Hyperthyroidism is a condition where the thyroid gland to work excessively, resulting in large amounts of thyroid hormone.
Hyperthyroidism can be found in the form of Graves' disease, toxic goiter or hyperthyroidism noduler secondary.
Common characteristics of people who have hyperthyroid disease, among others:
- Thin, eat a lot but can not be fat
- Large eyes (wide = exophthalmus)
- Another complaint in the eye (like pain, light sensitivity, vision disorders and conjunctivitis)
- Enlarged thyroid gland (struma nodosa), or may not
- Rapid heartbeat
- Trembling fingertips.
Graves' disease
Graves' disease (goiter difusa toksika) believed to be caused by an antibody that stimulates the thyroid to produce excessive hormones torid. Graves' disease patients have typical symptoms of hyperthyroidism and 3 special additional symptoms:
* The entire gland is stimulated, so that the gland is enlarged, causing a lump in the neck (goiter, goiter)
* Eksoftalmus (protruding eyes).
This occurs as a result of the accumulation of substances within the orbit of the eye.
* Kering.Otot bone protrusion of the skin over the muscles that move the eye is unable to function properly, making it difficult or impossible to move the eyes as normal or difficult to coordinate eye movements, resulting in the view ganda.Kelopak eye can not close completely, so that the eyes are exposed to by foreign objects and experiencing kekeringan.Perubahan eye can occur many years before other symptoms arise (an early sign of Graves' disease) or can also appear after other symptoms arise.
· Eye symptoms can even occur or get worse after the release of excessive thyroid hormone is successfully treated and controlled.
* Eye symptoms can be reduced by:
- Placing the head at a higher position in bed
- Provides eye drops
- Sleeping with the eyelids closed, with the help of plaster
- Taking diuretics (sometimes).
Double vision can be corrected by wearing prism glasses.
If the above measures do not help, may need to be given a corticosteroid drug, X-ray therapy or eye surgery.
Substance is buried in the back of the eye also can accumulate in the skin, usually on the shins. Regional thickening in can feel itchy and red and feels hard when pressed with your fingers.
Thickening of the skin can also occur before or after other symptoms of hyperthyroidism occur.
To reduce itching and skin hardness, can be given corticosteroid cream or ointment. This disorder often disappears by itself a few months or years later.
Goiter noduler toksika
In noduler toksika goiter, one or several nodules in the thyroid produces too much thyroid hormone and are beyond the control of TSH (thyroid-stimulating hormone.
These nodules is really a benign thyroid tumor and not related to the protrusion of the eyes and skin disorders in Graves' disease.
Secondary hyperthyroidism
Hyperthyroidism can be caused by a pituitary tumor that produces too much TSH, which stimulates the thyroid to produce excessive thyroid hormone.
Other causes are pituitary resistance to thyroid hormone, so the pituitary gland produces too much TSH.
Women with hydatidiform mole (pregnant wine) bus also suffered from hyperthyroidism because of excessive stimulation of the gland due tirois levels of HCG (human chorionic gonadotropin) is high in the blood.
If the pregnancy is terminated and HCG wine no longer found in the blood, the hyperthyroidism will disappear.
The cause of hyperthyroidism are: immunological reactions · thyroiditis · toxic thyroid adenoma
v In hyperthyroidism, whatever the cause, an increase in body functions:
- The heart beats faster and heart rhythm abnormalities may occur, which can cause palpitations (heart palpitations)
- Blood pressure tends to increase
- Patients feel warm even in a cool room
- The skin becomes moist and tend to spend excessive perspiration
- Hand showed tremors (shaking) fine
- People feel nervous, tired and weak even though not doing heavy activity
- Increases appetite, but weight loss
- Difficulty sleeping
- Frequent bowel movements, sometimes accompanied by diarrhea
- There is a change in the eye: swelling around the eyes, increased tear formation, irritation and sensitive to light. These symptoms will soon disappear after the release of thyroid hormones under control, except in Graves' disease causes specific eye disorders.
