Primary Hyperthyroidism

Primary Hyperthyroidism

Article
Women's Health
Diseases & Conditions
+2
Contributed byKrish Tangella MD, MBADec 19, 2018

What are the other Names for this Condition? (Also known as/Synonyms)

  • Overactive Thyroid Gland due to Primary Hyperthyroidism

What is Primary Hyperthyroidism? (Definition/Background Information)

  • Hyperthyroidism is a condition in which the thyroid gland (present in the neck) is overactive and produces too much of the hormone thyroxine
  • Thyroxine is responsible for regulating the body's metabolism: it stimulates cells of the body to produce proteins, and also increases the amount of oxygen used by them. It also has a very important role in fetal brain development
  • Hyperthyroidism is considered primary, when it occurs due to dysfunction of the gland itself, not due to factors extrinsic to the gland. Secondary hyperthyroidism indicates that the dysfunction is caused by factors extrinsic to the thyroid gland (i.e., not due to a disorder in the gland)
  • Graves’ disease is the most common cause of the condition and women are more commonly affected by Primary Hyperthyroidism
  • Some of the signs and symptoms of Primary Hyperthyroidism include rapid weight loss, irritability, heat sensitivity, diarrhea, irregular heartbeat, sweating, and fatigue
  • The complications associated with the condition may include osteoporosis, abnormal heart conditions, and thyroid storm or thyroid crisis
  • The prognosis is generally good with appropriate treatment, despite the requirement of medications for a lifetime

Who gets Primary Hyperthyroidism? (Age and Sex Distribution)

  • Primary Hyperthyroidism is more common in women than men
  • The condition is prevalent around the world; all racial and ethnic groups may be affected

What are the Risk Factors for Primary Hyperthyroidism? (Predisposing Factors)

Risk factors associated with Primary Hyperthyroidism include:

  • Family history of Grave’s disease
  • Smoking
  • Gender: Women are at higher risk than men
  • Age: Onset of Graves’ disease typically occurs between 20-25 years of age
  • Very high or very low iodine intake

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Primary Hyperthyroidism? (Etiology)

The most common cause of Primary Hyperthyroidism is Graves’ disease. In this condition, the body produces certain antibodies that lead to an excess production of thyroid hormone.

Other causes may include:

  • Intake of iodine supplements
  • Inflammation of thyroid gland due to a viral infection, certain medications, and pregnancy
  • Carcinoma of the thyroid gland
  • Toxic adenoma of thyroid gland (thyroid adenoma)

What are the Signs and Symptoms of Primary Hyperthyroidism?

The signs and symptoms of Primary Hyperthyroidism may include:

  • Rapid weight loss, fatigue
  • Irritability, paranoia
  • Heat intolerance
  • Diarrhea
  • Tremors
  • Thinning of skin
  • Red or protruding eyes, swelling or inflammation around the eyes
  • Irregular heartbeat, sweating, palpitations
  • High blood pressure

How is Primary Hyperthyroidism Diagnosed?

The diagnosis of Primary Hyperthyroidism may require:

  • Complete evaluation of medical history along with a thorough physical exam
  • Diagnostic tests for Primary Hyperthyroidism include:
    • TSH blood test: Low thyroid stimulating hormone (TSH) level may be observed
    • Imaging studies: High radioactive iodine uptake
    • T4 test: High serum T4 may be observed
    • Ultrasound scan of the thyroid gland

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Primary Hyperthyroidism?

Complications associated with Primary Hyperthyroidism include:

  • Osteoporosis: A condition causing brittle bones
  • Heart disorders such as abnormal heart rhythm and heart failure
  • Individuals with Graves’ disease may have eyes or skin related signs and symptoms
  • Thyroid storm/crisis: It is a medical emergency that needs to be treated in a hospital. In this condition, there is a sudden worsening of the symptoms of hyperthyroidism, which may occur with an infection, and it includes abdominal pain, fever, and decreased alertness

How is Primary Hyperthyroidism Treated?

The treatment of Primary Hyperthyroidism includes:

  • Administration of beta blockers to control the symptoms of hyperthyroidism
  • Radioactive iodine to destroy the gland and stop excess production of hormone
  • Surgery to remove the thyroid gland
  • The use of anti-thyroid medications such as propylthiouracil and methimazole

How can Primary Hyperthyroidism be Prevented?

  • There is no specific prevention method associated with Primary Hyperthyroidism. Knowledge about one’s family history is helpful to assess or predict future risk of the condition
  • Individuals at risk should refrain from smoking and regularly follow-up with a physician to ensure early detection

What is the Prognosis of Primary Hyperthyroidism? (Outcomes/Resolutions)

  • Prognosis of Primary Hyperthyroidism is generally good with appropriate treatment
  • However, individuals may either require lifelong medications to keep the symptoms under control or a surgical removal of the thyroid gland
  • Surgical removal may necessitate thyroid hormone replacement to prevent hypothyroidism

Additional and Relevant Useful Information for Primary Hyperthyroidism:

  • Hyperthyroidism occurs in about 1 in 250 people in the United States
  • TSH in conjunction with T4 is the starting point for testing, in order to evaluate the thyroid gland function. Some of the other tests, which are performed along with TSH include tests for T3 and for thyroid antibodies

The following article links will help you understand thyroid-stimulating hormone (TSH), total T3, and total T4 laboratory tests:

http://www.dovemed.com/common-procedures/procedures-laboratory/thyroid-stimulating-hormone-tsh-test/

http://www.dovemed.com/common-procedures/procedures-laboratory/total-t3-blood-test/

http://www.dovemed.com/common-procedures/procedures-laboratory/total-t4-blood-test/

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Krish Tangella MD, MBA

Pathology, Medical Editorial Board, DoveMed Team

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