Hyperthyroidism

Hyperthyroidism is a condition in which the thyroid gland produces excess thyroid hormones (T4 and T3), leading to an increased metabolic rate. Most cases result from autoimmune stimulation, most commonly Graves’ disease, but other causes include toxic multinodular goiter, solitary toxic nodule, thyroiditis, and certain medications.

Symptoms often include weight loss despite normal or increased appetite, heat intolerance, sweating, palpitations, anxiety or irritability, tremor, fatigue, muscle weakness, and menstrual changes. Physical examination may reveal a rapid heartbeat, warm and moist skin, and an enlarged thyroid (goiter). Complications can include atrial fibrillation, heart failure in severe cases, osteoporosis, and, if untreated, thyrotoxic crisis.

Diagnosis is based on laboratory tests showing suppressed thyroid-stimulating hormone (TSH) with elevated free T4 and/or free T3. Autoimmune markers such as thyroid-stimulating immunoglobulins may support Graves’ disease. Radioiodine uptake scans help determine the cause. Pregnancy requires specific management, as some treatments are contraindicated or modified during the first trimester.

Treatment aims to achieve and maintain a normal thyroid state and relieve symptoms. Options include antithyroid drugs (methimazole or propylthiouracil), radioactive iodine therapy, and thyroidectomy. The choice depends on age, comorbidities, cause, goiter size, and plans for pregnancy. Beta-blockers may be used to control symptoms. Long-term follow-up focuses on monitoring thyroid function and managing cardiovascular and bone health.