Thyrotoxicosis ( hyperthyroidism) - Causes, Symptoms and Treatment .MF .
Hyperthyroidism - a condition associated with an excess of thyroid hormones in the body.It is also a condition called hyperthyroidism.This is not a diagnosis, but a consequence of certain diseases of the thyroid gland or the impact of external factors.
«toxemia» Root well characterizes these changes.In hyperthyroidism there is an intoxication of its own excess thyroid hormone.An excess amount of hormones in the body leads to various physical changes and changes in the emotional sphere.
Causes of hyperthyroidism Causes of hyperthyroidism
enough.They can be divided into several groups:
1. Diseases accompanied by excessive production of thyroid hormones.
A) diffuse toxic goiter (Graves 'disease, Graves' disease).This disease in 80-85% of cases the cause of hyperthyroidism.
Due to any reason fails in the immune system.Leukocytes (white blood cells) begins to produce so-called antibodies - proteins which bind to the thyroid cells and cause it to secrete more hormones.Often, these ant
The disease can occur at any age, but most often occurs in young people from 20-40 years.
B) Toxic adenoma and multinodular toxic goiter.Availability
node (s) of the thyroid gland, which produces an excess of thyroid hormones.Normally, excess thyroid hormone production is suppressed pituitary hormone (TSH).Toxic adenoma and multinodular toxic goiter operate autonomously, that is, the excess of thyroid hormones is not suppressed pituitary hormone (TSH).This disease is more common in older people.
B) Tireotropinoma - is the formation of the pituitary gland, which synthesizes an excess of thyroid stimulating hormone (TSH), which stimulates the thyroid gland.It is a rare disease.Proceeds from the clinic hyperthyroidism.
2. Diseases associated with destruction (destruction) of the thyroid gland and the release of thyroid hormones in the blood.
These diseases include destructive thyroiditis (subacute thyroiditis, hyperthyroidism in patients with autoimmune thyroiditis, postpartum thyroiditis, painless thyroiditis).
to this group of diseases can also include Cordarone-induced (amiodarone-induced) hyperthyroidism.This thyrotoxicosis, which occurs as a result of the treatment of iodine-containing antiarrhythmic drugs (Amiodarone, Cordarone).Receiving drugs causes destruction (destruction) of the cells of the thyroid gland and the output of hormones in the blood.
3. Iatrogenic hyperthyroidism - hyperthyroidism caused by an overdose of drugs thyroid hormone (L-thyroxine, Eutiroks - drugs for the treatment of hypothyroidism - a condition associated with decreased production of thyroid hormones).
These are the main causes of thyrotoxicosis.
Symptoms of hyperthyroidism
If you feel lately irritable, emotional, notice frequent changes of mood, tearfulness, sweating, hot flashes, palpitations, a feeling of disruption of the heart, lost weight - it is an occasion to see a doctor and be tested for hormonesthyroid gland.It hyperthyroidism symptoms.
Symptoms of hyperthyroidism
also symptoms of hyperthyroidism include: high blood pressure, diarrhea, weakness, presence of fractures, intolerance to hot weather, increased hair loss, menstrual disorders, decreased libido (sexual desire), erectile dysfunction.
By increasing the size of the thyroid gland may appear complaints about violation of swallowing, increased neck volume.
to diffuse toxic goiter (Graves' disease) is also characterized by the presence of infiltrative ophthalmopathy - lacrimation, photophobia, and a feeling of pressure "sand" in the eyes, can be double vision, decreased vision possible.Noteworthy exophthalmos - "protrusion" eyeballs.
diagnosis of hyperthyroidism
If you notice these symptoms in yourself, you must pass the hormonal tests to rule out or confirm the presence of hyperthyroidism.
diagnosis of hyperthyroidism:
1. Hormonal blood test:
- blood TSH, T3, free T4 is free.
main study proving the existence of thyrotoxicosis.
for thyrotoxicosis is characterized by a decrease in blood TSH (pituitary hormone, which decreases production of hormones by the thyroid gland), increased T3 St., St. T4 - thyroid hormones.
2. Determination of antibodies - confirmation of the autoimmune nature of the disease.
- Antibodies against the TSH receptor (increased antibodies to receptor TTG - proves the presence of Graves 'disease)
- Antibodies to TPO (increased in Graves' disease, autoimmune thyroiditis).
3. Make a thyroid ultrasound.
to diffuse toxic goiter (Graves' disease) is the most common cause of hyperthyroidism, characterized by:
- enlargement of thyroid volume (increase in thyroid volume greater than 18 cubic cm in women and more than 25 cc in men is called a goiter)
- acceleration, increased blood flow in the thyroid gland.
For other causes of hyperthyroidism, these symptoms are not typical.When destructive processes is determined by a decrease in blood flow in the thyroid gland.
4. In some cases, your doctor may prescribe a study - thyroid scintigraphy.This study shows how the thyroid gland can capture iodine and other substances (technetium).This study helps to clarify the cause of hyperthyroidism.
for Graves' disease is characterized by an intense seizure reinforced radiopharmaceutical.
for hyperthyroidism due to destruction (destruction) of the thyroid gland is characterized by a decrease in the capture or the lack of iodine capture (technetium).
