Symptoms and treatment of hyperthyroidism in women. A late response to the symptoms of hyperthyroidism will lead to external deformities

The state of hyperthyroid metabolism occurs in the case of reduced rate TSH. If peripheral free hormones thyroid gland are still within the baseline range, they speak of subclinical hyperthyroidism. If peripheral concentrations of thyroid hormones are elevated, overt hyperthyroidism occurs.

Causes of hyperthyroidism of the thyroid gland

The causes of hyperthyroidism can be:

• Autoimmune process: Graves' disease> 50%, the most common cause, affecting mainly women aged 20 to 50 years; the pathophysiological basis is stimulation of TSH receptors by antibodies
• Monofocal or multifocal autonomy (with thyroid adenoma)
• Inflammation of the thyroid gland: Hashimoto's thyroiditis, de Quervain's thyroiditis
• Drugs: iodinated contrast agents, amiodarone (“amiodarone-induced hyperthyroidism types I and II”), thyroid hormone replacement
• Rarely, TSH-producing pituitary adenoma.

The causes of thyrotoxic crisis can be:

• Intake of iodine/iodine-containing medications (eg, amiodarone, radiocontrast agent)
• Cancellation of thyreostatics
• Operations.

The cause of hyperthyroidism may be an increase in the synthesis and secretion of the hormones thyroxine (T 4) and triiodothyronine (T 3) by the thyroid gland, caused by its stimulants present in the blood or associated with its autoimmune hyperfunction. Increased secretion thyroid hormones can occur without increasing their synthesis. The reason for this is usually destructive processes V thyroid gland for thyroiditis different types. Hyperthyroidism may also be one of the components of various clinical syndromes.

To the most common reasons hyperthyroidism include:

• Graves' disease; a thyroiditis; I have a multinodular goiter;
• single autonomous hyperfunctioning (“hot”) node.

Graves' disease, the most main reason hyperthyroidism, in addition to hyperthyroidism itself, is characterized by the presence of one or more of the following symptoms:

• exophthalmos;
• infiltrative dermopathy.

Graves' disease is caused by autoantibodies. These autoantibodies are stimulating, i.e. chronically increase the synthesis and secretion of T 4 and T 3. Graves' disease is sometimes accompanied by another autoimmune pathology, including diabetes Type 1, vitiligo, premature gray hair, pernicious anemia. The pathogenesis of infiltrative ophthalmopathy (causing exophthalmos) is not well understood but may involve the interaction of autoantibodies with TSH receptors on orbital fibroblasts and fat cells. As a result, the release of pro-inflammatory cytokines increases, inflammation develops and glycosaminoglycans accumulate. Ophthalmopathy may occur before the onset of hyperthyroidism or occur after long time after its development and often increases or decreases regardless of clinical course hypothyroidism.

With hydatidiform mole, choriocarcinoma and vomiting of pregnant women, it enters the serum a large number of HCG, which is a weak thyroid stimulant. HCG levels are highest in the 1st trimester of pregnancy, and during these periods there is sometimes a slight increase in the concentration of free T4 in the serum with a corresponding decrease in TSH levels. Hyperthyroidism with hydatidiform mole, choriocarcinoma and vomiting of pregnancy is a temporary phenomenon.

Drug-induced hyperthyroidism may result from the use of amiodarone or interferon-alpha, which cause thyroiditis with hyperthyroidism and other thyroid dysfunction. Although lithium is more likely to cause hypothyroidism, in rare cases may also cause hyperthyroidism. Patients using these drugs require close monitoring.

Artificial thyrotoxicosis occurs when deliberately or accidentally taking large doses of thyroid hormones.

Hyperthyroidism with excessive iodine intake most often develops against the background of pre-existing non-toxic nodular goiter when using drugs containing iodine or when conducting radiation studies with iodine-containing contrast agents. The reason may be that excess iodine serves as a substrate for the production of hormones by functionally autonomous (i.e., unregulated by TSH) areas of the thyroid gland.

In cases where ovarian teratomas contain sufficient amounts of thyroid tissue, the struma of the ovary develops, causing true hyperthyroidism. In these cases, the focus of accumulation radioactive iodine is localized in the pelvic cavity, and its uptake by the thyroid gland is sharply reduced.

Symptoms and signs of hyperthyroidism of the thyroid gland

• Tachycardia, arterial hypertension
• Hyperthermia and heat intolerance
• Weight loss
• Diarrhea
• Hyperkinetic movement disorders(choreiform, paroxysmal dyskinesias, trunk dystonias, tremor), rarely convulsive seizures
• Psychiatric symptoms: anxiety, agitation, psychosis
• Long-term consequences of hyperthyroidism: atrial fibrillation, osteopenia/osteoporosis, sexual dysfunction.

Thyrotoxic crisis is a potentially life-threatening illness that can occur within hours to days. The cause is usually (known or as yet undiagnosed) hyperthyroidism, which is provoked by certain conditions(for example, when iodine is supplied through contrast agent or amiodarone, in the case of infection, injury, surgery, or refusal to take antithyroid drugs).

The leading symptoms of thyrotoxic crisis are tachycardia (usually >150/min.), hyperthermia (>38.5 °C) and symptoms from the central nervous system(confusion, disturbances of consciousness, anxiety, agitation). In addition, other symptoms may develop (adynamia, myopathy and pseudobulbar palsy with impaired swallowing), as well as signs of cardiac decompression with peripheral and pulmonary edema and arterial hypotension.

The diagnosis of thyrotoxic crisis is established clinically.

Clinical manifestations can be both bright and faded. A goiter or thyroid nodule may be present. Many frequent symptoms hyperthyroidism - excitability, palpitations, fussiness, increased sweating, heat intolerance, fatigue, increased appetite, weight loss, insomnia, weakness and increased urge to defecate (sometimes diarrhea) - resemble signs of activation of the adrenergic system. Patients may complain of hypomenorrhea.

In elderly patients clinical picture can be atypical (“apathetic” or “masked” hyperthyroidism), and the symptoms are more reminiscent of depression or dementia. Most people do not have exophthalmos or tremor. Atrial fibrillation, fainting, confusion, and weakness are more often observed. Symptoms and signs of damage to one organ may predominate.

Ocular symptoms include staring, eyelid non-closure, and some conjunctival pinching, which is mainly due to increased adrenergic stimulation. Successful treatment hyperthyroidism usually results in the disappearance of these symptoms. More severe sign Specific to Graves' disease is an infiltrative ophthalmopathy that can manifest years before the development of hyperthyroidism and long after. It is characterized by orbital pain, lacrimation, irritation, photophobia, proliferation of retroorbital tissues, exophthalmos and lymphoid infiltration oculomotor muscles, which is accompanied by their weakness and often causes diplopia.

Infiltrative dermopathy, also called cutaneous myxidema nodosum (a misnomer because myxidema implies hypothyroidism), is characterized by dense infiltration of a proteinaceous ground substance that is usually found in the pretibial area. It rarely occurs in the absence of Graves' ophthalmopathy. On early stages Itching and redness often occur in the affected area, and subsequently the area hardens. Infiltrative dermopathy can occur years before or after hyperthyroidism.

Thyrotoxic crisis. Thyrotoxic crisis is acute form hyperthyroidism occurring against the background of untreated or insufficiently treated severe hyperthyroidism. His immediate reasons may be infections, trauma, surgery, emboli, diabetic ketoacidosis or preeclampsia. Thyrotoxic crisis is characterized by a sharp exacerbation of the symptoms of hyperthyroidism and is accompanied by one or more of the following manifestations: fever, severe weakness, muscle atrophy, extreme agitation, emotional lability, clouding of consciousness, vomiting, diarrhea and hepatomegaly with mild jaundice.

Diagnosis of thyroid hyperthyroidism

Noteworthy are endocrine orbitopathy, enlargement and sometimes tuberosity of the thyroid gland, as well as tachycardia.

Lab tests in subclinical hyperthyroidism is detected low TSH with normal (subclinical hyperthyroidism) or elevated (manifest hyperthyroidism) values ​​of T3 and T4.

There is no correlation between the level of thyroid hormone concentrations in peripheral tissues and the clinical severity of hyperthyroidism. Normal peripheral concentrations of thyroid hormones do not exclude thyrotoxic crisis!

In patients with subclinical hyperthyroidism but suppressed TSH levels (TSH<0,03 мЕД/л) повышен риск манифестного гипертиреоза и сердечно-сосудистых явлений.

During a thyrotoxic crisis, levels of transaminases, bilirubin, alkaline phosphatase and creatine kinase may increase.

In the case of autoimmune thyroiditis, the following is observed:

• Increased thyroid peroxidase antibodies (TPO-AA = macrosomal antibodies [MAC] are elevated in most cases of Hashimoto's thyroiditis and often in Graves' disease)
• Antithyroglobulin antibodies (TAC; often elevated in Hashimoto's thyroiditis, as well as in other autoimmune thyroiditis and differentiated thyroid carcinoma)
• The presence of antibodies to the TSH receptor (TRAK) in immunogenic hyperthyroidism (Graves' disease). TRAKs are also used for prognostic assessment; values ​​>10 mU/l after six months of drug thyreostatic therapy practically exclude remission.

