Hyperthyroidism

Hyperthyroidism, also referred to as an overactive thyroid, occurs when your thyroid gland produces too much thyroid hormone. The most common cause of hyperthyroidism is Graves' Disease.

Graves Disease

Graves' Disease is the most common cause of hyperthyroidism. The immune system, for reasons that are not clearly understood, releases antibodies that attack or “bind” to thyroid cells. The process stimulates the thyroid gland, causing it to grow and produce high levels of thyroid hormone. As many as 70-80 percent of patients with hyperthyroidism have Graves’ disease and it may run in families.

Graves’ disease is also referred to as diffuse toxic goiter because it affects the entire thyroid gland (diffuse), causes people with the condition to appear flushed (toxic) and the gland becomes enlarged (goiter).

People who have an autoimmune disease, such as Graves’ disease, are at higher risk of developing other autoimmune diseases, such as type 1 diabetes or Addison’s disease.

Graves' Eye Disease

In some patients with Graves' Disease, the eyes appear enlarged because the upper eyelids have receded. This condition can be successfully treated with surgery. In as many as one in five patients, the eyes protrude from the sockets creating “bulging eyes,” a condition called proptosis or exophthalmos.

The condition sometimes resolves when the underlying illness is treated, but occasionally it worsens after treatment. If it persists or worsens, it can be treated with medication (corticosteroids), radiation or surgery. Rarely, patients develop more serious eye problems such as double vision, infection of the cornea or even loss of sight.

Thyroid Nodules

Nodules are lumps or bumps on the thyroid gland. More than 90 percent are benign, meaning that they are not cancerous, and most do not cause any discomfort. They can be quite common, occurring in 1 in 15 women and 1 in 50 men. Thyroid nodules occur more often in the elderly.

Nodules may be filled with excess thyroid tissue (cells) or with liquid (cysts). Sometimes the nodules that contain thyroid cells release excessive amounts of thyroid hormone into the bloodstream, causing Hyperthyroidism. In rare instances, the nodules are cancerous (see Thyroid Cancer).

Signs and symptoms include:

  • Small lump in the neck that can be seen or felt
  • Rarely, pain
  • Most small nodules do not cause any symptoms

Your doctor will run a number of diagnostic tests to determine what treatment is appropriate.

Thyrotoxicosis

Thyrotoxicosis means an excess of thyroid hormone in the body. Having this condition also means that you have a low level of thyroid stimulating hormone, TSH, in your bloodstream, because the pituitary gland senses that you have “enough” thyroid hormone.

Treatment

Graves' Eye Disease (Ophthalmopathy)
In some patients with Graves' Disease, the most common cause of hyperthyroidism, the eyes appear enlarged because the upper eyelids have receded. This condition can be successfully treated with surgery. In as many as one in five patients, the eyes protrude from the sockets creating bulging eyes, a condition called proptosis or exophthalmos. The condition sometimes resolves when the underlying illness is treated, but occasionally it worsens after treatment. If it persists or worsens, it can be treated with medication (corticosteroids), radiation or surgery. Rarely, patients develop more serious eye problems such as double vision, infection of the cornea or even loss of sight.

Subclinical hyperthyroidism
There is controversy in the medical field about whether or not to treat mild hyperthyroidism or to carefully monitor the condition by means of an annual blood test. At Virginia Mason, your doctor may or may not choose to treat your condition, but will check your levels of thyroid hormone (T4) and thyroid stimulating hormone (TSH) periodically with a blood test. This is done to ensure that your condition is not worsening.