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Hyperthyroidism, Graves Disease, These antibodies activate the receptor…
Hyperthyroidism
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Lab Testing
Thyroid Panel which includes TSH, T3, and T4
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Diagnostics
A thyroid Ultrasound can be preformed to look for nodules and also measure the thyroid gland to look for enlargement and inflammation
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RAIU test: Tests the thyroids ability to take up iodine. Increased uptake is seen with graves disease.
Low uptake is seen with thyroiditis, where the thyroid is leaking hormone.
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Personal Experience
I have never been diagnosed with Hyperthyroidism but I have gone into a hyperthyroid state. I have Hashimoto's Thyroiditis which causes my thyroid to be in a consistent hypothyroid state. To manage this autoimmune disease I take synthetic thyroid hormone.
During my beginning diagnosis my levels of thyroid hormone were very low so my PCP prescribed me 75 mcg of Levothyroxine. My levels were still very low so my PCP upped my dosage to 88 mcg then to 100 mcg.
My levels started to become normal but then the dosage started to cause me to go into a hyperthyroid state. I began to have hot flashes, shaky hands, difficulty falling asleep, heart palpitations, and then I lost 30 pounds. I am still working on finding the right dose for me but I have experienced both a hypothyroid state and hyperthyroid state
Pathogenesis
Basic understanding
Hyperthyroidism is defined as overproduction of thyroid hormones (T3 and T4). This can be caused by multiple conditions such as Graves disease, too much iodine, too much synthetic thyroid hormone supplementation, thyroid nodules, tumor of the pituitary gland and thyrotoxicosis.
T3 and T4 are hormones produced by the thyroid gland. T4 accounts for 90% of thyroid hormone. T3 is produced in much lower quantities (10%) but is much more potent in body.
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Pituitary adenoma
In rare cases, presence of a pituitary adenoma can cause secretion of too much thyroid-stimulating hormone driving the thyroid into overactivity.
Graves disease is the most common cause of hyperthyroidism. Graves disease is an autoimmune disease that results in the body attacking the thyroid causing it to produce too much thyroid home.
The antibodies that the body is making are called IgG autoantibodies which are mediated by the B & T lymphocytes. These will target the TSH receptors in the body.
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Risk Factors
Modifiable Risk factors
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Having type 1 diabetes, Rheumatoid arthritis, celiac disease, and pernicious anemia can increase the risk of a future diagnosis of hyperthyroidism
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Incidence and Prevalence
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Hyperthyroidism is more common in women, with women being about 5 to 10 times more likely to develop hyperthyroidism than men.
The prevalence of hyperthyroidism can vary by region due to differences in iodine intake, which affects thyroid function. In areas with iodine deficiency, it can correlate to higher incidence of thyroid disorders.
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Treatments
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Surgery
Surgery to remove the thyroid or part of the thyroid. This will require the patient to be on replacement hormone for the rest of their life.
The goal of treating hyperthyroidism is to normalize thyroid levels and alleviate symptoms. There are many different ways we can treat hyperthyroidism such as:
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These antibodies activate the receptor leading to an excess of thyroid hormone production (T3,T4), upregulation of cAMP, Increase in thyroglobulin synthesis, and Increased iodine uptake
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