Diagnostic Imaging performed with ultrasound of the thyroid gland (nodular goiter, adenoma) and according to indications for scintigraphy.

The most reliable indicator is TSH level in serum, since in hyperthyroidism it is reduced. In certain populations, screening for TSH levels is warranted. In hyperthyroidism, the level of free T4 is increased, but in true hyperthyroidism against the background of severe systemic diseases(similar to its decrease in euthyroid pathology syndrome) and T 3 toxicosis may remain normal. If patients with mild symptoms and signs of hyperthyroidism, the level of free T 4 is normal, and the TSH content is reduced, the concentration of T 3 should be determined.

The causes of hyperthyroidism are often clear already clinical examination(for example, the action of some medicines or signs). In other cases, thyroid uptake testing may be indicated.

If artificial thyrotoxicosis is suspected, the content of thyroglobulin in the serum is determined.

Differential diagnosis of hyperthyroidism of the thyroid gland

Differential diagnoses of hyperthyroidism:

• Febrile infections (pneumonia, sepsis) without a hyperthyroid metabolic state
• Encephalitis, meningitis
• Psychoses
• Malignant hyperthermia.

Treatment of hyperthyroidism of the thyroid gland

Treatment depends on the cause and may include:

• methimazole or propylthiouracil;
• β-blockers;
• iodine;
• radioactive iodine;
• surgery.

Methimazole and propylthiouracil. These antithyroid drugs block thyroid peroxidase, thereby preventing the organification of iodide and the condensation of iodotyrosines. The simultaneous use of L-thyroxine with antithyroid drugs does not increase the frequency of remissions of Graves' disease. Since remission of toxic nodular goiter is rare, antithyroid drugs in these cases are prescribed only to prepare patients for surgery or radioiodine therapy.

Due to the toxic effect of propylthiouracil on the liver in many patients under 40 years of age, this drug is currently recommended for use only in certain situations (for example, in the 1st trimester of pregnancy or during thyrotoxic crisis). Preferred remedy is methimazole. After normalization of T4 and T3 levels, the doses are reduced to the minimum effective: methimazole is usually used 5-15 mg once, and propylthiouracil - 50 mg three times a day. The desired effect is usually achieved after 1-2 months of therapy. More quick effect can be achieved by increasing the dose of propylthiouracil. These or else large doses, as a rule, used in severe cases diseases, including thyrotoxic crisis, in order to block the conversion of T 4 to T 3. Methimazole in maintenance doses can be taken for many years depending on the situation. In Europe, carbimazole is widely used, which quickly turns into methimazole in the body.

Side effects include rash, allergic reactions, liver dysfunction (up to liver failure when taking propylthiouracil) and reversible agranulocytosis, developing in approximately 0.1% of cases. If agranulocytosis is detected, patients should not be transferred to another oral agent. You should resort to another method of treatment (radiiodine therapy or surgery).

Methimazole can be taken only once a day, which increases patient compliance. In addition, when using methimazole in doses<40 мг/сут агранулоцитоз развивается гораздо реже. При использовании же пропилтиоурацила частота агранулоцитоза не зависит от дозы. Метимазол с успехом применялся у беременных и кормящих женщин без вреда для плода или ребенка, но все же отмечены редкие случаи дефектов волосистой части головы и ЖКТ у новорожденных и еще более редкие эмбриопатии. Поэтому в 1 триместре беременности назначают пропилтиоурацил. Пропилтиоурацил является предпочтительным средством при лечении тиреотоксического криза.

The combination of high doses of propylthiouracil with dexamethasone further inhibits the conversion of T4 to T3, alleviating the symptoms of severe hyperthyroidism and normalizing serum T3 levels within a week.

β-blockers. Symptoms and signs of hyperthyroidism are treatable with β-blockers; Propranolol is most commonly used, but the preferred drugs are atenolol or metoprolol.

All other manifestations of hyperthyroidism during such treatment, as a rule, persist.

• Manifestations usually eliminated by beta-blockers: tachycardia, tremor, mental symptoms, eyelid failure, sometimes heat intolerance and sweating, diarrhea, proximal myopathy.
• Manifestations usually unresponsive to β-blockers: increased O2 consumption, exolphthalmos, goiter, vascular murmurs, increased thyroxine levels, weight loss. Propranolol quickly reduces the heart rate (usually within the first 2-3 hours when taken orally and in the first minutes when administered intravenously). Esmolol is used only in intensive care units, since careful selection of its doses and close monitoring of patients are necessary. Propranolol is also used to eliminate tachycardia, especially in elderly patients, since the full effect of antithyroid drugs usually appears only after a few weeks.

Iodine. Iodine in pharmacological doses already in the first hours reduces the secretion of T 3 and T 4 and inhibits its own organization. Iodine is used for emergency relief of thyrotoxic crisis, before emergency surgical operations on other organs in patients with hyperthyroidism and (since it reduces blood flow to the thyroid gland) in the preoperative preparation of patients with hyperthyroidism.

Radioactive sodium iodide(131 I, radio-iodine). In the United States, 131 I is most often used to treat hyperthyroidism. Radioiodine therapy is often considered the treatment of choice for Graves' disease and toxic nodular goiter in all patients, including children. Doses of 131 I are difficult to select, since the reaction of the thyroid gland cannot be predicted. Some doctors prescribe a standard dose of 8-10 mCi. Others prefer to calculate the dose based on the size of the thyroid gland and its absorption of trace amounts of radioiodine in 24 hours. In such cases, 80 to 120 μCi/g of thyroid tissue is administered.

When using a dose of 131 I sufficient to induce euthyroidism, approximately 25-50% of patients develop hypothyroidism a year later, and its frequency increases annually. Thus, hypothyroidism will eventually develop in most patients. However, when lower doses of 131 I are used, the relapse rate increases. Large doses (10-15 mCi) often cause hypothyroidism within the first 6 months.

Radioactive iodine is not used during pregnancy because it passes through the placenta and can cause severe hypothyroidism in the fetus. The ability of radioiodine to increase the incidence of tumors, leukemia, thyroid cancer, or birth defects in children of mothers with a history of hyperthyroidism remains unproven.

Surgery. Thyroidectomy is indicated for relapse of hyperthyroidism after treatment of Graves' disease with antithyroid drugs, refusal of radioiodine therapy, intolerance to antithyroid drugs, and very large goiter. The operation is also performed in elderly patients with huge sizes of nodular goiter.

The risk of hypothyroidism directly depends on the extent of the operation. Rare complications include vocal cord paralysis and hypoparathyroidism. Previous surgery or radioiodine therapy makes surgery difficult.

Treatment of infiltrative dermopathy and ophthalmopathy. The manifestations of infiltrative dermopathy can be weakened by local use of corticosteroids or their injections into the lesions. Sometimes, after months and years, spontaneous remission of dermopathy is observed. Not only an endocrinologist, but also an ophthalmologist should take part in the treatment of ophthalmopathy; Selenium, corticosteroids, orbital radiation, or surgery may be required.

In the case of immunogenic and manifest hyperthyroidism, antithyroid drug therapy (thyreostatics: for example, thiamazole, carbimazole; attention: dose-dependent neutropenia up to atarnulocytosis) is first indicated until normal fT4 values ​​are achieved.

For mono- or multinodular goiter, radioactive iodine therapy is then recommended. For persistent or recurrent immunogenic hyperthyroidism, both radioiodine therapy and thyroidectomy can be subsequently used (the decision is made individually, for example, depending on the severity and duration of the therapeutic effect, or pregnancy and the desire to have children).

In the event of a thyrotoxic crisis, intensive medical therapy is required. Treatment should begin immediately, even if laboratory test results are not yet available. In addition to supportive measures (rehydration, adequate caloric intake, antipyretic therapy, cooling and, if indicated, sedation), the primary focus is a rapid decrease in the synthesis and secretion of thyroid hormones.

Medication strategies include:

• Thyreostatics (timazol, carbimazole)
• Inhibition of iodine absorption by potassium perchlorate
• Inhibition of the peripheral effects of thyroid hormones with beta blockers (eg, propranolol).

Attention: after eliminating hyperthyroidism, the effect of Marcumar (increased risk of bleeding!), beta-blocker receptors, digoxin and theophylline increases, so dose adjustment is required. If there is no improvement with conservative measures of intensive medical therapy within the first 24-48 hours, a decision must be made on emergency thyroidectomy. After a thyrotoxic crisis, one should strive for definitive treatment of the underlying thyroid disease that caused the crisis.

Treatment of diffuse toxic goiter

As we now understand, the cause-and-effect relationship between the formation of a goiter and an increase in the activity of the thyroid gland is quite complex. On the one hand, with hyperthyroidism, it is normal for the suppression of thyroid activity to cause its reduction in size. On the other hand, this does not always work out. Thirdly, goiter often becomes a source of problems not only with hormone levels, but also with breathing, voice timbre, and the position of the patient’s head. What should we definitely know here to improve our chances of making the right choice?

