Thyroid gland is a small butterfly shaped gland located at the front door, which produces hormones important in many processes taking place in the body. These hormones have important effects on growth, production of heat in the body, fertility, use of energy. The two most important hormones are thyroxine (T4) and L-trijodtiroksin (T3). Iodine is an important element for the construction of the thyroid hormone. The whole process of installation of iodine and thyroid hormone production is controlled from the anterior pituitary gland that secretes thyrotropin, or TSH. Thyrotropin secretion is regulated by the parts of the brain – the hypothalamus, which secretes so. thyrotropin releasing factor (TRH). As seen, the release of thyroid hormone is very complicated process involving many factors.
What is hyperthyroidism?
Metabolic disorder is the result of excessive secretion of thyroid hormones or excessive activity of the thyroid gland. It is predominantly a disease of adult women, with the highest frequency between 30 and 50 years. Clinical condition known as hyperthyroidism and thyrotoxicosis are. It occurs as part of a syndrome that may include throat and protrusion of eyeballs, and is known as Graves’ disease or illness Basedowljeva. Do hyperthyroidism or thyrotoxicosis is due to excess thyroid hormone in the body. More than a specific disease, it is classified as a syndrome that describes the characteristics that result from this condition.
Causes, incidence, and risk factors
The cause of hyperthyroidism is unknown. There is much evidence suggesting a strong hereditary factor in the development of Graves’ disease. It is believed that this is an autoimmune disease. Tumors of the thyroid, pituitary, testicles or ovaries, inflammation of the thyroid due to viral infections or other infections, intake of excessive amounts of thyroid hormones and too much intake of iodine, are also causes of hyperthyroidism.Graves’ disease comprises 85% of all cases of hyperthyroidism. Risk factors associated with the causes.
Symptoms
The main symptoms are: weight loss, increased appetite, nervousness, restlessness, heat intolerance, increased sweating, fatigue, muscle cramps, frequent stools, menstrual irregularities in women, and may be present and throat.
Manifestations of hyperthyroidism can vary from mild symptoms of weakness, insomnia, weight loss and trembling to the very pronounced tachycardia (rapid heartbeat), palpitations, shortness of breath with effort and swelling ankles. Patients with Graves’ disease also have increased thyroid gland (goiter) and abnormal eyes protrusion (exophthalmos). The metabolism of patients with hyperthyroidism was greatly accelerated, leading to acceleration of all bodily processes and emotional stress as a response to increased physical activity. The patient often has episodes of extreme emotions and episodes of crying and depression, followed by intense physical activity and mental euphoria and hysteria.
Tests and examinations that can be done?
Vital signs (temperature, pulse, breathing rate, blood pressure) show increased heart rate. Physical examination revealed an increase of the thyroid gland or goiter.
Laboratory tests that evaluate thyroid function:
TSH in serum was reduced;
T3, T4 in serum are usually elevated.
This disease may also alter the results of the following tests:
vitamin B-12;
field of view;
triglycerides;
acceptance of radioactive iodine;
blood glucose;
cholesterol testing.
Treatment
Treatment will vary depending on the cause of the condition and the severity of symptoms. Hyperthyroidism is treated with antithyroid drugs, radioactive iodine or surgery. General supportive measures the patient suffering from hyperthyroidism include physical and emotional rest and high calorie, nutritious diet with added vitamins and calcium. It can be prescribed a sedative in order to encourage rest. Adrenergic blockers are prescribed to control symptoms of tremor, restlessness, and tachycardia. Selection of additional medications and surgical interventions will depend on the patient’s age, size and suppress the selected patient’s response to therapy.Radioactive iodine is the drug of choice for those middle-aged women who are not pregnant. Its main drawback is the possibility of developing hypothyroidism as a result of “predjelotvornog” treatment. This can occur immediately after initiation of treatment or long after treatment is completed. The dose depends on the size of the gland and its sensitivity to radiation. Radioactive iodine can be administered orally, usually in small doses, and patients can return home. Patients receiving higher doses are placed in isolation for eight days, as the half-life of 131I. Radioactive iodine is excreted by the kidneys and circulates in the blood because the necessary precautions when handling needles and syringes used in patients, night jars and bottles to collect urine samples. All patients receiving 131I must be observed for signs of “thyroid crisis.” Thyroid crisis is a result of radiation induced thyroiditis. Patients who receive low doses of radioactive iodine can be taken two and sometimes three doses. It should be borne in mind that the goal of treatment with radioactive iodine and antithyroid drugs reduce the activity of the thyroid gland to normal levels. It can not be achieved easily, so patients should be frequently viewed in terms of signs of inefficient treatment and lasting, both in terms predjelotvornog treatment that can cause symptoms of hypothyroidism.
Antithyroid drugs
Antithyroid drugs, especially propylthiouracil, are prescribed as initial treatment for children, young adults and pregnant women. Prime candidates for this treatment are patients with small Gusam, recent outbreaks of the mild symptoms. Preparations of iodine, such as propylthiouracil and saturated solution of potassium iodide are only temporary effects. They require that the patient takes the medication prescribed time and strictly according to the program. Propylthiouracil cause agranulocytosis, which can be developed fairly quickly. Therefore, patients receiving this drug given instructions to report to your doctor whenever you have a sore throat, fever or rash, to be made and results (leukocytes), assess the patient’s condition. Preparations of iodine are often given routinely in the 10 to 14 days before surgery to reduce the blood supply of the thyroid gland. Antithyroid drugs are used in the treatment of thyroid crisis.
Surgical treatment of
Thyroidectomy is the surgical removal of the thyroid gland and the treatment of choice for children who do not respond to antithyroid medications or have side effects in adults who can not or will not be subjected to long-term drug therapy in patients with highly increased thyroid or when there is likely to develop cancer.
Forecast
Hyperthyroidism caused by Graves’ disease is usually progressive and associated with complications.
Complications
Cardiac complications include rapid heartbeat, heart failure and atrial fibrillation (a heart rhythm disorder).Thyroid crisis or “storm” is an acute worsening of symptoms of hyperthyroidism or gain that may occur due to infection or stress. There may be fever, decreased mental ability, and abdominal pain and an urgent need to place patients in the hospital.
Prevention
Patients with hyperthyroidism are subject to numerous complex and long-term physical disabilities and mental health. Among the diagnoses that often occur in these patients the discomfort and irritation associated with increased metabolism, anxiety and psychological stress associated with frequent diagnostic tests and their results and long-term treatment; imbalanced nutrition: less than body requirements, which are associated with increased metabolism, changes feelings of comfort associated with heat intolerance, the potential injury associated with thyroid crisis, and impaired perception of their own people associated with the uncontrolled emotional outbursts, weight loss and chronic nature of the disease. Patients require increased supervision and support of the whole family and associates in the vicinity.
