Online consultations with MCSC doctors n. a. A. S. Loginov

Thyrotoxicosis

Thyrotoxicosis is a condition associated with an excess of thyroid hormones in the body. This condition is also called hyperthyroidism. This is not a diagnosis, but a consequence of certain diseases of the thyroid gland or the influence of external factors.

  • Causes of thyrotoxicosis:

1. Diseases accompanied by excessive production of thyroid hormones.

A) Diffuse toxic goiter (Graves ' disease, Bazedov's disease). This disease is the cause of thyrotoxicosis in 80-85% of cases.

Due to any reason, there is a failure in the immune system. Such diseases, when the cells of the immune system begin to produce substances that attack their own organs, are called autoimmune. Graves ' disease is an autoimmune disease.

B) Toxic adenoma and multi-node toxic goiter.

Presence of a node (s)) the thyroid gland, which produces thyroid hormones in excess.  This disease is more common in the elderly.

C) Thyrotropinoma is the formation of the pituitary gland, which in excess synthesizes thyroid-stimulating hormone (TSH), which stimulates the thyroid gland. A very rare disease. It proceeds with clinical signs of thyrotoxicosis.

2. Diseases associated with the destruction (destruction) of thyroid tissue and the release of thyroid hormones into the blood.

These diseases include destructive thyroiditis (subacute thyroiditis, thyrotoxicosis in autoimmune thyroiditis, postpartum thyroiditis, pain-free thyroiditis).

This group of diseases can also include cordarone-induced (amiodarone-induced) thyrotoxicosis. This is thyrotoxicosis, which occurs as a result of treatment with iodine-containing antiarrhythmic drugs (Amiodarone, Cordarone). Taking drugs causes the destruction (destruction) of thyroid cells and the release of hormones into the blood.

3. Iatrogenic thyrotoxicosis – thyrotoxicosis caused by an overdose of thyroid hormone preparations (L-thyroxine, Eutirox-drugs for the treatment of hypothyroidism – a condition associated with a decrease in the production of thyroid hormones).

 

  • Symptoms of thyrotoxicosis:

 

In addition to the increase in the size of the thyroid gland, the main symptoms of thyrotoxicosis include:

 

  1. high blood pressure;

  2. circulatory insufficiency, often manifested in the form of cardiac arrhythmias;

  3. increased excitability and rapid fatigue;

  4. tearfulness;

  5. sleep disorder;

  6. attention and memory disorders;

  7. tremor (tremor) of the body and especially of the fingers;

  8. increased sweating;

  9. increased tendon reflexes;

  10. weight loss with a good or even increased appetite. The weight is reduced due to increased heat transfer, which requires a large amount of energy. Some patients, on the contrary, gain weight due to an appetite that does not correspond to the metabolic rate;

  11. increased body temperature;

  12. muscle weakness;

  13. delamination and brittle nails;

  14. brittle and hair loss;

  15. unstable and frequent stools;

  16. impaired liver function up to hepatitis;

  17. development of adrenal insufficiency;

  18. violation of the menstrual cycle in women up to amenorrhea;

  19. decreased libido in men;

  20. miscarriage;

  21. defeat of the mammary and breast glands;

  22. violation of carbohydrate tolerance up to the development of diabetes mellitus;

  • Diagnosis of the cause of thyrotoxicosis:

The main direction in the diagnosis of thyrotoxicosis is the diagnosis carried out according to the external signs indicated above. In addition, it is necessary to conduct:

  1. Hormonal blood test;

  2. Determination of antibodies-confirmation of the autoimmune nature of the disease.

  3. Ultrasound of the thyroid gland.

In some cases, the doctor may prescribe a study – scintigraphy of the thyroid gland. This study shows the extent to which the thyroid gland can capture iodine and other substances (technetium). This study allows us to clarify the cause of thyrotoxicosis. Graves ' disease is characterized by increased intensive capture of radiopharmaceuticals. Thyrotoxicosis due to destruction (destruction) of thyroid tissue is characterized by a decrease in the capture or absence of capture of iodine (technetium).

In the presence of endocrine ophthalmopathy, exophthalmos, an ultrasound of the eye socket or magnetic resonance or computed tomography of the eye socket area is performed.

  • Treatment of thyrotoxicosis:

In the treatment of this disease, there are three main ways: traditional (conservative), surgical, and therapy with radioactive iodine.

Under the surgical method of treating thyrotoxicosis, we understand the removal of part of the thyroid gland to reduce the production of hormones. This method is applicable and effective in the case of nodular formations and/or seals in the organ, which cause the violation. 

Treatment with radioactive iodine involves taking special drugs containing I131.

Conservative treatment consists in reducing the level of thyroid hormone release with the help of pharmaceutical drugs.

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