First of all, we emphasize: diffuse toxic goiter is initially a benign growth of glandular tissue. Just like a nodular goiter is a benign growth of connective tissue. However, if we talk about the most general patterns, both types of goiter have a great potential for malignancy. And statistics clearly state that of the two types of growths, cases of degeneration of diffuse toxic goiter are more often recorded.

Signs that clearly hint at the threat of a malignant tumor in this case include:

• goiter resistance to various types of therapy;
• a combination of normalizing the functioning of the gland with maintaining and increasing the size of the goiter;
• gradual inhibition of gland function - like a transition from hyperthyroidism to hypothyroidism;
• the appearance in the neck, face and head of areas of swollen, as if inflamed, lymph nodes.

We presented these considerations due to the fact that most often a goiter can be reduced artificially. However, in the case of the thyroid gland, this path can be not only surgical, but also radiological. Since diffuse toxic goiter is usually “hot”, the death of its tissues is most conveniently caused by administering radioactive iodine. As a rule, this is iodine 131 - the least stable isotope with a half-life of 7-8 days.

The mechanism is simple, and we have already explained it above. Yes, on the one hand, exposure to radioactive radiation itself is carcinogenic. But on the other hand, it destroys malignant cells faster and more actively than healthy ones. This means that the use of a radioactive iodine preparation in conditions where a strong carcinogenic factor is already present in our body is justified. And not just one, but several considerations at once.

Treatment of autoimmune reactions

Since we will be able to deal with anomalies in the functioning of the pituitary gland for now either by stabilizing the functioning of the thyroid gland or not at all, we will skip the topic of treating the glands inside the brain. It is likely that we have a pathology of its development in its pure form. But then we simply cannot do without the help of a neurologist. We ourselves have nothing to do here - this requires a huge store of knowledge, which we do not have. Therefore, let’s move straight to the issues that we have a chance to solve on our own.

As we understand by analogy with hypothyroidism, if the problem is the immune response to thyroid hormones, treatment should begin with work in two directions simultaneously. Namely, to suppress the immune response and reduce the activity of the thyroid gland. On average, the stage of bilateral exposure should not last longer than a month. After this period, suppressive thyroid therapy is discontinued, leaving only the immune part.

What can we add “on our own” to the medical course of hormones that suppress the activity of the thyroid gland? We can resort to some measures that traditional medicine will readily advise us. For example, vegetables containing relatively high doses of sulfur and thiocyanates - derivatives of thiocyanic acid. These vegetables include cabbage (all types), turnips, spinach, soybeans, and beans. Fruits include peaches, mangoes and cassava. As for the series of thiocyanates themselves, mercury thiocyanate most actively suppresses the thyroid gland.

However, it should be remembered that mercury thiocyanate is an extremely toxic substance, the intake of which on its own, in a chemically pure form, is simply unacceptable! For therapeutic purposes, it can only be used under the supervision of a specialist, whose experience we completely trust!

The action of substances of a number of thiocyanates is generally based on disruption of the flow of iodine molecules into thyrocytes (thyroid cells). Naturally, this significantly reduces the synthesis of hormones.

In addition to including the mentioned vegetables and fruits in the diet, we may be advised to take other measures. Let's say there is a gradual, deliberate creation of a deficiency of selenium in the body. Let us recall that the meaning of this recommendation will be that without selenium, thyroxine cannot be broken down into triiodothyronine. And if we increase the cobalt content in the diet, we will thereby reduce the activity of the enzyme that allows cells to absorb gland hormones.

As you can see, the problem here is not even that some of these measures involve the intake of highly toxic substances - salts of heavy metals. The point is that no one can say for sure why the patient started an autoimmune process against the body’s own hormones. There are two scenarios here.

Scenario 1. The immune reaction began in response to excess hormones in the blood - as one of the mechanisms of biological self-defense. Then the scheme proposed by alternative medicine to suppress the production and chemical activity of hormones will work, and quite effectively.

Scenario 2. It began because the thyroid gland produces hormones that are, as they say, incorrect from a biochemical point of view. Hormones are defective, containing foreign proteins or changes in structure. These defects, recognized by immune bodies as a sign of invasion, can appear in the product of gland synthesis for various reasons.

Including due to:

• congenital or acquired genetic abnormality in the DNA of gland cells;
• malignant degeneration of gland cells, which results in the appearance in the hormone molecule of special proteins secreted by cancer cells;
• chronic deficiency of synthesis components - amino acids (especially tyrosine) and iodine.

As we understand, if the second scenario is present, the measures listed above to disrupt individual synthesis processes will either not help us in any way or will outright harm us. Let’s say that if proteins are formed with an error due to a hereditary abnormality in the DNA section responsible for their synthesis, no therapy will help. Perhaps an operation to completely remove the thyroid gland and subsequent transition to hormone replacement therapy. The described option is by no means fantastic. Diabetes mellitus is inherited by name I in this way. In inherited diabetes, insulin molecules are formed in the pancreas at a normal rate. But tissue cells literally do not recognize them due to defects in their structure. And they do not capture either them or the glucose attached to them. In the same way, when endocrinologists talk about hereditary predisposition to thyroid pathologies, they mean a completely similar mechanism:

If hormones are formed incorrectly due to the appearance of tumor markers (special cancer proteins) in their structure, their activity is already reduced. Actually, this forces the thyroid gland to increase synthesis. The pituitary gland records deviations associated with the lack of hormone activity. And it stimulates the gland, although its actual “fault” is not here. We will only make our problems worse by further reducing the effectiveness of its work.

Finally, if there is already a deficiency of components, what additional reduction in iodine absorption can we even talk about?

It should be noted in fairness that official medicine combats thyroid hyperactivity using the same methods. The antithyroid drugs she uses suppress the synthesis of hormones in the thyroid gland by interrupting various stages of this transformation. For example, the drug “Propylthiouracil” (the active substance is indicated, the name of the drug may differ) suppresses the conversion of thyroxine to triiodothyronine. And the drug “Tyrozol” (trade name) blocks the enzyme peroxidase, without which the synthesis of triiodothyronine in the thyroid gland is impossible in principle.

Naturally, pharmaceuticals invariably work more effectively than alternative medicines. Perhaps it is for this reason that in cases of mild disease one should not rush to resort to them. Especially if, for various reasons, we are not able to accurately establish the mechanism of development of thyrotoxicosis. It should be remembered that in such a situation the doctor himself will act very much at random. Meanwhile, as was said, in some scenarios the prescribed therapy can further aggravate our problems and make the process irreversible.

Thus, if the state of affairs leaves us some time to select a therapy empirically, it is better to begin experiments with less effective means. The first thing you should include in your diet is all the foods with an inhibitory effect - the vegetables and fruits listed above. In addition to them, it is permissible to diversify the menu with root vegetables such as radish, and often use horseradish as a seasoning. It is permissible to start taking one of the medications with the most gentle effect at the same time. These include drugs that inhibit the conversion of thyroxine to triiodothyronine.

The drugs in this line affect not so much the activity of the thyroid itself, but rather the breakdown of the hormone in the tissues themselves. Our thyroid gland is already functioning incorrectly. Therefore, attempts to further interfere with the work of its cells can lead to their failure or degeneration - now they do not need as much for this as it seems Plus, substances that inhibit the breakdown of thyroxine will inevitably increase the amount of unclaimed hormone in the blood. Indirectly giving the thyroid gland a signal that its level is sufficient. As for the threat of irreversible damage to tissue cells, it should be remembered that they are renewed much more often than the cells of the endocrine glands. This means that over time, cells that have lost the ability to absorb thyroxine will be replaced by new, viable ones.

Thus, we will have to make a choice here according to the principle of “two evils.” But if we find ourselves in similar circumstances, let us at least make the best decision available.

After two weeks on thyroid-suppressing products, you can move on to the second stage. In principle, the period of primary inhibition here can be longer, depending on the speed of onset of a positive result. The second stage will consist of attempts to gradually return the gland to normal functioning. Precisely because for this we will need to restore the intake of all elements involved in the synthesis into the body, it is better to start it during the period of decreased activity of the gland.

You should start taking amino acids and iodine with dosages half as much as normal. If we use substances that disrupt the breakdown of thyroxine, it is better to divide the dosage of selenium by 4 - not even by 2. However, no matter how small our “starting” doses are, they must enter the body daily, stably, constantly. That is, the iodide application method is not suitable for us here. The explanation for the last requirement is simple: the thyroid gland works continuously. Then)" the more stable the substances she needs arrive, the more stable she will get used to working.

Let's summarize briefly. Hyperthyroidism is an unreasonable increase in the daily production of thyroid hormones by the thyroid gland. As a rule, it is accompanied by a physical increase in the amount of normal, viable gland tissue. There are several reasons why the thyroid gland accelerates the secretion of its hormones. And one of them, in turn, can be a consequence of a number of different phenomena.

