have their hyperthyroidism go away (go into remission) after taking antithyroid medicine for 12 to 18 months.3 Antithyroid medicine works best if you have mild hyperthyroidism, if this is the first time you are being treated for Graves' disease, if you are younger than 50, or if your thyroid gland is only swollen a little bit (small goiter). It is not used forthyroiditis. Antithyroid medicine is used instead of radioactive iodine if you are pregnant,breast-feeding, or trying to become pregnant. Children are treated with antithyroid medicine, because experts do not know if radioactive iodine treatment is safe for children. Treating children with antithyroid medicine is challenging. It is hard to know how much medicine they need when they are growing so quickly. Your doctor may prescribe low doses of thyroid hormone medicine to take with your antithyroid medicine so that your thyroid hormone levels do not get too low.

Home Treatment
Be sure to see your doctor regularly so he or she can be sure that your hyperthyroidism treatment is working, that you are taking the right amount of medicine, and that you are not having any side effects. If you are taking antithyroid medicine, take it at the same time every day.
Recommended Related to Thyroid Disorders
Hypothyroidism (Underactive Thyroid) Hypothyroidism, also called underactive thyroid disease, is a common disorder. With hypothyroidism, your thyroid gland does not make enough thyroid hormone. The thyroid gland is located in the front lower part of your neck. Hormones released by the gland travel through your bloodstream and affect nearly every part of your body, from your heart and brain, to your muscles and skin. The thyroid controls how your body's cells use energy from food, a process called metabolism. Among other... Read the Hypothyroidism (Underactive Thyroid) article > >

If you have Graves' ophthalmopathy, you may need to use eyedrops to help moisten youreyes and wear sunglasses to protect your eyes. To help reduce the symptoms ofhyperthyroidism, you can:

Lower stress. This helps relieve symptoms of anxiety and nervousness. For more information, see the topic Stress Management. Avoid caffeine. Caffeine can make symptoms worse, such as fast heartbeat, nervousness, and difficulty concentrating. Quit smoking. If you have Graves' diseaseand you are a smoker, you are more likely to develop Graves' ophthalmopathy. For more information, see the topic Quitting Smoking.