COMPLICATIONS
Thyroid storm is a very excessive activity of the thyroid gland, which occurred suddenly.
v thyroid storm usually occurs because of hypothyroidism is not treated or because of inadequate treatment, and can be triggered by:
- Infection
- Trauma
- Surgery
- Uncontrolled diabetes
- Fear
- Pregnancy or childbirth
- Do not continue treatment of thyroid
- Other stress.
Thyroid storm is rare in children.
v thyroid storm can cause:
- Fever
- Muscle weakness and exceptional pengkisutan
- Anxiety
- Mood swings
- Confusion
- Change of consciousness (even happen commas)
- Liver enlargement accompanied by mild jaundice.
Thyroid storm is an emergency situation that is very dangerous and requires immediate action.
Heavy pressure on the heart can cause heart rhythm irregularities that can be fatal (arrhythmias) and shock.
DIAGNOSIS
Vital signs (temperature, pulse, respiratory rate, blood pressure) show increased heart rate. Systolic blood pressure may increase.
Physical examination may reveal thyroid enlargement or goiter.
To assess thyroid function examination:
- TSH serum (usually decreased)
- T3, T4 (usually increasing).
TREATMENT
Hyperthyroidism can usually be treated with drugs, other options are surgery to remove the thyroid gland or radioactive iodine.
Each treatment has advantages and disadvantages.
In order to work properly, the thyroid gland requires a small amount of iodine; excessive amount of iodine can reduce the amount of hormone that is made and prevents the release of thyroid hormones.
Therefore, to stop the release of thyroid hormone excess, can be given high doses of iodine.
Provision of iodine especially useful if hyperthyroidism must be controlled (eg in case of thyroid storm or prior surgery).
Iodine is used in the treatment of routine or long-term treatment.
Propylthiouracyl or metimazol, is the drug most often used to treat hyperthyroidism. These drugs slow down thyroid function by reducing the formation of thyroid hormone by the gland.
Both drugs were given by mouth (swallowed), starting with high doses, then disesuaika with the results of blood tests of thyroid hormone.
These drugs can usually control the thyroid function within 6 weeks to 3 months. Higher doses can accelerate fungis control thyroid, but the risk of side effects also increases.
Side effects that occur can be an allergic reaction (skin rash), nausea, loss of taste and suppression of red blood cell synthesis in bone marrow. Bone marrow suppression can cause a reduction in the number of white blood cells, so that patients are very susceptible to infection.
In pregnant women, use more secure than propiltriurasil metimazol because fewer drugs to the fetus.
The drugs, beta blockers (eg propranolol) help control some symptoms of hyperthyroidism. These drugs are effective in slowing a rapid heart rate, reduce the shaking and anxiety control.
Beta blockers, especially useful in dealing with thyroid storm and patients who have symptoms that are disturbing or dangerous, which hipertiroidismenya not be controlled by other drugs. But beta blockers do not control the abnormal thyroid function.
Hyperthyroidism can also be treated with radioactive iodine, which destroys the thyroid kelanjar.
Radioactive iodine by mouth gives a very small effect on the body, but gives a great influence on the thyroid gland. Therefore, the dose is adjusted so that only destroys a small amount for the formation of thyroid hormones returned to normal, without too much reducing thyroid function.
Most of the use of radioactive iodine in the end cause hypothyroidism. About 25% of patients experienced hypothyroidism within 1 year after radioactive iodine.
Radioactive iodine is not given to pregnant women because it can pass through the placenta barrier and can damage the fetal thyroid gland.
At thyroidectomy, thyroid glands removed surgically.
Surgery is the treatment of choice for:
- Young people
- People with a very large gondoknya
- Patients who are allergic to drugs or suffer side effects from drugs.
After undergoing surgery, may develop hypothyroidism. The patient was given hormone replacement therapy throughout his life.
Other complications of surgery are vocal cord paralysis and damage to the parathyroid glands (small glands behind the thyroid gland that controls calcium levels in the blood).
