In these conditions there is an overproduction of thyroid hormone by the thyroid gland. Goiter, which is the name given to any thyroid enlargement, is not the same as hyperthyroidism, although in some cases it is associated. While hyperthyroidism can be seen at any age, it occurs most frequently from 20 to 40 years, and occurs more in females - especially during puberty, pregnancy, and menopause - than in males. The disease appears to run in families. The cause is completely unknown, but there may be some relationship to over stimulation by the pituitary gland. In some cases it seems to be correlated with infections, stresses, or psychic trauma, but the relationship is unclear.
The Symptoms
The classical patient with an overactive thyroid has protruding, staring eyes, tremors of the fingers when they are extended, increased nervousness, and profuse sweating. Hot weather bothers her. Her breath is short and she has palpitations or associated findings which may be related to the effects on the heart. Menstruation may cease. Enlargement of thyroid gland may become apparent to the eye or touch. Muscle weakness is common. The patient complains she cannot climb stairs as she did previously. She has a marked stare and blinks infrequently. Her skin appears reddened and sweaty. The nail's shape changes and becomes concave, like a shallow spoon. On examination the doctor may find a change in the heart rate and rhythm, and in the blood pressure.
As the disease advances there is very evident weight loss. The patient becomes almost intolerably irritable. A basal metabolism test, specific blood studies, and radioactive iodine studies are used by the doctor to establish a diagnosis.
Complications. A serious complication is thyroid storm which occurs is debilitated patients or those exposed to unusual stress or strain. There is high fever, delirium, and abnormal racing of the heart. Shock, and even death, can occur. Thyroid heart disease is not unusual and can end in heart failure.
Another complication has to do with the unfavorable appearance caused by the protruding eyes characteristic of this condition. Unfortunately, this may or may not change- even after treatment.
Prevention. There is no known way of preventing hyperthyroidism. In areas where iodine is lacking in diet, it is recommended that iodized foods be used to prevent the development of simple goiter. If treated early enough and before complication develop, hyperthyroidism responds to treatment by drug, surgery, or radioactive chemicals. Early recognition is usually not to difficult and prompt therapy, simple in nature, may be enough to control all symptoms and any disability.
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