So, the activity of the thyroid gland can increase due to the low biological value of the hormones it produces. In addition, its functioning may be affected by a malfunction of the pituitary gland or hypothalamus. But the decrease in the value of hormones has various roots. Firstly, this happens when an autoimmune reaction is triggered, when for some reason agents of the immune system block the functioning of hormones in tissues. Secondly, it happens that the gland begins to produce hormones with a disturbed, defective structure.

This is possible when a congenital anomaly manifests itself at the level of the patient’s genetic code. Or during malignant degeneration of gland cells, when special proteins synthesized by tumor cells - tumor markers - are woven into the composition of the proteins of the hormone molecule. Finally, defects in the structure of hormone molecules can be explained by a chronic lack of substances necessary for their normal synthesis.

In all of these cases, the activity of such hormones will be significantly lower than normal. And an aggravated reaction of the immune system to them will clearly indicate the presence of defects in their structure.

However, as we see, in order to identify the true causes of hyperthyroidism, a rather complex, multi-stage diagnosis is sometimes necessary. Let's be honest: such detailed studies are not always available and, accordingly, are not always prescribed by a doctor. Meanwhile, it is clear that traditional therapy to suppress the synthesis of hormones or their absorption does not take into account all of the above scenarios. In particular, in some cases (such as a deficiency of components), artificial interruption of synthesis in certain areas of the process can only aggravate the pathology, but not correct it.

Prevention of hyperthyroidism of the thyroid gland

• In the case of a hyperthyroid metabolic situation when using iodine-containing contrast agents, sodium perchlorate (Irenat; 500 mg [= 25 drops] 2-4 hours before iodine application is pre-administered and continued daily for 2 weeks).
• For treatment-requiring atrial fibrillation and a hyperthyroid metabolic situation, or in the case of amiodarone-induced hyperthyroidism, switch to dronedarone (Multaq).

Hyperthyroidism (or thyrotoxicosis) is a clinical condition in which the thyroid gland produces excessively active thyroid hormones - triiodothyronine and thyroxine. Hyperthyroidism, the symptoms of which manifest themselves as a result of oversaturation of the blood with these hormones and their distribution by the blood flow throughout the body, including tissues, organs and systems, leads to the acceleration of all processes in it, which negatively affects the general condition of the patient in a number of ways.

general description

Hyperthyroidism is the result of various types of pathologies that are relevant to the thyroid gland, and these pathologies can be provoked directly by disturbances in the thyroid gland itself, and by disturbances that arise in those processes that are regulated by it. Similar to hypothyroidism, hyperthyroidism, depending on the degree of damage to the thyroid gland, can manifest itself in a primary form (which implies the pathology of the thyroid gland itself), in a secondary form (with pathology of the pituitary gland), and also in a tertiary form (which implies a pathology of the hypothalamus).

As we initially noted, hyperthyroidism leads to stimulation of the activity of all systems, tissues and organs in the body, and the cardiovascular system especially suffers from such changes. The fact is that against the background of the disease in question and the processes that it entails, tissues and organs begin to need a larger volume of oxygen, which is accompanied, in turn, by an increase in the frequency of heart contractions, due to which such needs are satisfied. Naturally, this affects the heart accordingly; in hyperthyroidism, it is defined as a “thyrotoxic heart.” Of course, the work of other organs is also accompanied by tension. It should be noted that patients with hyperthyroidism without the necessary treatment for this disease may encounter the development of a condition such as thyrotoxic crisis, which, in turn, without proper medical care, can cause the development of coma.

Women are predominantly affected by hyperthyroidism. Thus, per 1000 women there are about 18-20 cases of this disease, while in men per a similar number (1000) hyperthyroidism occurs in no more than two cases. As for the age range, the period for hyperthyroidism is 20-50 years.

Hyperthyroidism: causes

As we have already noted, hyperthyroidism develops as a result of pathological processes in the gland itself, as well as as a result of violations of its regulation. Hyperthyroidism mainly develops as a result of the following diseases:

• Diffuse toxic goiter (or Graves' disease) - this cause most often leads to the development of hyperthyroidism, with this disorder there is a uniform enlargement of the thyroid gland while at the same time persistent production of hormones on its part.
• Nodular/multinodular toxic goiter (Plummer's disease) is diagnosed much less frequently, and mainly in older people. The peculiarity of the pathology in this case is that it causes the formation of compactions of unknown origin in the thyroid gland, which, as can be understood from the definition of this pathology, have the appearance of nodules. The impact they have leads to even greater activity of the thyroid gland.
• In some cases, hyperthyroidism develops against the background of subacute thyroiditis, which implies an inflammatory process that develops as a result of viral infections. Such viral inflammations lead to destructive processes in the follicular cells of the thyroid gland, as well as to an excessive release of thyroid hormones into the blood. The course of hyperthyroidism in this variant is mild and short-term in nature (its duration can range from several weeks to several months).
• There is also a form of the disease called artificial hyperthyroidism. It develops against the background of uncontrolled use of thyroid hormones. In addition, it can also develop when these hormones are used due to the actual tissue immunity of the pituitary gland to them.
• There are also more rare causes that contribute to the development of hyperthyroidism:
• ovarian teratomas, accompanied by the production of thyroid hormones (otherwise the pathology is defined as ovarian struma, which implies the formation of tumor formations, the basis of which are the cells of the thyroid gland in combination with these hormones produced);
• pituitary tumors in which there is an increased production of thyroid-stimulating hormone (TSH) (for example, this may be acromegaloid hyperthyroidism with hyperostosis, which implies a combination of signs of hyperactivity of the thyroid gland due to its increased production of TSH with acromegaly and diffuse hyperostosis of the calvarium);
• increased production of hormones by the thyroid gland due to the introduction of excessive amounts of iodine into the body.

Features of the course of hyperthyroidism

Let us highlight some features characteristic of the course of hyperthyroidism. For example, we have already noted that due to thyroid hormones, oxygen consumption increases, in particular from tissues, this causes an increase in tissue formation while simultaneously increasing energy metabolism.

Also a feature of hyperthyroidism is an increase in tissue sensitivity to sympathetic stimulation (i.e. stimulation of the sympathetic nervous system, which is part of the autonomic nervous system) and to catecholamines (i.e. to physiologically active substances that act as a control type of molecules and chemical messengers within the framework of intercellular interaction, in particular these are neurotransmitters in the form of dopamine, norepinephrine and adrenaline).

Due to the increased level of conversion of androgens to estrogens, there is an increase in the volume of circulating globulin in the tissues, which ensures the binding of sex hormones, and this, in turn, leads to an increase in the ratio between estrogens and androgens. Against the background of this kind of hormonal changes, the possibility of developing gynecomastia in men cannot be ruled out (a pathology that implies excessive enlargement of the mammary glands in men (unilateral or bilateral type), which in some cases determines compliance with the female type).

Due to the acceleration of the process of destruction of cortisol against the background of the influence of thyroid hormones, a clinic of hypocortisolism develops, which determines a reversible form of renal failure.

Forms of hyperthyroidism

Hyperthyroidism can occur in mild or moderate form, as well as in severe form.

The mild form of the disease (subclinical form) is characterized by an asymptomatic course, triiodothyronine (T4) is normal according to current indicators, TSH (thyroid-stimulating hormone) levels are slightly reduced.

The next form is a moderate form (in other words, obvious or manifest). In this case, T4 levels are characterized by an increase, while TSH levels are significantly reduced, and symptoms characteristic of the disease appear.

And, finally, a severe (complicated) form of the severity of the disease, in which there is adrenal or heart failure, severe body weight deficiency, psychosis and other types of pathology, indicating, respectively, damage to certain specific systems, organs and their inherent functions.

Let's consider the main signs of hyperthyroidism, corresponding to the indicated degrees of severity of its manifestation:

• Light form

In addition to the initially noted changes in the levels of hormones in the blood (which is revealed by an appropriate blood test), a moderate degree of weight loss is noted (within 5 kg). Tachycardia also appears, in which the heart rate is no more than 100 beats per minute, there are no changes in the rhythm of contractions. There are also no signs from the endocrine glands indicating a violation of their functions (with the exception of the thyroid gland). In addition, patients experience a certain degree of irritability and sweating (manifested even in rooms with normal temperature).

• Medium form

Weight loss is pronounced (about 10 kg). Pathological changes are observed in the myocardium, tachycardia manifests itself with a heart rate ranging from 100 to 120 beats/min. In this case, tachycardia is characterized by the stability of its own manifestation, and this does not depend on what position the person is in; there is also no connection with previous sleep and a state of long-term rest. Carbohydrate metabolism is subject to disturbances, blood cholesterol decreases, and gastrointestinal disorders appear (which is characterized by loose and frequent stools).

The signs indicating the relevance of adrenal insufficiency gradually intensify. Patients experience thyrotoxic tremor - trembling of the fingers, noted when the arm is outstretched. In addition, patients become more irritable and excitable, sleep disturbances, excessive anxiety and tearfulness appear. There are also signs such as exophthalmos (a characteristic forward displacement of the eyeball, in other words, protrusion, bulging eyes), as well as hyperhidrosis (that is, increased sweating) of a general type of manifestation.