5. In the presence of endocrine ophthalmopathy, exophthalmos is performed ultrasound of the orbit, MRI or CT scan of the orbits area.
Treatment of hyperthyroidism
To determine the treatment strategy, you must first determine the cause of hyperthyroidism.The most common cause of hyperthyroidism - Graves' disease.
There are three methods of treatment of Graves' disease: medical treatment, surgical treatment and therapy radoaktivnym iodine.Drug treatment is to appoint thyreostatics (drugs that reduce the formation of thyroid hormones).There are two such drugs: Tiamazol (tyrosol, Merkazolil, Metizol) and propylthiouracil (propitsil).Initially, a drug administered in a dose of about 30 mg per day, after the normalization of thyroid hormones pass to a maintenance dose of 5-15 mg per day.Duration of treatment is usually tireostatikami 1-1.5 years.
Treatment of destructive processes in the thyroid gland (hyperthyroidism associated with the destruction of the cells of the thyroid gland and the release into the bloodstream of excess amounts of thyroid hormones) held glucocorticosteroid hormone (prednisolone).These drugs reduce the process of destruction of the thyroid cells.The dosage and duration of treatment are chosen individually.
Surgical treatment of thyroid thyrotoxicosis is performed only after treatment tireostatikami when the normalization of thyroid hormones.
What lifestyle should be conducted in order to promote healing?
To promote healing, you need to regularly take drugs prescribed to you doctor and undergo hormonal control study.
Also, keep in mind that the probability of sustained remission is higher in non-smokers.If you smoke, the likelihood of recurrence of hyperthyroidism after treatment tireostatikami you above.Therefore, if you smoke, smoking refusal will increase your chances of recovery.
Treatment of hyperthyroidism folk remedies
should warn against the treatment of folk remedies.Hyperthyroidism - a serious condition that without adequate timely treatment can lead to serious complications, especially on the part of the cardiovascular system (eg, severe arrhythmia).
therefore revealed thyrotoxicosis requires mandatory treatment of medical drugs.Treatment of various folk remedies "from the thyroid gland", which will tell you to the neighbors is likely to not only help, but and harm, as hyperthyroidism without treatment can lead to serious complications.
In addition to the basic treatment can be advised a balanced diet, eat more fruits and vegetables.Perhaps the appointment of multivitamin complexes (Vitrum, Centrum and others) or additional appointment to the primary therapy of B vitamins (Milgamma, Neyromultivit).
complications of hyperthyroidism
At untimely, inadequate treatment of developing complications of hyperthyroidism, such as atrial fibrillation, hypertension (high blood pressure), hyperthyroidism contributes to the development and worsening of coronary heart disease, central nervous system damage in severe cases can lead to thyrotoxic psychosis.These complications are associated with cardiotoxic excess thyroid hormones (ie, an increased amount of thyroid hormones impairs the cardiovascular system: leads to accelerated metabolism in the cells of the myocardium, increases heart rate and as a result develop complications).
acute complications is thyrotoxic crisis - a serious complication that occurs after suffering a stress during surgery on the thyroid gland against the background of hyperthyroidism.This life-threatening condition.The main symptoms are fever up to 38-40 °, expressed heart to 120-200 beats per minute, heart rhythm disorders, disorders of the central nervous system.
To prevent these complications require prompt diagnosis and treatment of hyperthyroidism.Therefore, should definitely see a doctor and undergo hormonal examination when the signs of hyperthyroidism.
thyrotoxicosis should be remembered that there is a genetic predisposition to thyroid diseases.If your relatives are diseases of the thyroid gland, it is also recommended that you regularly perform ultrasound of the thyroid gland, hormonal studies.
If you notice symptoms of hyperthyroidism at - it is necessary to perform a study of thyroid hormones.
If hypothyroidism has been detected, for the prevention of complications of hyperthyroidism need to start treatment promptly.
Medical consultation for thyrotoxicosis
Question: When treating tireostatikami how often should undergo hormone research?
Answer: If it is a course of medical treatment of hyperthyroidism, the first study of thyroid hormones (T3, free T4 free) after initiation of therapy should be performed tireostatikami a month of therapy.Further, due to lower dose thyreostatics should be a few more times to perform a study with an interval of 1 month.TTG study should be carried out not earlier than 3 months after initiation of therapy tireostatikami, so long as it remains low.After selecting a maintenance dose thyreostatics hormonal research can be conducted 1 time in 2-3 months.
Question: What are the restrictions while taking thyreostatics?
Answer: It is not normal level of thyroid hormone is recommended to reduce physical activity.After normalization of hormones (reaching euthyrosis) may increase the level of physical activity.
Question: What is the probability of remission after a course of thyreostatic therapy?
Answer: The course of thyreostatic therapy usually lasts 12-18 months.After that conducted the study in order to be convinced of the possibility of remission (performed ultrasound of the thyroid gland, the study of antibodies to the TSH receptor).After this treatment is terminated.However, the likelihood of recurrence of the disease are sometimes more than 50%.Typically, a relapse occurs within the first year after treatment discontinuation tireostatikami.In the case of treatment failure shows the surgical removal of the thyroid gland or treatment with radioactive iodine.
More specific recommendations can give you the doctor on internal consultation.Be healthy!
endocrinologist Artemyev Marina S.