Hyperthyroidism

The symptoms of hyperthyroidism can vary depending on the severity of the disease and the individuals affected. Some of the most common symptoms include:

• Unexplained weight loss despite normal or increased appetite.
• Heart palpitations: an accelerated heart rate (tachycardia), sometimes irregular, is a major symptom. It can lead to rhythm disorders such as atrial fibrillation. 
• Nervousness and irritability
• Excessive sweating and heat intolerance.
• Changes in bowel habits, including frequent bowel movements or diarrhea
• Muscle fatigue and generalized weakness.
• Goiter, or swelling of the neck due to an enlarged thyroid gland.

In some cases, symptoms may be more subtle, especially in the elderly, where they may manifest as fatigue or depression.

Hyperthyroidism can be caused by several medical conditions affecting the thyroid gland. The most common are :

• Graves' disease: An autoimmune disease in which the immune system stimulates the thyroid gland to produce too many hormones. It is the most common cause of hyperthyroidism. It mainly affects young women, and there is a genetic predisposition.
• Toxic thyroid nodules: These are benign tumors in the thyroid gland that can overgrow and produce too much thyroid hormone.
• Thyroiditis: This inflammation of the thyroid gland can occur after a viral infection, pregnancy (postpartum thyroiditis) or in response to certain medications. Thyroiditis temporarily releases large quantities of hormones into the bloodstream, leading to transient hyperthyroidism, which in some cases can progress to hypothyroidism.
• Iatrogenic (drugs: amiodarone, radioactive iodine or iodinated contrast media and thyroid hormone overdose)
• Pituitary tumours (very rare)

Certain factors can increase the risk of developing hyperthyroidism. These include

• Family history of thyroid disease, particularly Graves' disease.
• History of autoimmune diseases such as type 1 diabetes or pernicious anemia.
• Excessive intake of iodine, an essential element in thyroid hormone production.
• Gender and age: women are much more likely than men to develop this condition, especially between the ages of 20 and 40, and women who have recently given birth are at greater risk of developing postpartum thyroiditis.

Diagnosis of hyperthyroidism often begins with a clinical examination based on the symptoms reported. Several examinations may then be carried out to confirm the pathology:

• Physical examination: The doctor palpates the thyroid to detect enlargement or nodules, and checks for signs such as tremors or eye abnormalities associated with Graves' disease.
• Blood tests: These measure levels of thyroid hormones (T3 and T4) and thyroid stimulating hormone (TSH). A high T3/T4 level combined with a low TSH level is characteristic of hyperthyroidism.
• Medical imaging: Tests such as thyroid scintigraphy or ultrasound can help assess the underlying cause of hyperthyroidism.

There are several treatment options, and the choice often depends on the underlying cause of the hyperthyroidism, as well as the patient's general condition and age. The main options include:

• Antithyroid drugs: These drugs block the production of thyroid hormones. They are effective for mild to moderate forms of the disease.
• Radioactive iodine therapy: This method aims to destroy part of the thyroid gland, thereby reducing hormone production.
• Surgery: In some cases, partial or total removal of the thyroid gland is necessary. This is particularly the case when other treatments fail, or when the patient is unable to take antithyroid medication. It is also used in cases of bulky, compressive goiter.
• Beta-blockers: Although they don't directly reduce thyroid hormone levels, these drugs help control symptoms such as palpitations.

If left untreated, hyperthyroidism can lead to serious complications, including:

• Heart problems: Untreated hyperthyroidism can cause atrial fibrillation, increasing the risk of stroke.
• Osteoporosis: Excess thyroid hormone makes calcium absorption more difficult, leading to brittle bones.
• Thyroid crisis: This rare but potentially fatal complication is characterized by a severe acceleration of symptoms and requires urgent treatment.

Although it is difficult to prevent all causes of hyperthyroidism, certain measures can reduce the risk, including :

• Controlling iodine intake: It is recommended that excessive consumption of iodine-rich foods, particularly seafood and iodized salt, be limited in those at risk.
• Regular medical monitoring: Individuals with a family history or pre-existing thyroid disorders should have regular thyroid check-ups.
• Post-partum follow-up: Close medical follow-up is recommended for women who have recently given birth, due to the risk of post-partum thyroiditis, a form of temporary hyperthyroidism that can occur a few months after childbirth.

It is essential to consult a physician if you experience symptoms such as :

• Unexplained weight loss.
• Frequent heart palpitations.
• Neck swelling or changes in bowel habits.

If hyperthyroidism is diagnosed, regular medical follow-up is necessary to adjust treatment and monitor possible complications.

Hôpital de La Tour offers a comprehensive, personalized approach to thyroid disorders, particularly hyperthyroidism. In the vast majority of cases, the diagnosis is made by the attending physician, on the basis of a clinical examination and biological tests. If necessary, the GP can refer the patient to an endocrinologist or other specialist for further investigations or specific follow-up.

For patients already treated at Hôpital de La Tour, or who do not have their own GP, the Centre de médecine générale de l'Hôpital de La Tour offers access to a team of general internists. This center facilitates the coordination of care within the hospital, in close collaboration with other specialists, in a spirit of continuity and responsiveness.

What is hyperthyroidism?
Hyperthyroidism is a condition in which the thyroid gland produces too many hormones, speeding up metabolism.

What are the main symptoms of hyperthyroidism?
Symptoms include weight loss, heart palpitations, anxiety and sleep disturbances.

What causes hyperthyroidism?
Causes include Graves' disease, toxic thyroid nodules and thyroiditis.

How is hyperthyroidism diagnosed?
Diagnosis is based on a physical examination, blood tests and imaging tests.

What treatments are available for hyperthyroidism?
Treatment options include antithyroid drugs, radioactive iodine therapy, surgery and beta-blockers to control symptoms.

Can hyperthyroidism be cured permanently?
Yes, treatments such as radioactive iodine or surgery can be curative. However, they often lead to hypothyroidism, which is generally easier to control than hyperthyroidism, thanks to lifelong hormone replacement therapy.