In this case, in addition to the general description that we initially proposed in the classification of forms of hyperthyroidism, we can note a sharp and pronounced weight loss. Tachycardia is a stable manifestation; the pulse ranges from 120-140 beats per minute, but the possibility of exceeding these limits cannot be ruled out. Blood pressure is characterized by increased systolic pressure with simultaneously decreased diastolic pressure. Exophthalmos is even more pronounced in comparison with the previous form of the disease, as is thyrotoxic tremor, which this time manifests itself as spreading throughout the body (and not just when the hands are affected).

Hyperthyroidism: symptoms

Considering the peculiarity of the disease we are considering, which is the acceleration of all processes occurring in the body, we can understand that the symptoms of hyperthyroidism are extremely multifaceted and, accordingly, they are determined based on the severity of the disease, its course and the degree of damage to specific organs, tissues and systems. Excessive production of hormones produced by the thyroid gland determines the following effects on the patient’s body:

• CNS. The central nervous system reacts to the current impact of the disease in the form of increased excitability, irritability, emotional imbalance, fears and causeless worries, rapid speech, hand tremors and sleep disturbances.
• Ophthalmology. Ophthalmological symptoms consist in the previously noted manifestation, which is exophthalmos (in which the eyeball undergoes protrusion when it is displaced forward and with a simultaneous increase in the palpebral fissure). In addition, swelling of the eyelids, double vision of objects in the field of vision and rare blinking are noted. It should be emphasized that due to the characteristic compression in this case, against the background of which optic nerve dystrophy also develops, the possibility of absolute loss of vision for the patient cannot be ruled out. Also among the current ophthalmological symptoms can be identified severe dry eyes and pain in the eyes, increased tearing, the development of corneal erosion, bags under the eyes, the inability to concentrate on a specific object, etc.
• The cardiovascular system . As we initially noted, for her the symptoms of hyperthyroidism and the peculiarities of its course are not easy due to the acceleration of processes in the body and the special need for oxygen because of this. The cardiac arrhythmia that is relevant in this situation responds extremely poorly to the treatment provided to it. Atrial flutter and fibrillation and persistent tachycardia are noted here. Against the background of simultaneously increased systolic pressure and decreased diastolic pressure, a significant increase in pressure indicators (upper and lower) occurs in the gap. Heart failure develops.
• Gastrointestinal tract. On the part of the gastrointestinal tract, changes in appetite are noted (its decrease or, conversely, increase); in older people, this symptom can go as far as a complete refusal to eat. Frequent and loose stools, disturbances in the processes of bile formation and digestion, and paroxysmal abdominal pain are also noted.
• Respiratory system. Against the background of edema and congestion, negative changes occur regarding the vital capacity of the lungs, and persistent shortness of breath develops.
• Musculoskeletal system . Thyrotoxic myopathy develops, in which chronic weakness and muscle fatigue, muscle wasting (muscle condition caused by insufficient supply of nutrients to the body or insufficient absorption of them) become characteristic symptoms. There is also trembling of the limbs and the body as a whole, osteoporosis (a chronic progressive disease or clinical syndrome (in this case), characterized by a decrease in the inherent density of bones with a simultaneous violation of microarchitecture and with increased fragility, relevant due to a number of damaging processes). Against the background of the listed symptoms, difficulties arise that are noted during long walking (especially when climbing stairs), as well as when carrying heavy objects. The possibility of developing muscle paralysis, which in this case is reversible, cannot be ruled out.
• Reproductive system . Characteristic changes are also observed in this area. Thus, against the background of disturbances in the secretion of gonadotropins, infertility may develop. As described earlier, men may develop gynecomastia and potency decreases. As for the impact on the female body of processes relevant to the disease, here, in particular, disruptions of the menstrual cycle are noted. The manifestation of menstruation is characterized by pain and irregularity, the discharge is scanty, and accompanying symptoms are severe weakness (which can reach a state of fainting), severe headaches. In extreme cases, disruptions in the menstrual cycle reach amenorrhea, that is, the complete absence of menstruation.
• Metabolism . Against the backdrop of accelerated metabolic processes, patients experience persistent weight loss, which is achieved even with increased appetite. In addition, heat production increases (which manifests itself in the form of increased sweating and temperature). As the breakdown of cortisol accelerates, a reversible form of adrenal insufficiency develops. An enlarged liver is also noted, and if we are talking about a severe form of hyperthyroidism, then this is accompanied by jaundice. As an additional symptom that accompanies this part of the manifestations, the following can be identified: swelling of the soft tissues; thinning nails, hair and skin; early and pronounced gray hair; severe thirst, copious and frequent urination (which is important due to impaired water metabolism).

External signs of hyperthyroidism include, first of all, an enlargement of the thyroid gland, which can manifest itself to varying degrees. In some cases, examination and palpation of the neck can determine the cause that provoked hyperthyroidism (nodular or diffuse goiter). For example, if we are talking about Graves' disease, then the enlargement of the thyroid gland is characterized by its own symmetry. If palpation determines a nodular formation in the area under study, then this, in turn, is an indication of the current tumor process in it.

What is noteworthy is that the listed symptoms of hyperthyroidism often do not appear in older people, which defines latent (masked) hyperthyroidism. Typical symptoms accompanying this disease in older people, however, may include frequent depression and weakness, drowsiness and some lethargy. It can also be noted that, in a pronounced version, disorders associated with the functioning of the cardiovascular system in elderly patients with hyperthyroidism occur many times more often than in young patients.

Thyrotoxic (hyperthyroid) crisis

This complication occurs as a result of untreated thyrotoxicosis or when treatment is prescribed that does not actually correspond to the necessary measures. A crisis can also be triggered by mechanical manipulations performed during examination of a patient or during surgery that in one way or another affects the thyroid gland. The possibility of a crisis developing due to stress cannot be ruled out.

In general, a hyperthyroid crisis manifests itself by reaching a peak with symptoms characteristic of hyperthyroidism. It begins acutely and its course is lightning fast. Patients experience severe mental agitation, and it is often accompanied by hallucinations and delusions. The trembling of the hands intensifies, in addition, the trembling spreads to the lower extremities and throughout the body as a whole. Blood pressure drops sharply, muscle weakness appears with general lethargy of the patient. Vomiting manifests itself in an indomitable form, accompanied by elevated temperature (signs indicating the relevance of the infection are absent in this case), diarrhea, and rapid heartbeat (reaching 200 beats per minute). When you urinate, you can detect the characteristic acetone odor in your urine. Temperature (up to 41 degrees) and pressure rise.

In some cases, jaundice develops, which manifests itself as a result of an acute form of fatty degeneration, relevant for the liver, and adrenal insufficiency can also develop.

It is important to note that the lack of timely assistance can cause the death of the patient due to the transition of the crisis to a coma. Death can occur as a result of an acute form of fatty liver disease or due to adrenal insufficiency.

Diagnosis

The diagnosis is made, first of all, on the basis of current manifestations of symptoms, which in particular consists of highlighting the features of the appearance of patients and data obtained from relevant laboratory tests. Thus, a blood test determines changes in the content of hormones, an ultrasound allows one to identify nodules in the thyroid gland, and electrocardiography, in view of the complaints arising against the background of the disease regarding the activity of the cardiovascular system, allows one to add certain specifics regarding the symptoms that appear in this area.

In addition, a computed tomography may be prescribed, in which images of the organ are taken in a layer-by-layer mode, due to which a clear idea appears of where exactly the compaction that is relevant to it is localized. The use of the listed diagnostic methods allows you to fully clarify the diagnosis, after which you can prescribe an appropriate course of individual therapy.

Treatment

The treatment of hyperthyroidism is focused on achieving specific goals. So, first of all, it is necessary to achieve normal hormone levels, which is ensured by prescribing appropriate drug treatment. In addition, the need for surgical treatment is considered, which implies the need to remove an adenoma, goiter or tumor formation in the thyroid gland. Additional therapeutic measures consist of symptomatic effects, due to which it is possible to improve the functioning of systems and organs in the body of a sick person. Let's take a closer look at these methods.

Drug treatment of hyperthyroidism primarily involves the use of antithyroid drugs, which are mainly used in cases of slight enlargement of the thyroid gland. If the gland reaches a significant size (more than 40 ml), and the general condition is characterized by the manifestation of symptoms indicating compression of nearby organs, then drug treatment becomes only a preparatory stage for another treatment - surgical treatment. In the treatment of the disease we are considering, the use of antithyroid drugs, which are a group of thionamides (drugs Propylthiouracil, Thiamazol, etc.), is now quite common. The basis of the mechanism of drugs corresponding to this group is that they have a targeted suppressive effect on processes directly involved in the formation of hormones in the thyroid gland (in particular, thyroid peroxidase is suppressed).

Under the conditions of highly developed countries, treatment of thyrotoxicosis is carried out through the use of carbimazole for this purpose. This is a long-acting (otherwise known as prolonged) drug; it is especially effective in cases of severe forms of the disease. In addition to the necessary effect on the formation of hormones in the thyroid gland, this drug inhibits the conversion of T4 (that is, thyroxine) to T3 (or triiodothyronine). It is noteworthy that when taking 20 mg of this drug, the condition provoked by hypothyroidism is completely compensated.

