An attractive thyroid (hyperthyroidism or thyrotoxicosis ) results from the overproduction of the thyroid hormones, T4 and T3 , by the thyroid gland . in three quarters of patients this is the result of the presence in the blood of an anti body that stimulates the thyroid , not only to secrete excessive amounts of thyroid hormones but also , in some , to increase the size of the thyroid gland, produsing a goitre.
This type of hyper thyroidism is known as Graves disease , named after one of the physicians who described the condition in considerable details more than 200 years ago . The cause of antibody production is not known but, as Grave’s disease runs in families , genes must play a part . There is thought to be some environmental trigger that starts off the disease in genetically susceptible individuals , but the culprit has not been identified . stress in the form of major life events , such as death in the family or divorce , may play a role . Some patient’s with Grave’s disease develop prominent eyesand a few also suffer from raised , red , itchy areas of skin on the front of the lower legs or on the top of the feet, which are known as pretibial myxoedima . These like the production of the thyroid stimulating antibodies , are caused by abnormality in the patient’s immune system , which doctors do not yet fully understand . most other patients with hyperthyroidism have a goitre containing one or more nodules or lumps , these over produce thyroid harmones in their own right and are not under the control of TSH , as is the normal thyroid gland .
Grove’s disease can come on at any age but most commonly affects women in the 40 to 50 years age group . Between a third and a half of all patients will have a single episode of hyperthyroidism lasting several months . the rest will have successive episode of hyperthyroidism that will occur over many years . unfortunately , it is not possible to predict the pattern of hyperthyroidism when it first occurs .Hyperthyroidism resulting from a nodular goitre is unusual before the age of 40 and , unlike some instances of Grave’s disease , it persists idefinitely once it has developed.
HOW DOES IT DEVELOP: In retrospect , most patients will have had symptoms for at least 6 months before they go to see their doctor ,but in some , usually teenagers ,
the onset is more rapid , with symptoms present for only a few weeks . not all patients with hyperthyroidism have all symptoms listed as –SYMPTOMS OF AN OVER ACTIVE THYROID –weight loss, heat tolerance , irritability palpitations , breathlessness, tremor, muscle weakness, increase in bowel
movements , irregular menstruation, itchy skin thinning of the hair , brittle nails watering eyes , goitre. In elderly people , the predominant features , in addition to weight loss , are often a reduction in appetite,muscle weakness and apathy . a young woman , on the other hand , may appear to be full of energy and be unable to sit still for more than a few seconds. An over active thyroid gland causes the chemical reactions in the body to speed up, producing mental as well as physical symptoms.
WEIGHT LOSS: this happens to almost all patients as a result of a “burning off” of calories caused by the high levels of thyroid hormones in the blood . you will probably find you are hungry all the time , and that you even have to get up in the night to get something to eat .the weight loss from 2—3 kgs up to as much as 35 kgs or more .
HEAT INTOLERANCE AND SWEATING: As metabolism is increased , your body produces excessive heat , which it then gets rid of by sweating.
IRRITABILITY: this most often affects women with young families . you may find your self increasingly unable to cope with the demands and stresses of looking after the children , you may loose your temper frequently and find that you are abnormally sensitive to criticism , bursting into tears for no apparent reason.
PALPITATIONS: most patients experience palpitations , or you may may be aware of heart beating at a faster rate than normal .
BREATHLESSNESS :This is most likely to be noticeable when you have exerted yourself , for example after climbing 2 or 3 short flights of stairs .
MUSCLE WEAKNESS :the thigh muscles become weak , making it hard to climb stairs or to get up from a squatting position or from a low chair.
BOWEL MOVEMENTS CHANGES : there tends to be an increase in their frequency such that you pas sa softer than normal stool two or three times daily.
IRREGULAR PERIODS: periods are often irregular , light or even absent. Until the hyperthyroidism has been adequately treated , it may be difficult to conceive .
GOITRE :
Although you will obviously be able to see when you have a goitre , it’s unlikely to cause any actual symptoms other than a symptom that there is something in your neck that should not be there .
HOW IS IT DIAGNOSED : You will probably have had a blood test taken , but you may well have further blood tests done for confirmation when you go to the specialist endocrinologist . the specialist may also wish to carry out a thyroid scan to obtain more information about the cause of the Hyperthyroidism, as this may affect the type of treatment that you will need . A thyroid scan requires a tiny dose of technetium, and this will be given either by mouth or by injection into a vein .
WHAT IS THE TREATMENT ?:there are three form of treatment for the hyperthyroidism caused by Grave’s disease . these are drugs , surgery, and radio active iodine .
DRUGS: anti thyroid drugs are usually given to younger patients who go to their doctor when they have their first episode of hyperthyroidism. The most commonly used drug is (in Australia)“neomercazole”, which reduces the amount of hormones made by the thyroid gland . It is available as 5 mg and 20mg tablets treatment is normally continued for 6—18 months
FOR DETAIL TREATMENT , A SPECIALIST DOCTOR MAY BE CONSULTED, AND ADVISE TAKEN , SELF MEDICATION IS DANGEROUS. HOMOEOPATHIC TREATMENT IS ALSO EFFICACIOUS ,SUITABLE HOMOEOPATH MAY BE CONSULTED, FOR COMPLETE TREATMENT AND GET CURED
