Download Graves Disease Booklet

your thyroid
What you should know about hyperthyroidism
and the most common cause, Graves’ disease
function
If you have a thyroid problem, it doesn’t necessarily
mean that you will miss out on a happy and healthy life.
This pamphlet explains the conditions that lead to the
disease known as hyperthyroidism. As with any healthcare
issue, you should talk to your doctor about your
particular situation.
What is the thyroid,
and why is it important?
The thyroid is an endocrine gland that plays a key role in
regulating growth, development, and normal function of
the body.1 It is a butterfly-shaped gland located in the front
of your neck. The thyroid can affect your heart rate, your
emotional state, your feelings of tiredness and hunger,
and the condition of your skin and hair. In fact, your thyroid
influences most cells in your body.
Your thyroid controls your body’s functions by making
several hormones, including thyroxine (T4), which is
converted to triiodothyronine (T3).1 If you do not get
enough iodine in your diet, your thyroid cannot produce
enough T3 and T4. The amounts of T3 and T4 released into
the bloodstream:
• Regulate the body’s ability to turn food into energy
• Affect rates of tissue growth
• Affect the function of organ systems throughout
the body
The amount of thyroid hormones released by the thyroid
gland is monitored and controlled by the pituitary gland
which releases thyroid-stimulating hormone (TSH) when
the thyroid hormone levels are too low.1 When your thyroid
is functioning normally, TSH levels are relatively low.
Thyroid disease
With thyroid disease, thyroid hormones are over-produced
or under-produced. Diseases of the thyroid gland include1,2:
• Hashimoto’s disease – An autoimmune disease
that causes the thyroid to produce too little thyroid
hormone, causing hypothyroidism
• Goiter – Enlargement of the thyroid gland
• Thyroid nodules – Growth of thyroid tissue causing
circular or oval-shaped lumps in the thyroid gland
• Thyroid cancer – Growth of the thyroid gland, either
goiter or thyroid nodules, that becomes cancerous
Abnormal thyroid function can cause discomfort and
symptoms such as tiredness, irritability, weight loss
or gain, and inability to sleep.
Hyperthyroidism
Hyperthyroidism results from an overactive thyroid gland.
With too much thyroid hormone in the bloodstream, the
body “speeds up,” and may experience rapid heartbeat,
mood swings, weight loss, or shaky hands. Since these
symptoms are general, they may be mistaken for
other conditions.
The symptoms of hyperthyroidism and the severity may
vary from patient to patient. A patient may or may not
experience signs and symptoms.
Signs and symptoms of hyperthyroidism are2:
• Nervousness
• Mental disturbances
• Sleep disturbances
• Vision disturbances
• Thyroid enlargement
• Rapid heartbeat
• Weight loss
• Shortness of breath
• Heat intolerance
• Tremor
• Sudden paralysis
• Alterations in appetite
• Frequent bowel movements
• Menstrual disturbance
• Impaired fertility
• Leg swelling
• Fatigue and muscle weakness
• Hyperthyroidism – Too much thyroid
hormone is produced
• Graves’ disease – An autoimmune disease
that causes the thyroid to produce too much thyroid hormone, causing hyperthyroidism
Thyroid gland
• Hypothyroidism – Not enough thyroid
hormone is produced
Trachea
(Windpipe)
1
What you should know about hyperthyroidism
and the most common cause, Graves’ disease
thyroid function and
hyperthyroidism
How do I know if I have
hyperthyroidism?
Thyroiditis. Thyroiditis is an inflammation of the thyroid
tissue that may be caused by bacteria or a virus.8 This
causes the thyroid gland to temporarily leak extra hormone
into your bloodstream. For some people, hyperthyroidism
caused by thyroiditis may be a recurring problem.
If you have a family history of thyroid disease or if you
report certain symptoms to your doctor, he or she can
use several simple laboratory tests to check whether your
thyroid gland is functioning normally. Your doctor may
order a TSH test, which is the recommended test for
evaluating thyroid hormone levels. It measures the level
of thyroid-stimulating hormone (TSH), a hormone that
controls the amount of thyroid hormone (T4 ) produced.3
Another test that may be used measures the amount
of thyroxine (T4 ), circulating in your blood. Of these, the
TSH test is recognized to be the most sensitive test for
detecting too much or too little thyroid hormone.
Postpartum hyperthyroidism. Women can develop
hyperthyroidism after delivery of their babies when the
thyroid becomes inflamed. The hyperthyroidism may evolve
into hypothyroidism.
Drug-related hyperthyroidism. Certain medications
may cause the thyroid to function abnormally, causing
hyperthyroidism. Patients should talk to their doctor if
they experience any signs and symptoms.
Over-treatment with thyroid hormone replacement.
Taking too much thyroid hormone replacement may
lead to symptoms of hyperthyroidism.
• Mild hyperthyroidism – TSH levels fall below
the normal range and T4 levels are normal.
Signs and symptoms may or may not occur
• Overt hyperthyroidism – Your thyroid makes too much thyroid hormone. T4 levels rise above the normal range while TSH levels fall below.4
Signs and symptoms are likely to occur
What conditions lead to
hyperthyroidism?5
Graves’ disease. The most common cause of
hyperthyroidism is an autoimmune disease. Instead
of responding to and removing substances which the
body recognizes as foreign invaders, such as bacteria or
viruses, the body’s immune system attacks its own tissue.
