Ruchi Mathur, MD, FRCP(C)
Ruchi Mathur, MD, FRCP(C) is an Attending Physician with the Division of Endocrinology, Diabetes and Metabolism and Associate Director of Clinical Research, Recruitment and Phenotyping with the Center for Androgen Related Disorders, Department of Obstetrics and Gynecology at Cedars-Sinai Medical Center.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Hyperthyroidism facts
- What is hyperthyroidism?
- What are the thyroid hormones?
- Thyroid hormone regulation - the chain of command
- What causes hyperthyroidism?
- What are the symptoms of hyperthyroidism?
- How is hyperthyroidism diagnosed?
- How is hyperthyroidism treated?
- What's best for you?
- Pictures of Hyperthyroidism - Slideshow
- Pictures of Thyroid Medical Anatomy
- Pictures of Thyroid Conditions - Slideshow
- Thyroid FAQs
- Find a local Endocrinologist in your town
What are the symptoms of hyperthyroidism?
Hyperthyroidism is suggested by several signs and symptoms; however, patients with mild disease usually experience no symptoms. In patients older than 70 years, the typical signs and symptoms also may be absent. In general, the symptoms become more obvious as the degree of hyperthyroidism increases. The symptoms usually are related to an increase in the metabolic rate of the body.
Common symptoms include:
- Excessive sweating
- Heat intolerance
- Increased bowel movements
- Tremor (usually fine shaking)
- Nervousness; agitation
- Rapid heart rate
- Weight loss
- Decreased concentration
- Irregular and scant menstrual flow
In older patients, irregular heart rhythms and heart failure can occur. In its most severe form, untreated hyperthyroidism may result in "thyroid storm," a condition involving high blood pressure, fever, and heart failure. Mental changes, such as confusion and delirium, also may occur.
How is hyperthyroidism diagnosed?
Hyperthyroidism can be suspected in patients with:
- excessive sweating,
- smooth velvety skin,
- fine hair,
- a rapid heart rate, and
- an enlarged thyroid gland.
There may be puffiness around the eyes and a characteristic stare due to the elevation of the upper eyelids. Advanced symptoms are easily detected, but early symptoms, especially in the elderly, may be quite inconspicuous. In all cases, a blood test is needed to confirm the diagnosis.
The blood levels of thyroid hormones can be measured directly and usually are elevated with hyperthyroidism. However, the main tool for detection of hyperthyroidism is measurement of the blood TSH level. As mentioned earlier, TSH is secreted by the pituitary gland. If an excess amount of thyroid hormone is present, TSH is "down-regulated" and the level of TSH falls in an attempt to reduce production of thyroid hormone. Thus, the measurement of TSH should result in low or undetectable levels in cases of hyperthyroidism. However, there is one exception. If the excessive amount of thyroid hormone is due to a TSH-secreting pituitary tumor, then the levels of TSH will be abnormally high. This uncommon disease is known as "secondary hyperthyroidism."
Although the blood tests mentioned previously can confirm the presence of excessive thyroid hormone, they do not point to a specific cause. If there is obvious involvement of the eyes, a diagnosis of Graves' disease is almost certain. A combination of antibody screening (for Graves' disease) and a thyroid scan using radioactively-labelled iodine (which concentrates in the thyroid gland) can help diagnose the underlying thyroid disease. These investigations are chosen on a case-by-case basis.
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