Also, in developed countries, treatment using radioactive iodine is an integral method of treatment. This iodine quickly penetrates the thyroid gland, after which it gradually accumulates within its area. When radioactive iodine decays, the cells of the thyroid gland, thyrocytes, are destroyed.

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Kidney amyloidosis is a complex and dangerous pathology in which protein-carbohydrate metabolism is disrupted in the kidney tissue. As a result, the synthesis and accumulation of a specific substance – amyloid – occurs. It is a protein-polysaccharide compound, which in its basic properties is similar to starch. Normally, this protein is not produced in the body, so its formation is abnormal for humans and entails impaired renal function.

Hyperthyroidism is a chronic disease characterized by increased hormonal activity of the thyroid gland and excessive production of the hormones thyroxine (T4) and triiodothyronine (T3). Due to an excess of these hormonal substances in the blood, metabolism in the patient’s body is significantly accelerated. Thyroid hyperthyroidism is also called thyrotoxicosis.

Anatomy and functions of the thyroid gland

The thyroid gland is the largest gland in the human body, located in the anterior lower region of the larynx. The endocrine organ is responsible for the synthesis of thyroid hormones containing iodine atoms. Iodine is extremely necessary for the body of every person, since this substance is directly involved in the regulation of metabolic processes, thermoregulation, and affects the nervous system and psyche.

The synthesis and release of thyroid hormones occurs in the follicles of the organ in several stages. First, iodine enters the body along with food, which enters the blood in inorganic form. Thyroid cells take it up and convert it into organic iodine. After oxidation, iodine molecules attach to the non-essential amino acid tyrosine, forming compounds such as monoiodotyrosine and diiodotyrosine. Then condensation occurs and the formation of the hormones T3 and T4, which are released into the bloodstream. Blood oversaturated with hormones carries these substances to all tissues of the body, which leads to an acceleration of metabolic processes in almost all human organs.

In addition, with hyperthyroidism, hormonal changes develop due to the conversion of androgens (male sex hormones) into estrogens (female sex hormones) and the accumulation of the latter in the blood. The sensitivity of tissues to the effects of the sympathetic nervous system increases noticeably

The hypothalamus and pituitary gland are mainly involved in the regulation of thyroid function.

According to statistics, hyperthyroidism occurs eight times more often in women than in men. When the thyroid gland is dysfunctional, reproductive function suffers, which can lead to infertility.

The development of the disease becomes a consequence of certain pathological processes occurring directly in the gland, or a violation of the process of regulation of its function.

There are a number of pathologies in which hyperthyroidism most often occurs:

• Graves' disease (diffuse) - manifests itself as a uniform enlargement of the gland with excessive synthesis of thyroid hormones;
• Plummer's disease (nodular toxic goiter) - detected mainly in adulthood and is characterized by the presence of nodular seals in the organ;
• Subacute thyroiditis is an inflammatory process that occurs as a result of viral infections. The pathology provokes the destruction of follicular cells of the gland and excessive secretion of thyroid hormones;
• tumor diseases of the pituitary gland;

In addition, the cause of hyperthyroidism can be:

• systematic intake of thyroid hormones;
• taking a large number of drugs;
• ovarian teratomas;

Hyperthyroidism can also be congenital. In this case, it develops as a result of an illness suffered by a pregnant woman or is caused by a genetic factor.

Types of hyperthyroidism

The modern classification distinguishes three types of this disease:

1. Primary hyperthyroidism– the main reason leading to the development of the disease – pathology of the thyroid gland
2. Secondary– caused by a malfunction of the pituitary gland
3. Tertiary– the cause of this type of hyperthyroidism is pathological processes in the hypothalamus

Primary hyperthyroidism goes through several successive stages in its development:

• subclinical– usually does not have severe symptoms, but there is a decrease in the level of TSH (thyroid-stimulating hormone, thyrotropin) with a normal T4 level;
• manifest form (explicit)– characterized by a vivid clinical picture; an increase in T4 levels and a more pronounced decrease in TSH levels are noticeable in the blood;
• complicated form– manifested by the presence of psychoses, weight loss, cardiac and adrenal failure, dystrophy of organs rich in parenchymal tissue, arrhythmias and other complications of hyperthyroidism from various organs and systems.

Pathological symptoms, depending on the severity of the disease, can affect many systems and organs of the human body. The main external sign is an enlarged thyroid gland.

Symptoms of hyperthyroidism from the central nervous system

On the part of the central nervous system, an excess of the hormones T3 and T4 causes:

• sleep disorders,
• hand tremors,
• sudden mood swings,
• irritability,
• excessive excitability,
• memory and concentration disorders.

Symptoms of pathologies of the cardiovascular system, indicating hyperthyroidism

Many patients with hyperthyroidism experience symptoms of heart rhythm disturbances: persistent sinus tachycardia, atrial flutter. There is also an increase in systolic pressure with a simultaneous decrease in diastolic pressure. Signs of heart failure appear.

Clinical signs of the disease in the genital area

Hyperthyroidism in women is manifested by menstrual irregularities up to amenorrhea, and soreness of the mammary glands occurs. Due to disruption of the production of sex hormones, the reproductive sphere also suffers, which can cause infertility.

Men experience a decrease in potency and sexual desire, and often develop gynecomastia - swelling of the mammary glands.

With a disease such as hyperthyroidism, signs of pathological processes in the thyroid gland extend to the organs of vision. One of the external symptoms of the pathology is protrusion of the eyeballs and limitation of their mobility. There is also a widening of the palpebral fissure, dryness and burning in the eyes, and increased lacrimation.

Characteristic symptoms of hyperthyroidism from other organs and systems

Other typical clinical signs of hyperthyroidism include:

• loss of body weight due to accelerated metabolism; appetite may be increased or decreased;
• digestive disorders;
• frequent urination;
• increased sweating and extreme thirst;
• muscle wasting;
• trembling in the limbs;
• adrenal insufficiency;
• liver dysfunction; in severe cases, hepatitis may develop;
• deterioration of nails and hair
• thinning of the skin

Note! In old age, symptoms of the disease may not appear - this is the so-called latent hyperthyroidism. In older people, a typical reaction to an excess of thyroid hormones is drowsiness, a tendency to depression, and lethargy.

In severe cases of the disease and the absence of adequate therapy, a complication may occur - hyperthyroid crisis. It can also be triggered by stress. In this condition, the clinical symptoms of the pathology reach their maximum peak.

Hyperthyroid crisis is characterized by an acute, rapid onset. Patients experience mental agitation, which may be accompanied by delusions and hallucinations. Severe tremor spreads throughout the body, blood pressure drops sharply, severe weakness, indomitable vomiting appears, and body temperature rises. The heart rate can reach up to 200 beats per minute.

Important! Lack of timely medical care during a hyperthyroid crisis can lead to coma and death of the patient.

Hyperthyroidism is diagnosed based on the patient’s clinical symptoms and research data:

An important point in the presence of symptoms of hyperthyroidism is its differentiation from other thyroid diseases. In this case, this diagram will be a good help:

Treatment of hyperthyroidism, depending on the extent of the lesions present, can be carried out by conservative and surgical methods. Therapeutic tactics are developed by an endocrinologist; he can recommend existing treatment methods in combination or separately.

Drug correction for the disease in question is aimed at suppressing the secretory activity of the organ. For this purpose, patients are prescribed thyreostatic drugs. Hydrotherapy and diet therapy are of great importance in conservative treatment. Patients need to include foods rich in proteins, carbohydrates and fats in their diet, and limit the consumption of foods that irritate the central nervous system.

Another method used in the treatment of the described pathology is radioiodine therapy. The patient ingests radioactive iodine, which destroys malfunctioning gland cells. As a rule, such therapy is carried out in conjunction with drug correction.

Surgical treatment of hyperthyroidism involves surgical excision of a section of the gland. The remaining part of the organ will function normally, but if a large area is excised, the opposite of hyperthyroidism, hypothyroidism, may develop. In this case, the patient is indicated for lifelong replacement therapy.

Main indications for surgery:

• the presence of a large goiter;
• individual intolerance to medications necessary for effective drug treatment;
• relapse of the disease after a course of drug therapy.

Note! During the treatment and recovery period, diet plays an important role. Twice a year, patients with hyperthyroidism are recommended to undergo a course of treatment aimed at eliminating disorders of the cardiovascular system.

For a disease such as hyperthyroidism, alternative treatment can give good results, but you should only contact it with the permission of your doctor.

Alcohol tinctures of medicinal plants are considered effective in combating the disease:

In addition to alcohol tinctures, traditional medicine offers healing infusions as effective treatments for hyperthyroidism. This way you can prepare an infusion of valerian by pouring a glass of boiling water over a spoonful of the raw material and letting it sit for a couple of hours. The drug is drunk in small portions throughout the day.