The immune system produces antibodies that attach to
the cells of the thyroid gland, which in turn stimulates
excessive production of thyroid hormones.
The tendency to develop the disease may be inherited.
Some experts believe Graves’ can result from stress,6
though that does not appear to be the case for everyone
with the disease.
Many people with Graves’ disease also have eye
problems. Swelling of the tissue behind the eyes pushes
them forward, resulting in eyes that are red, inflamed,
and appear to bulge.7
Thyroid nodules. Nodules are growths on the thyroid
gland. They may increase in size and will often appear
as a lump in your neck known as a goiter. The nodules
may cause your thyroid to increase production of thyroid
hormone, which causes the body’s functions to speed up.
How is hyperthyroidism treated?5
The treatment for hyperthyroidism varies between patients.
If you have hyperthyroidism, your age, severity of disease,
overall state of health, and other factors all play a role in
what your doctor chooses for you. One or more of the
following treatments may be used:
ntithyroid drugs. These drugs block the ability of the
A
thyroid to produce thyroid hormone. They do not damage
the thyroid gland and may be used for short- or long-term
treatment.9 Antithyroid drugs are also used to prepare a
patient for treatment with radioactive iodine or for surgery.
Radioactive iodine. This treatment, usually a pill taken
once by mouth, damages or destroys thyroid cells that
produce excess thyroid hormone. This process may take
a few weeks or months. The thyroid gland is reduced in size,
and the amount of hormone produced is also reduced.
People given this treatment commonly become hypothyroid,
which can be treated with medication.10
Surgery. Surgery may remove all or part of the thyroid
gland to cure hyperthyroidism. This treatment often results
in hypothyroidism. To maintain adequate levels of thyroid
hormone in the body, daily treatment with thyroid hormone
replacement will be required after surgery.
Beta-blockers. These drugs help reduce some of the
symptoms of hyperthyroidism, such as rapid heart rate
and nervousness.
2
What you should know about hyperthyroidism
and the most common cause, Graves’ disease
managing
my thyroid
How can I manage the health
of my thyroid?
1.Pay attention to how you feel and report
symptoms to your doctor. If you are a woman,
older than age 60, have an autoimmune disease
(such as type 1 diabetes or rheumatoid arthritis),
have a family history of thyroid disease, have had
surgery, radiation therapy, or are pregnant,
you may need to discuss your thyroid function
with your doctor.
2.If you suspect that you may have thyroid disease,
ask your doctor about a TSH test. If you have
concerns and symptoms of thyroid disease,
TSH levels should be measured.
Tips on taking medication
If you have hyperthyroidism that is treated with surgery or
radioactive iodine, you may develop hypothyroidism after
treatment.9 If you become hypothyroid and thyroid hormone
replacement is prescribed, consider the following advice:
1.Take your medication every day, as prescribed.
2.Take your medications at the same time
every day. If you’re taking other medications,
prescribed or over-the-counter products,
including vitamin supplements, consult with
your doctor.
3.Tell your doctor if you stop taking one of your
regular medications or start taking a new one.
3.If you have thyroid disease, follow your doctor’s
directions. Take your medications exactly as
prescribed by your doctor.
4.Have your thyroid function checked every year.
An annual TSH test can confirm if your thyroid is
functioning normally.
The take-home message
Having a thyroid disease such as hyperthyroidism
may require you to take anti-thyroid medications,
undergo special treatment procedures, and see
your doctor for frequent follow-up checks.
Over time, you may require daily thyroid hormone
replacement pills, and you should continue to visit
your doctor at least once a year for a checkup.
References: 1. The Cleveland Clinic. Thyroid disease. http://www.clevelandclinic.org/health/health-info/
docs/2000/2011.asp?index=8541. Accessed July 15, 2011. 2. AACE Thyroid Task Force. American Association
of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of
hyperthyroidism and hypothyroidism. Endocrinol Pract. 2002;8:457-469. 3. Lab tests online: TSH. http://
www.labtestsonline.org/understanding/analytes/tsh/test.html. Accessed July 15, 2011. 4. EndocrineWeb.
Hyperthyroidism: overactivity of the thyroid gland. Part 3: making the diagnosis. http://www.endocrineweb.com/
hyper3.html. Accessed July 15, 2011. 5. Reid J, Wheeler S. Hyperthyroidism: diagnosis and treatment. Am Fam
Physician. 2005;72:623-630. 6. Winsa B, Adami HO, Bergstrom R, et al. Stressful life events and Graves’ disease.
Lancet. 1991;338(8781):1475-1479. 7. American Thyroid Association. Graves’ Disease FAQ. http://www.thyroid.
org/patients/brochures/GravesFAQ.pdf. Accessed July 15, 2011. 8. American Thyroid Association. Thyroiditis
FAQ. http://www.thyroid.org/patients/brochures/ThyroiditisFAQ.pdf. Accessed July 15, 2011. 9. American
Thyroid Association. Hyperthyroidism FAQ. http://www.thyroid.org/patients/brochures/HyperthyroidismFAQ.
pdf. Accessed July 15, 2011. 10. American Thyroid Association. Hypothyroidism FAQ. http://www.thyroid.org/
patients/brochures/HypothyroidismFAQ.pdf. Accessed July 15, 2011.
This pamphlet is provided to you by Abbott.
©2011 Abbott Laboratories Abbott Park, IL 60064 605-640911 June 2011 Printed in U.S.A.