Endocrine Surgery

Hyperthyroidism

Hyperthyroidism is an overproduction of thyroid hormone.  Patients with Hashimoto’s thyroiditis, Grave’s disease, a toxic nodule or a toxic multinodular goiter sometimes are hyperthyroidHyperthyroidism may be treated with anti-thyroid medication, radioactive iodine therapy or thyroid surgery.  Hyperthyroidism occurs in almost one percent of all Americans and affects women five to 10 times more often than men.

Symptoms can be discomforting, disabling or even life-threatening. When hyperthyroidism develops, a goiter (enlargement of the thyroid) usually is present and may be associated with some or many of the following symptoms:

  • Fast heart rate, often more than 100 beats per minute
  • Nervousness, anxiety or an irritable and quarrelsome feeling
  • Trembling hands
  • Weight loss, despite eating the same amount or even more than usual
  • Intolerance of warm temperatures and increased likelihood to perspire
  • Loss of scalp hair
  • Rapid growth of fingernails and tendency of fingernails to separate from the nail bed
  • Muscle weakness, especially of the upper arms and thighs
  • Loose and frequent bowel movements
  • Thin and delicate skin
  • Change in menstrual pattern
  • Increased likelihood for miscarriage
  • Prominent “stare” of the eyes
  • Protrusion of the eyes, with or without double vision (in patients with Graves’ disease)
  • Irregular heart rhythm, especially in patients older than 60 years of age
  • Accelerated loss of calcium from bones, which increases the risk of osteoporosis and fractures

when to see a doctor

If you experience unexplained weight loss, a rapid heartbeat, unusual sweating, or other signs and symptoms associated with hyperthyroidism, see your doctor. It's important to completely describe the changes you've observed, because many signs and symptoms of hyperthyroidism may be associated with a number of other conditions.

If you've been treated for hyperthyroidism, schedule follow-up visits as often as your doctor recommends. Initially, it's important to make sure you're receiving the correct dose of medicine. Over time, the dose you need to keep your thyroid hormone in the normal range may change.

HOW IS HYPERTHYROIDISM TREATED

  • Anti-thyroid medications – There are several medications that may be used.  When effective, they usually must be taken indefinitely or the hyperthyroidism recurs. Some patients do not tolerate one or more of the medications.
  • Radioactive Iodine therapy – I-131 is a radioactive isotope of iodine which will ablate thyroid function.  It takes an unpredictable period of time for it to cause the patient to become hypothyroid.  The patient will eventually require thyroid hormone replacement for life.
  • Thyroid surgery – Total thyroidectomy is usually required unless the patient has a single toxic nodule.  Hyperthyroidism must be contolled medically before proceeding with surgery.   After total thyroidectomy the patient will require thyroid hormone replacement for life.

One of these choices is not superior to the others.  Each have advantages and disadvantages.  Your University Surgeons Associates surgeon along with your doctor and/or endocrinologist will help you decide which choice fits your needs best.

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