Table of contents:
- What are the causes of hyperthyroidism?
- Primary hyperthyroidism
- Secondary hyperthyroidism
- What are the symptoms of hyperthyroidism?
- What should I do if I see the above symptoms?
- How to treat hyperthyroidism?
- 1. Thyrostatics (anti-thyroid drugs)
- 2. Radioactive iodine
- 3.Thyroidectomy (thyroid surgery)
The thyroid gland is located at the bottom of the neck, consists of two parts and is held together by a "bridge" called the isthmus that covers the second and third pharyngeal rings. This gland produces the hormone thyroxine which is needed by almost all body processes, including temperature regulation, metabolism of carbohydrates, protein, fat and vitamin A. This hormone also affects the work of organs such as the heart, digestion, muscles, and the nervous system.
Disorders of the production of the hormone thyroxine are divided into two: too much hormone production (hyperthyroidism) or too little hormone production (hypothyroidism). Hyperthyroidism is a collection of symptoms caused by an overproduction of thyroid hormone, while thyrotoxicosis is a symptom that occurs due to excess circulation of thyroid hormone in the blood. In Indonesia, the prevalence of hyperthyroidism is around 6.9%, and this disease is more common in women.
What are the causes of hyperthyroidism?
Hyperthyroidism is usually divided into primary and secondary hyperthyroidism. Generally hyperthyroidism is caused by Graves' disease, toxic multinodular goiter, and toxic adenoma, although there are many other diseases that can cause it.
Primary hyperthyroidism
- Graves' disease
- Toxic multinodular goiter
- Toxic adenoma
- Drugs: excess iodine, lithium
- Thyroid cancer
Secondary hyperthyroidism
- Thyroid hormone resistance
- Thyrotoxicosis in pregnancy (first trimester)
- TSH-Secreting tumor
What are the symptoms of hyperthyroidism?
Symptoms of hyperthyroidism are divided into two: general symptoms, and symptoms specific to the organs in which this hormone works. Common symptoms include: heat loss, fatigue, enlarged neck, weight loss, frequent hunger, frequent bowel movements. While the specific symptoms are as follows:
- Digestive system: a lot of food, thirst, vomiting, difficulty swallowing, enlarged lymph nodes.
- Reproductive system: menstrual cycle disorders, decreased libido, infertility, gynecomastia in men.
- Skin: excessive sweating, wet skin, hair loss.
- Psychic and nervous: unstable, irritable, difficulty sleeping, trembling hands.
- Heart: heart palpitations, heart rhythm disorders, hypertension, heart failure.
- Muscle and bone system: fatigue, bone pain, osteoporosis.
In Graves' disease, other symptoms are usually found, such as swelling in the shins of the feet, protruding eyeballs, decreased vision, double vision and sores in the cornea of the eye.
What should I do if I see the above symptoms?
Immediately go to the nearest doctor or health center if you experience the symptoms above, usually the doctor will do some additional tests to make a diagnosis. Additional checks that are often done are:
- Thyroid function tests (TSH and thyroid hormone). TSH is produced in a part of the brain called the pituitary, and functions to stimulate the thyroid gland to release its hormone. In hyperthyroidism, there is usually a decreased TSH level and an elevated thyroid hormone.
- Ultrasound. Ultrasound serves to see the presence of nodules, size, shape, and distinguish them from cysts.
- Thyroid scan. This test aims to determine the cause of hyperthyroidism. The patient is injected with iodine isotope, then performed scanning to see the thyroid response. Nodules that produce excess hormones are called hot nodules, usually cancer, although some cold nodules are cancer.
How to treat hyperthyroidism?
Treatment of hyperthyroidism can be categorized into 3 forms: thyrostatics, radioactive iodine, and thyroidectomy.
1. Thyrostatics (anti-thyroid drugs)
This drug serves to inhibit thyroid hormone synthesis and suppress autoimmune processes. The administration of this drug is initially in the largest dose or as clinically appropriate, then reduced to the lowest dose at which thyroid hormone is still within normal limits. Side effects of this drug are rash on the skin, itching, allergies, muscle & joint pain.
Examples of drugs: propyltiouracil (PTU), metimazole, carbimazole
2. Radioactive iodine
Radioiodine in small doses can damage the thyroid gland and improve symptoms of hyperthyroidism. This treatment has several advantages such as being quick and easy to administer and a low recurrence rate. The drawback is post-therapy hypothyroidism (50%).
This treatment is not recommended for pregnant women, or those planning a pregnancy in the next 6 months.
3.Thyroidectomy (thyroid surgery)
Thyroid surgery can be done totally or partially (partially). This option is made if the following indications are found:
- Severe hyperthyroidism in children
- Patients who do not recover with anti-thyroid drugs
- Swelling of the thyroid gland or severe eye symptoms
- Patients who need a fast recovery such as pregnant women, mothers planning a pregnancy within 6 months or people with unstable heart disease
The advantage of this method is that many patients have normal postoperative thyroid function without any hypothyroid symptoms. The disadvantage is that the recurrence rate is quite high and requires regular long-term treatment.
Other drugs that are often given in hyperthyroidism are beta-blockers. This drug works to reduce symptoms of hyperthyroidism such as palpitations, shaking hands and others. Examples of these drugs are propranolol and metoprolol.