In early spring, it is time to prepare an infusion from cherry buds and twigs. To do this, you need to cut 100 grams of branches with swollen buds, add half a liter of water and boil for half an hour. The drug should be taken one tablespoon before meals three times a day.

Everyone's favorite citrus fruits, lemon and orange, also help with hyperthyroidism. Any of these fruits must be grated along with the zest and a little sugar added. The result is a very tasty and healthy remedy, which should be taken one spoon three times a day.

You can also resort to treatment with natural clay, which will help normalize the functioning of the thyroid gland. The clay must be diluted with water to a paste-like state and lotions applied to the front of the neck for an hour.

Thyroid hyperthyroidism, even after successful treatment, can recur, so patients need to regularly visit an endocrinologist. As a preventative measure, all people are advised to monitor their diet, consume iodine-containing foods, and promptly consult a specialist at the first signs of thyroid disorders.

Chumachenko Olga, medical observer

Information about hyperthyroidism, analysis of the symptoms that manifest themselves and the causes that can lead to overactive functioning of the thyroid gland.

Let's see what therapeutic strategies are used in treatment and how to counteract the pathology.

What is hyperthyroidism of the thyroid gland

Hyperthyroidism is a pathological condition in which there is an increase in the activity of the thyroid gland. This means that it releases more hormones into the blood.

Before proceeding, a brief explanation is necessary, what is the thyroid gland, what hormones does it produce and what is their function?.

Thus, the system the formation of hormones T3 and T4 is finely regulated, but due to some changes in this mechanism, we can find two extreme conditions: hypothyroidism, when the thyroid gland reduces its function, and hyperthyroidism, in which the thyroid gland works more actively than necessary.

In this article we want to focus only on the condition of hyperthyroidism.

Normal and pathological values ​​of thyroid hormones

It is already clear that with hyperthyroidism we are dealing with hormonal overproduction. In this condition, the pituitary gland reduces the secretion of TSH to reduce the levels of T3 and T4 in the bloodstream.

• T3 - 1.1-2.6 nmol/l
• T4 - 60-150 nmol/l
• TSH - 0.15-3.5 mIU/l

• T3 is more than 2.6 nmol/l
• T4 more than 150 nmol/l
• TSH less than 0.15 mIU/l

The normal range varies depending on the laboratory that performs the test and the method that is used.

Changes in hormonal levels, of course, alarm signal to diagnose hyperthyroidism. But this pathology has various forms and types, which we can classify as follows.

Types of hyperthyroidism of the thyroid gland

We may be dealing with several pathological conditions that lead to an overactive thyroid gland.

It is important to distinguish between primary and secondary forms of hyperthyroidism:

• Primary hyperthyroidism: This form is associated exclusively with pathologies of the thyroid gland, which lead to an increase in the production of T3 and T4.
• Secondary hyperthyroidism: this form is associated with pathologies at the level of the pituitary gland, which secretes TSH, and thereby regulates the functioning of the thyroid gland.

There is also state of subclinical hyperthyroidism, in which symptoms are minor or completely absent. In this case, you may not need any treatment as it may be a temporary situation and will go away on its own. But, sometimes it can develop into hyperthyroidism. Therefore, monitoring and control by a doctor is very important.

However, when we talk about overt hyperthyroidism, we are talking about a condition in which there are obvious hormonal changes (low TSH and high thyroid hormone levels), in which case treatment must be started.

Causes of an overactive thyroid gland

There are several reasons for increased thyroid activity:

• Graves' disease: is the most common cause of hyperthyroidism. This is an autoimmune pathology, that is, the body produces antibodies that attack the thyroid gland, which leads to the activation of the synthesis and secretion of hormones. In addition, there is an increase in the volume of the gland with the formation of a goiter. It can be hereditary, but is more common in women. A typical manifestation of Graves' disease is very large and bulging eyes.
• Toxic nodular goiter: characterized by the presence of one or more nodules operating within the thyroid gland that interfere with the synthesis of hormones and cause overproduction.
• Plummer's disease: a benign tumor of the thyroid gland is characterized by cellular proliferation in the area of ​​the thyroid gland with the formation of connective tissue capsules, which in some cases is accompanied by hormonal hyperfunctionality (about 2-3%).
• Hashimoto's thyroiditis: This autoimmune pathology is very common in areas with high iodine intake. It begins with hyperfunction of the thyroid gland, and then, over time, hypofunction develops.
• Querven's thyroiditis: Also known as subacute thyroiditis. This is a subacute inflammation of the thyroid gland caused by a viral infection and is characterized by hyperfunction of the gland.
• Thyroiditis after childbirth: inflammation of the thyroid gland of an autoimmune nature, which manifests itself in the period after pregnancy and, as a rule, is temporary.

Hyperthyroidism can also occur when using iodine supplements or medications.

• Hyperthyroidism from iodine: Typically, iodine, which we obtain through food, is used to produce thyroid hormones. Therefore, excess consumption may cause an increase in hormone synthesis and thus a state of hyperthyroidism occurs.
• Drug-induced hyperthyroidism: Also called “iatrogenic hypothyroidism.” It is caused by medical procedures. Among them is amiodarone therapy, this medicine is used to treat cardiac arrhythmias.

What are the symptoms of hyperthyroidism

The clinical picture of increased activity of the thyroid gland is very diverse, and the symptoms and signs are characteristic of many other diseases, which significantly complicates the correct diagnosis.

As thyroid hormones increase your body's metabolism, the following symptoms may appear:

• Weight loss, despite the fact that you continue to eat in the same volume: the metabolism and activity of the body accelerate, so more carbohydrates, lipids and proteins are consumed.
• Nervousness, irritability and insomnia: All are associated with an increase in metabolic rate, which puts the patient in a state of hyperactivity.
• Tachycardia: Excessive production of T3 and T4 hormones leads to an increase in heart rate, so that arrhythmia and palpitations may occur.
• Loss of muscle strength and muscle fatigue: Thyroid hormones increase protein synthesis. But when hormones are produced in excess, it leads to a condition known as “muscle catabolism,” which is a decrease in muscle mass because proteins will be used for energy.
• Goiter and protruding eyes: characteristic symptoms of Graves' disease.
• High body temperature and sweating: Thyroid hormones regulate thermogenesis, which is the production of heat. Its excessive production will lead to increased sweating.
• Feeling short of breath: This condition occurs when the volume of the thyroid gland is increased.
• Infertility: Women experience disruption or disappearance of the menstrual cycle.
• Blood sugar values: Thyroid hormones regulate blood glucose levels by increasing the rate of carbohydrate absorption in the intestinal tract. Thus, after eating a meal rich in carbohydrates, blood glucose levels increase significantly and then quickly decrease.

How is hyperthyroidism diagnosed?

This entire set of symptoms that we have listed is certainly an indicator to begin to suspect changes in the thyroid gland.

In fact, diagnosing hyperthyroidism is not particularly difficult. First of all, the doctor will conduct palpation of the gland to assess its size, and then perform blood tests to directly assess the concentration of hormones (T3, T4 and TSH).

After detecting increased activity of the thyroid gland, optimization and differentiation of diagnosis through:

• Study for the presence of specific thyroid antibodies to determine the autoimmune causes of the disease.
• Ultrasound of the gland Doppler method to determine its volume and the presence of active nodules.
• Scanning after taking radioactive iodine. In this way, it is possible to evaluate the ability of the gland to use iodine and, therefore, evaluate its ability to produce hormones.

Traditional and folk methods of treatment

Treatment of hyperthyroidism aims to normalize the values ​​of the hormones T3 and T4.

There are currently three treatment options:

Drug treatment: uses two categories of drugs - thyreostatics and beta blockers. The former directly block hormone synthesis. The latter counteract the effect thyroid hormones have on the body and therefore eliminate the clinical manifestations described above.

Treatment with radioactive iodine: In this case, radioactive radiation destroys the thyroid cells. Iodine in particular radioactive iodine 131, is administered to the patient in the form of a tablet, it partially passes into the cells of the thyroid gland, and the excess is eliminated through urine. Sometimes after such treatment the opposite problem arises: hypothyroidism, but it is not such a serious problem, since the hormone deficiency can be replenished by taking pills daily. This therapy is not suitable for pregnant women or nursing women, since the radiation will affect the fetus or child.

Surgery: a surgical procedure called thyroidectomy, consists of complete or partial removal of the thyroid gland. This treatment is used mainly in cases where the volume of the gland becomes too large. After removal of the thyroid gland, it is necessary to provide drug therapy and administer the thyroid hormones that the thyroid gland produced.

Foods for hyperthyroidism

Those who suffer from hyperthyroidism must be very careful, especially in terms of lifestyle and diet. The first goal is to restore proper body weight by normalizing the calorie intake in the diet.

It is necessary to ensure optimal intake of vitamins, minerals and fiber. Alcohol and smoking are absolutely prohibited.

Authorized Products:

Cruciferous vegetables (broccoli, arugula, cabbage and cauliflower). They contain a substance that causes a reduction in the production of thyroxine.

Foods that contain little iodine:

• legumes;
• freshwater fish;
• peaches, grapes, melon, oranges;
• green beans, lettuce, tomatoes, turnips.