Hyperthyroidism can be found in the form of Graves' disease, toxic goiter or hyperthyroidism noduler secondary.
Common characteristics of people who have hyperthyroid disease, among others:
- Thin, eat a lot but can not be fat
- Large eyes (wide = exophthalmus)
- Another complaint in the eye (like pain, light sensitivity, vision disorders and conjunctivitis)
- Enlarged thyroid gland (struma nodosa), or may not
- Rapid heartbeat
- Trembling fingertips.
Graves' disease
Graves' disease (goiter difusa toksika) believed to be caused by an antibody that stimulates the thyroid to produce excessive hormones torid. Graves' disease patients have typical symptoms of hyperthyroidism and 3 special additional symptoms:
* The entire gland is stimulated, so that the gland is enlarged, causing a lump in the neck (goiter, goiter)
* Eksoftalmus (protruding eyes).
This occurs as a result of the accumulation of substances within the orbit of the eye.
* Kering.Otot bone protrusion of the skin over the muscles that move the eye is unable to function properly, making it difficult or impossible to move the eyes as normal or difficult to coordinate eye movements, resulting in the view ganda.Kelopak eye can not close completely, so that the eyes are exposed to by foreign objects and experiencing kekeringan.Perubahan eye can occur many years before other symptoms arise (an early sign of Graves' disease) or can also appear after other symptoms arise.
· Eye symptoms can even occur or get worse after the release of excessive thyroid hormone is successfully treated and controlled.
* Eye symptoms can be reduced by:
- Placing the head at a higher position in bed
- Provides eye drops
- Sleeping with the eyelids closed, with the help of plaster
- Taking diuretics (sometimes).
Double vision can be corrected by wearing prism glasses.
If the above measures do not help, may need to be given a corticosteroid drug, X-ray therapy or eye surgery.
Substance is buried in the back of the eye also can accumulate in the skin, usually on the shins. Regional thickening in can feel itchy and red and feels hard when pressed with your fingers.
Thickening of the skin can also occur before or after other symptoms of hyperthyroidism occur.
To reduce itching and skin hardness, can be given corticosteroid cream or ointment. This disorder often disappears by itself a few months or years later.
Goiter noduler toksika
In noduler toksika goiter, one or several nodules in the thyroid produces too much thyroid hormone and are beyond the control of TSH (thyroid-stimulating hormone.
These nodules is really a benign thyroid tumor and not related to the protrusion of the eyes and skin disorders in Graves' disease.
Secondary hyperthyroidism
Hyperthyroidism can be caused by a pituitary tumor that produces too much TSH, which stimulates the thyroid to produce excessive thyroid hormone.
Other causes are pituitary resistance to thyroid hormone, so the pituitary gland produces too much TSH.
Women with hydatidiform mole (pregnant wine) bus also suffered from hyperthyroidism because of excessive stimulation of the gland due tirois levels of HCG (human chorionic gonadotropin) is high in the blood.
If the pregnancy is terminated and HCG wine no longer found in the blood, the hyperthyroidism will disappear.
The cause of hyperthyroidism are: immunological reactions · thyroiditis · toxic thyroid adenoma
v In hyperthyroidism, whatever the cause, an increase in body functions:
- The heart beats faster and heart rhythm abnormalities may occur, which can cause palpitations (heart palpitations)
- Blood pressure tends to increase
- Patients feel warm even in a cool room
- The skin becomes moist and tend to spend excessive perspiration
- Hand showed tremors (shaking) fine
- People feel nervous, tired and weak even though not doing heavy activity
- Increases appetite, but weight loss
- Difficulty sleeping
- Frequent bowel movements, sometimes accompanied by diarrhea
- There is a change in the eye: swelling around the eyes, increased tear formation, irritation and sensitive to light. These symptoms will soon disappear after the release of thyroid hormones under control, except in Graves' disease causes specific eye disorders.
