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Thyroid disorders - hyperthyroidism

Aroundonein20peoplewillexperiencesomeformofthyroiddysfunctionintheirlifetime.The thyroidglandispartoftheendocrinesystem,whichsecretesregulatoryhormonesintotheblood. ThethyroidsitsjustbelowtheAdam'sapple(larynx)andhastwolobes,oneoneithersideofthe windpipe.Thisglandcontrolsmanyvitalmetabolicprocesses,suchasgrowthandenergy expenditure. Anoveractivethyroidisknownashyperthyroidism,andthisconditiontendstoaffectwomenmore thanmen.Aroundtwoinevery100womenwillexperiencesomedegreeofhyperthyroidism.The mostcommoncauseisGraves'disease,whichisduetoanimmunesystemabnormality.Other causesofanoveractivethyroidincludelocalinflammation(thyroiditis),nodulesorlumps.Thereis nocureforhyperthyroidism,butitcanbesuccessfullymanagedwithtreatmentssuchasantithyroidmedication. Symptoms Thesymptomsofhyperthyroidisminclude: Acceleratedheartrateorpalpitations Muscleweaknessandtrembling Unexplainedweightloss Sensitivitytoheat Diarrhoea Sleepingdifficulties Sweating Irritability Nervousness,agitationandanxiety Changesinmenstruation,includingscantierflowandincreasedcyclelength.

Ima ge des crip

Thyroid hormones Thethyroidglandproducesthehormonesthyroxine(tetra-iodothyronine)andtri-iodothyronine, whichsetthebody'smetabolicrate.Themoreofthesehormonesintheblood,thefasterthe metabolism.ThehormonesarereferredtoasT4andT3respectively,reflectingthenumberof iodineatomsineachhormone.Thebodyneedsabout150mcgofiodineadaytoallowthethyroid tomakesufficienthormones.Thepituitaryglandinthebrainregulatestheproductionofthe hormonesbyreleasingachemicalcalledthyroidstimulatinghormone(TSH). Graves' disease ThemostcommoncauseofhyperthyroidismisGraves'disease.Anabnormalityoftheimmune systemisthecause.Theimmunesystemisacollectionofspecialcellsandchemicalsthatfight infectionfromforeignagents,suchasbacteriaandviruses.Akeyelementoftheimmunesystemis theantibody,whichisatypeoftailor-made'poison'producedbylymphocytes(whitebloodcells) tokillaparticularforeignagent.InapersonwithGraves'disease,theimmunesystem manufacturesantibodieswhichbehavelikeTSHandstimulatethethyroiduncontrollably.Lessthan onepercentofthepopulationhasGraves'disease.Eighttimesmorewomenthanmenhavethis condition.Graves'diseaseismorecommoninmiddleage,althoughchildrenandadolescentscan alsobeaffected. Causes of Graves' disease NoonereallyknowswhatcausesGraves'diseasebecausethecausesofautoimmunityarenotfully understood.Stress,bothphysicalandemotional,isknowntoaffecttheresponsivenessofthe immunesystemandthereappearstobesomeassociationbetweenstressandtheonsetof autoimmuneconditions-includingGraves'disease.Autoimmuneconditionshaveadistinctgenetic element,withsomefamilylineshavingmultiplecasesofGraves'diseaseandotherautoimmune conditions.Itislikelythatsomepeople'sgeneticinheritancecouldpredisposethemtoGraves' disease.Anothercauseisexcessiveiodineintake.X-raycontrastmediumsandanumberof disinfectantscontainalotofiodineandcantriggerGraves'diseaseinsusceptiblepeople.

Thyroiddisorders-hyperthyroidism

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Symptoms of Graves' disease Aswellasthegeneralsymptomsofhyperthyroidism,apersonwithGraves'diseaseshows particularsymptomsincluding: Thyroideyedisease,causinginflammationandprotrudingeyesin50percentofcases Eyeswelling(50percentofcases) Coarseningandreddeningoftheskinontheshins.