Prohibited foods:

First of all, you should avoid stimulants such as caffeine, theine, nicotine and alcohol. You should also exclude:

• smoked cheeses;
• molluscs and crustaceans;
• fat meat;
• sauces;
• foods rich in salt (eg, crackers, chips, peanuts), and salt intake should be limited.

Drinking plenty of water is important to keep your body properly hydrated.

Consequences of an overactive thyroid gland

The most common consequences include disorders of the cardiovascular system. Tachycardia is very characteristic of hyperthyroidism.

Not to be underestimated acceleration of metabolism, which will lead to continuous weight loss, that is, excessive pathological thinness, menstrual irregularities, increased heartbeat, heart rhythm disturbances.

Thus, hypothyroidism should not be underestimated; at the first signs, you should consult a doctor who can advise the most productive and correct path of treatment.

Treatment of hyperthyroidism with folk remedies very effective, since restoration of hormone levels occurs with minimal side effects. With the use of medicinal herbs, the symptomatic manifestations of the disease become less aggressive, the problems recede.

Local therapeutic procedures with medicinal plants help well with thyrotoxicosis, since the active substances in plants are absorbed through the skin, almost directly entering the blood vessels that supply the thyroid gland.

In addition, an extraordinary role is given to reflex effects through skin receptors. Often, a specific active component of the plant used affects the receptors.

A disease called hyperthyroidism is characterized by a persistent increase in the level of thyroid hormones. The speed of metabolic processes in the body increases. In men, pathology is less common than in women.

At risk are older people and children with a hereditary predisposition. Secondarily, the disease is called thyrotoxicosis.

Symptoms of hyperthyroidism

The list of clinical manifestations is impressive, here are the characteristic ones:

• excessive irritability, short temper
• weight loss despite appetite
• systematic feeling of heat
• increased sweating
• rapid pulse
• trembling hands
• in advanced stages - “bulging eyes”
• sleep disturbance

Since the signs listed above are identical to other pathologies, sometimes, especially in elderly patients, the disease is not detected in time. If you have the slightest suspicion of problems with the thyroid gland, it is recommended to visit an endocrinologist’s office.

It is possible to overcome hyperthyroidism using traditional methods, but such therapy must be agreed upon with an endocrinologist. The best option would be a competent combination of folk and drug treatment.

A balanced diet, plus a properly selected list of products, plays an important role.

Treatment of hyperthyroidism with herbs

Thyroid, is capable of “adjusting” to the increased loads that arise when its functions are impaired. The structure changes, the number of working cells increases.

Such a compensatory reaction of the gland is the basis for the formation of nodes. Moreover, the formation of nodes is equally possible with an increase and decrease in the function of the gland. Iron compensates for its own reduced activity by increasing the number of functioning cells.

However, due to a number of causative factors, cell modification occurs and nodes are formed. When the function of the gland is normal (neither decreased nor increased), then structural changes in the gland are still possible under the influence of pathological processes.

The topic of neoplasms in the thyroid gland requires a separate article.

In the future, it is planned to publish similar material on the site, but for now, let’s get down to the recipes.

1. Cabbage leaf is a popular “natural material” that can soften and dissolve seals of various types. The composition contains substances that block the formation of thyroid hormones. Twice a week, do a compression treatment using crushed cabbage leaves.

2. An alternative to the procedure described above would be a compress of crushed fresh plantain leaf with grated carrots. Plantain has medicinal properties similar to cabbage leaves: it relieves inflammation and resolves compactions. Carrot pulp is a good helper, because carotene is a strong antioxidant.

3. Now, let’s talk in more detail about three medicinal plants widely used in herbal medicine for hyperthyroidism:

• Zyuznik
• white cinquefoil
• sparrow

Let's start with zyuznik, the indications for use of which are:

• increased thyroid function
• female pathologies
• breast tumors

The plant relieves excitement in nervous disorders and calms the nerves. European sage, reduces hypoxia in thyrotoxicosis, the weight of the thyroid gland in hyperplasia, stabilizes blood counts.

In our country, this plant has not yet received official recognition. Although in other countries, for example in Germany, it has long been used by official medicine.

Decoctions and infusions, alcohol tinctures, and medicinal teas are prepared from zyuznik.

1. For a quarter liter of water, take 1 tsp. Boil the herbs for five minutes, strain thoroughly. A single serving is 50 ml, three times a day.

2. Boiling water (200 ml.), Brew 30 g. zyuznik, let stand for half an hour, filter. You need to consume 100 ml three times.

3. Brew (1/4 liter) a teaspoon of pre-dried herb. After standing for a quarter of an hour, filter. It is recommended to take in small sips, warm. Two cups a day for two weeks.

4. Cut off the tops of the plant, pour alcohol in a ratio of 1:10. Provide the opportunity to brew for fourteen days, in a place where sunlight is not available. After filtering, take drops with water. Start with 10 drops, and then, every week, add five drops to a single dose. Having brought the one-time dose to forty drops, move back, gradually reducing the portion of the tincture.

White cinquefoil is a universal helper for problems with the thyroid gland. A good regulator that stabilizes the activity of the gland. Moreover, this applies to increasing or decreasing function. This is something that artificial drugs cannot do. Indications for use of cinquefoil:

• thyroid adenoma

Extracts prepared from the herb and roots of this plant have a minimal level of toxicity. In addition to the positive effect on the thyroid gland, the above-ground part of the plant stimulates the nervous system and can create antibacterial protection.

However, the key medicinal purpose of cinquefoil is to combat thyroid pathologies. First of all, this applies to thyrotoxicosis. The substances included in the composition affect the “production” of the anterior lobe of the pituitary gland thyroid-stimulating hormone. The morphological structure of the gland returns to normal.

To prepare the tincture, you will first need to thoroughly grind the roots of the plant. Pour the resulting mass with alcohol, ratio 1:10. The guideline is 50 grams of root per 0.5 liter. alcohol Keep the contents in a dark place for a month. The servings are as follows: 20 drops per 2 tbsp. l. boiled water. Take it a third of an hour before meals. The duration of such therapeutic therapy is a month, after which a ten-day break is necessary. Then, the procedure must be repeated. In advanced forms of hyperthyroidism, the concentration of the tincture can be increased.

Sparrow - directly affects the process of hormone synthesis. The composition contains lithospermic acid, which makes the thyroid-stimulating hormone of the pituitary gland inactive. This hormone is a catalyzing mechanism for the “production” of active thyroid hormones. As a result, thyroid function changes.

On its own, lithospermic acid functions rather weakly. However, during an oxidative reaction, due to the enzymes present in the composition of the European grasshopper, the activity of the acid increases.

Properly combining the above mentioned in one recipe, they achieve an effective result.

For collection we will need the following components:

• zyuznik (5 parts)
• cocklebur, sweet clover, hawthorn blossom, sparrow leaves (1 part)

After thoroughly mixing the components, the resulting mixture (1 tbsp) is poured with a glass of water. Heat for a third of an hour over low heat, leave for half an hour, filter. Then the original volume is replenished with boiled water. Take 30 minutes before. before meals, 70 ml. The course is two months.

Here is a recipe for another collection, where the key ingredients are zyuznik and sparrow.

• We take cinquefoil, arnica flower, caper fruits in three parts.
• Catnip, mulberry leaf (2 hours).
• Zyuznik, lemon balm, motherwort, 1 part at a time.

Pour boiling water (500 ml) over the resulting mixture (2 tbsp) and leave in a thermos for ten hours. After straining, take 100 ml. before eating. The course is two months, then a similar break, and then a repeat course is required.

In conclusion, a collection that can be used regardless of the severity of hyperthyroidism. However, I will clarify that the stronger the degree of pathology, the less it is necessary to take a dose of medicinal plants.

As a maximum, a single dose should not exceed 1/4 tsp. mixtures per 200 ml. water. The collection is multi-component, but the main ingredients are: arnica, cinquefoil, mistletoe.

The components of the collection are taken in grams:

• white mistletoe - 30
• flowers of arnica, elderberry, calendula, St. John's wort, wild rosemary, celandine - 20
• Potentilla root - 60
• motherwort, rose hips, peony root - 50
• thyme, hawthorn color - 40

Grind the ingredients and mix. The resulting mixture is 1/2 tsp. Brew with boiling water (500 ml.). After allowing it to brew for half an hour, filter it. Take 100 ml, 20 minutes before meals.

Considering that the composition contains poisonous plants, select the dosage individually, be sure to consult with your doctor.

The collection has a complex effect on the body, since the herbs present in the composition have different medicinal characteristics.

• antihormonal - white cinquefoil
• antitumor - wild rosemary, celandine
• normalizing gastrointestinal tract - St. John's wort, calendula
• arnica, hawthorn, motherwort, peony - stabilize the performance of the heart muscle and nervous system
• rosehip - antioxidant

It is possible to protect the thyroid gland using folk remedies for treating hyperthyroidism, but the treatment process is lengthy and requires consultation with an endocrinologist.

Take an interest in your health in time, goodbye.