Excess Thyroid Hormones

23 October, 2020 Arush Michael

Introduction

The thyroid hormones are released by the thyroid gland under the influence of thyroid-stimulating hormone. Due to excess secretion of thyroid hormones in the body their level increases above normal, this condition is referred to as thyrotoxicosis.

Causes of excess thyroid hormones

The two main causes are:

  • Grave’s disease: It is an autoimmune disorder involving the production of thyroid-stimulating immunoglobulin which binds to the thyroid-stimulating hormone (TSH) receptor resulting in excessive stimulation of thyroid cells.
  • Toxic nodular goiter: Independent of TSH it produces the thyroid hormones. The elderly have a higher disposition of developing toxic nodular goiter resulting in thyrotoxicosis.

Certain drugs can also result in the condition if used excessively, such as lithium, amiodarone, phenobarbitone, phenytoin, and sulphonamides.

Symptoms Of Thyrotoxicosis

The thyroid hormones are responsible for the normal functioning of your metabolism and the other systems of your body. Its increased secretion can produce the following symptoms:

  • Increased appetite and weight loss
  • Tremors
  • Increased heartbeat rate
  • Anxiety
  • Nervousness
  • Sweating
  • Difficulty sleeping
  • Menstrual pattern changes
  • Brittle hair
  • Exophthalmos (bulging of an eye out of the socket)
  • Bowel pattern changes
  • Goiter (enlarged thyroid gland)

If a person experiences any of the above symptoms they should consult a doctor as soon as possible. The physician shall provide a course of treatment, for which you can now buy medicines online in India

Diagnosis Of Thyrotoxicosis

On the basis of a patient’s symptom and history, the doctor shall conduct some tests to check the TSH and thyroid hormone levels. In thyrotoxicosis, the level of TSH is decreased below normal and that of the free thyroid hormones are increased above normal. Radioactive Iodine might be used to take a scan of the thyroid gland which can be used to differentiate between graves’ disease and toxic nodular goiter. On the basis of the results of the tests and the scan, the diagnosis is made.

Treatment Of Thyrotoxicosis

The treatment for thyrotoxicosis is done with thyroidectomy or thyroid inhibitors which can be classified on the basis of how they act:

  • Inhibit hormone synthesis: Thioamides e.g.Propylthiouracil and Carbimazole
  • Inhibit Iodide trapping: Ionic inhibitors e.g. Thiocynates and Nitrates (not clinically used)
  • Inhibit hormone release: Iodine, Iodides of sodium and potassium and Organic Iodide
  • Destroy thyroid tissue: Radioactive iodine

Thioamides (Antithyroid Drugs)

They control grave’s disease and toxic nodular goiter caused thyrotoxicosis. In 1-2 weeks the patient starts showing improvement. They are used as definitive therapy, preoperatively and along with radioactive Iodine. They have advantages like no surgical risk, if hypothyroidism is caused it is reversible and it can be used even in children and young adults. Carbimazole is the thioamide marketed in India along with propylthiouracil. The disadvantages of thioamides are the prolonged treatment needed, drug toxicity, and certain side effects such as goiter, skin rashes, joint pain, goiter, and gastric intolerance. Propylthiouracil in low doses is the main drug used during thyrotoxicosis in pregnancy because thyroidectomy and radioactive Iodine are contraindicated and greater plasma protein binding allows less transfer of the drug to the fetus.

Iodine And Iodides

They are used for preoperative preparation for thyroidectomy in Graves’ disease, thyroid storm, and prophylaxis of endemic goiter. It is the fastest acting thyroid inhibitor but after peak effects, the thyrotoxicosis returns and the hyperthyroidism worsens is generally given 10 days before a thyroidectomy to make the glandless vascular, firm, and easier to operate on. During a thyroid storm, Lugol’s iodine administered orally stops the further release of thyroid hormones. The above medications and others are now available with 24-hour online medicine delivery in India.

Radioactive Iodine

The most common use is for hyperthyroidism due to Graves’ diseases or toxic nodular goiter. The advantages are that the treatment is simple and inexpensive, no surgical risk, and once hyperthyroidism is controlled the cure is permanent. The disadvantages include hypothyroidism, long period of response, pregnancy contraindication, and unsuitability for young patients.

Conclusion

Thyrotoxicosis is a disease prevalent in 2% of women and 0.2% of men and affects a large number of people every year. It is a treatable condition and if action is taken promptly the patient can be well in a matter of time. If you face symptoms relating to thyrotoxicosis or general disturbances in your health and wellbeing whether it be physical or mental kindly approach your healthcare provider.