Diagnosis Hyperthyroidismcanbediagnosedwithasimplebloodtestthatmeasuresthyroidhormonelevels. Apersonwithhyperthyroidismhashighlevelsofthyroxine,butlowlevelsofTSH.Thepresenceof thyroidstimulatingantibodiescanalsobecheckedand,ifpresent,confirmsadiagnosisofGraves' disease.Ifthehyperthyroidismisduetonodules,aradioactivescanofthethyroidwillindicate isolatedpocketsofoveractivity. Treatment options Thereisnocureforhyperthyroidism,buttherearewaystosuccessfullymanagethecondition, including: Medication-thethyroidglandreliesoniodinetomakethethyroidhormones.Anti-thyroid drugsworkbyinterferingwiththegland'sabilitytouseiodine.Aroundoneinfourpeople willexperienceaprolongedperiodofremissionafteroneyearormoreofanti-thyroid medication.Sideeffectsofthemedicationsincludeskinrashesandjointpain.Patientson thesedrugswhoexperiencefeverorflu-likesymptomsshouldseetheirdoctor immediately,asthedrugscansuppresstheimmunesystem. Radioiodine therapy-radioactiveiodineistakenasadrink.Theiodineistakenupbythe activecellsinthethyroid,whicharethenkilled.Othercellsdonotabsorbtheiodine.The radioactiveiodineisthenexcretedintheurinewithnoreportedsideeffects.Onedoseis usuallysufficienttocontrolhyperthyroidism,butoneortwosubsequenttreatmentsmaybe required.Patientsshouldavoidcontactwithadultsforafewdaysandwithchildrenand pregnantwomenforalongerperiod. Surgery-someorallofthethyroidglandissurgicallyremovedundergeneral anaesthesia.Therearenormalsurgicalrisksassociatedwiththisprocedure,aswellasthe possibilityofdamagingtheparathyroidglands(whichlienexttothethyroidgland)andthe nervesupplyingthevocalcords.

From overactive to underactive Apersonwhohashadhyperthyroidismshouldhavehisorherthyroidhormonelevels(TSH,T4and T3)checkedonaregularbasis.Thisisbecausemostpeoplewhoaretreatedforhyperthyroidism eventuallydevelophypothyroidism.Thetreatmentcausesthethyroidtobecomeunderactive.The symptomsincludelethargy,unexpectedweightgain,constipationandsensitivitytothecold. Underactivityistreatedbyhormonereplacementwiththyroxinetablets. Thisswitchfromoveractivetounderactivecanseemliketreatmentsimplyreplacingonecondition withanother,butunderactivityiseasilytreatedwithhormonereplacementwithoutsideeffects, whereasuntreatedoveractivityisaseriousconditionwhichinvariablyprovesfatalifallowedto persist. Where to get help Yourdoctor Endocrinologist.

Things to remember

Thethyroidglandcontrolsimportantmetabolicprocessessuchasgrowthandenergy expenditure. Hyperthyroidismmeansthethyroidglandisoveractive. AnimmunesystemabnormalitycalledGraves'diseaseisthemostcommoncauseof hyperthyroidism. Peopletreatedforhyperthyroidismnormallyendupwithanunderactivethyroid-whichis calledhypothyroidism.

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ThyroidAustralia
Contentonthiswebsiteisprovidedforeducationandinformationpurposesonly.Information aboutatherapy,service,productortreatmentdoesnotimplyendorsementandisnotintendedto replaceadvicefromyourdoctororotherregisteredhealthprofessional.Contenthasbeen preparedforVictorianresidentsandwiderAustralianaudiences,andwasaccurateatthetimeof publication.Readersshouldnotethat,overtime,currencyandcompletenessoftheinformation maychange.Allusersareurgedtoalwaysseekadvicefromaregisteredhealthcareprofessional fordiagnosisandanswerstotheirmedicalquestions. Forthelatestupdatesandmoreinformation,visitwww.betterhealth.vic.gov.au Copyight 1999/2011StateofVictoria.ReproducedfromtheBetterHealthChannel (www.betterhealth.vic.gov.au)atnocostwithpermissionoftheVictorianMinisterforHealth. Unauthorisedreproductionandotherusescomprisedinthecopyrightareprohibitedwithout permission.

Thyroiddisorders-hyperthyroidism

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