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Thyrotoxicosis
Thyrotoxicosis occurs when there are abnormally high blood levels of triiodothyronine (T3) and thyroxine (T4) which are your body's thyroid hormones. They increase your metabolic rate, causing symptoms such as tachycardia, weight loss, and other complications. Thyrotoxicosis is rare, affecting around 2% of women and 0.2% of men.
Symptoms
Whether you have mild or moderate thyrotoxicosis, the symptoms are similar.
- Unexplained weight loss.
- Irregular heartbeat.
- The rapid heartbeat of more than 100 beats per minute.
- Muscle weakness.
- Tremors, anxiety, and irritability.
- Heat sensitivity.
- Menstrual change
Causes
- Hyperthyroidism is the most common underlying cause of thyrotoxicosis, and Graves’ disease is the leading cause of hyperthyroidism. You may develop hyperthyroidism and/or thyrotoxicosis if you have one or more nodules in your thyroid.
- Thyroiditis occurs when your thyroid is inflamed, releasing thyroid hormones into your bloodstream. Medications such as lithium and interferon, immunity problems, fungal and bacterial infections, or childbirth may cause inflammation.
- Excessive thyroid medication for hypothyroidism. You may accidentally take too much thyroid medication, or the doctor may intentionally prescribe excess thyroid medication to suppress the production of thyroid-stimulating hormone (TSH) to prevent or decrease the growth of lumps in your thyroid.
- Excessive thyroid hormone consumption from eating beef contaminated with thyroid tissue from the cow neck leads to rare “hamburger thyroiditis.”
Diagnosis
- The doctor will perform a physical exam to check if
- You have a heart palpitation.
- You have swollen, or bulging eyes.
- You have a bumpy, tender, or enlarged thyroid.
- You have hand tremors.
- You sweat more than usual.
- Blood tests to check the level of thyroid hormones. If you have thyrotoxicosis, the T3 and T4 levels will be high, while the thyroid-stimulating hormone (TSH) levels will be low.
- Imaging tests
- The radioactive iodine uptake test checks how well your thyroid absorbs the radioactive iodine. The high radioactive iodine uptake means excessive production of T4. You may develop thyroid nodules and Graves’ disease. The low radioactive iodine uptake means there is a leakage of T4 into your bloodstream from thyroiditis.
- Thyroid scan to look for inflammation, nodules, goiter, and thyroid cancer by injecting radiotracer or radioactive liquid into your veins before taking your thyroid images for a proper diagnosis.
- Thyroid ultrasound to determine if you have nodules on the thyroid.
Treatment
Your doctor will determine the cause of thyrotoxicosis to plan suitable treatment options.
- Anti-thyroid drugs such as methimazole and propylthiouracil (PTU) help reduce the production of thyroid hormones.
- Radioactive iodine can shrink the thyroid cells to lower the release of thyroid hormone. However, your thyroid cells can be permanently damaged, leading to hypothyroidism. You may need to take thyroid hormone medications for the rest of your life.
- Thyroidectomy to remove the thyroid gland for the treatment of hyperthyroidism. Like radioactive iodine, you may need to take thyroid hormones to maintain the level of thyroid hormones. Otherwise, you can develop hypothyroidism.
- Beta-blockers can relieve symptoms of thyrotoxicosis, including tremors and rapid heart rate.
- Glucocorticoids can help reduce the pain of thyroiditis.
Risk factors
- Age: The risk of thyrotoxicosis increases with age. Older adults over 60 years old are at higher risk.
- Gender: Females are more likely to be affected by thyrotoxicosis than males.
- Medical condition: An autoimmune disease, Type 1 diabetes, pernicious anemia, and family history of Addison disease: You have a direct family member with thyroid disease or Graves’ disease.
- Childbirth: If you recently gave birth to a child, your hormonal change can lead to thyrotoxicosis.
Prevention
Thyrotoxicosis is not preventable. But if your condition results from the overuse of thyroid medication, reducing the dosage can prevent the risk of developing thyrotoxicosis.
- Hyperthyroidism
- Thyrotoxicosis
- Thyroid storm
All three conditions are due to excess thyroid hormone production and release.
- Hyperthyroidism is the condition of excess thyroid hormone production and release. It is a type of thyrotoxicosis. The most common cause is Graves’ disease.
- Thyrotoxicosis is when a high level of thyroid hormone circulates in your body. Taking excessive thyroid hormone, hyperthyroidism, or thyroiditis are the common causes.
- A thyroid storm or thyroid crisis occurs when the thyroid glands suddenly release excessive thyroid hormone. It is a rare but life-threatening complication of hyperthyroidism; immediate medical care is necessary. Its symptoms include:
- Rapid heartbeat.
- High fever.
- Agitation and confusion.
- Diarrhea.
- Syncope.