COMPLICATIONS
Thyroid storm is a very excessive activity of the thyroid gland, which occurred suddenly.
v thyroid storm usually occurs because of hypothyroidism is not treated or because of inadequate treatment, and can be triggered by:
- Infection
- Trauma
- Surgery
- Uncontrolled diabetes
- Fear
- Pregnancy or childbirth
- Do not continue treatment of thyroid
- Other stress.
Thyroid storm is rare in children.
v thyroid storm can cause:
- Fever
- Muscle weakness and exceptional pengkisutan
- Anxiety
- Mood swings
- Confusion
- Change of consciousness (even happen commas)
- Liver enlargement accompanied by mild jaundice.
Thyroid storm is an emergency situation that is very dangerous and requires immediate action.
Heavy pressure on the heart can cause heart rhythm irregularities that can be fatal (arrhythmias) and shock.
DIAGNOSIS
Vital signs (temperature, pulse, respiratory rate, blood pressure) show increased heart rate. Systolic blood pressure may increase.
Physical examination may reveal thyroid enlargement or goiter.
To assess thyroid function examination:
- TSH serum (usually decreased)
- T3, T4 (usually increasing).
TREATMENT
Hyperthyroidism can usually be treated with drugs, other options are surgery to remove the thyroid gland or radioactive iodine.
Each treatment has advantages and disadvantages.
In order to work properly, the thyroid gland requires a small amount of iodine; excessive amount of iodine can reduce the amount of hormone that is made and prevents the release of thyroid hormones.
Therefore, to stop the release of thyroid hormone excess, can be given high doses of iodine.
Provision of iodine especially useful if hyperthyroidism must be controlled (eg in case of thyroid storm or prior surgery).
Iodine is used in the treatment of routine or long-term treatment.
Propylthiouracyl or metimazol, is the drug most often used to treat hyperthyroidism. These drugs slow down thyroid function by reducing the formation of thyroid hormone by the gland.
Both drugs were given by mouth (swallowed), starting with high doses, then disesuaika with the results of blood tests of thyroid hormone.
These drugs can usually control the thyroid function within 6 weeks to 3 months. Higher doses can accelerate fungis control thyroid, but the risk of side effects also increases.
Side effects that occur can be an allergic reaction (skin rash), nausea, loss of taste and suppression of red blood cell synthesis in bone marrow. Bone marrow suppression can cause a reduction in the number of white blood cells, so that patients are very susceptible to infection.
In pregnant women, use more secure than propiltriurasil metimazol because fewer drugs to the fetus.
The drugs, beta blockers (eg propranolol) help control some symptoms of hyperthyroidism. These drugs are effective in slowing a rapid heart rate, reduce the shaking and anxiety control.
Beta blockers, especially useful in dealing with thyroid storm and patients who have symptoms that are disturbing or dangerous, which hipertiroidismenya not be controlled by other drugs. But beta blockers do not control the abnormal thyroid function.
Hyperthyroidism can also be treated with radioactive iodine, which destroys the thyroid kelanjar.
Radioactive iodine by mouth gives a very small effect on the body, but gives a great influence on the thyroid gland. Therefore, the dose is adjusted so that only destroys a small amount for the formation of thyroid hormones returned to normal, without too much reducing thyroid function.
Most of the use of radioactive iodine in the end cause hypothyroidism. About 25% of patients experienced hypothyroidism within 1 year after radioactive iodine.
Radioactive iodine is not given to pregnant women because it can pass through the placenta barrier and can damage the fetal thyroid gland.
At thyroidectomy, thyroid glands removed surgically.
Surgery is the treatment of choice for:
- Young people
- People with a very large gondoknya
- Patients who are allergic to drugs or suffer side effects from drugs.
After undergoing surgery, may develop hypothyroidism. The patient was given hormone replacement therapy throughout his life.
Other complications of surgery are vocal cord paralysis and damage to the parathyroid glands (small glands behind the thyroid gland that controls calcium levels in the blood).
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