A hyperthyroidism is a thyroid hyperthyroidism. The thyroid gland produces too much of the hormones thyroxine and Triiodthyronin. The opposite, will be described as a lack of thyroid hormones, hypothyroidism. A special form of hyperthyroidism is one thyrotoxicosis, literally translated; this is a poisoning of the body with thyroid hormone, ie a severe hyperthyroidism.

Severities

The case of hypothyroidism is called sub-clinical hyperthyroidism altered laboratory values, which are not yet familiar with symptoms.

In contrast the latent hyperthyroidism with symptoms or be asymptomatic. It is characterized by the fact that the TSH activity in blood serum is decreased, but the peripheral thyroid hormones thyroxine (T4) and Triiodthyronin (T3), are still normal. In contrast, overt hyperthyroidism is both TSH activity as well as the plasma levels of peripheral thyroid hormones pathologically.

A hyperthyroidism with clinical symptoms is always behandlungsbedürftig. The most serious and life form is the thyreotoxische crisis.

Causes of hyperthyroidism

* Common:

* M. Basedow: an autoimmune process – immunogenic form of hyperthyroidism, by stimulating TSH receptor autoantibodies causing
* Autonomous nodes: nodes, the control by TSH independently absorb iodine and hormone, but not demand competence
* Hashimoto thyroiditis and regu-thyroiditis: an early exit due to increased hormone cell destruction in inflammation (“Freisetzungshyperthyreose”).

* Rare:
* Peripheral hypersensitivity to thyroid hormone
* Hyperthyreosis Factitia in overdose of T4 or T3;
* A postpartum hyperthyroidism in postpartum thyroiditis

* Very rare:

* A TSH-producing Hypophysentumor (easily recognizable by an elevated TSH concentration with a high FT3 levels),
* Paraneoplastic production increased stimulant substances,
* Increased hormone production by large tumor mass of differentiated thyroid carcinoma.
* Iatrogenic or patient-induced (Hyperthyreosis Factitia)

Symptoms

* Palpitations: resting heart rate over 90/min
* Possibly hypertension, cardiac arrhythmias
* Possibly increased blood pressure amplitude (High systolic, low diastolic blood pressure)
* Restlessness, hyperactivity
* Weight loss despite excessive appetite
* Increased sweating, hypersensitivity to heat
* Warm and moist skin, increased trembling
* Possibly diarrhea, hair loss, etc.
* Possibly severe insomnia or fatigue
* Depressive disorders to depression
* Irritability
* The endocrine Orbitopathie (Morbus Basedow): projecting eyes (Exophthalmus), dry, burning eyes, unilateral or bilateral

Diagnosis

* Determination of thyroid hormone levels T3, T4 and TSH in the blood and TRAK
* Ultrasound of the thyroid
* Szintigrafie thyroid

Example of a typical hyperthyroidism in Basedow’s Disease

* FT4 5.5 ng / dl (normal 0.71 – 1.85)
* FT3 22.5 pg / ml (normal 1.64 – 3.45)
* TSH <0.03 mU / l (normal 0.3 – 4.00)
* TRAK 20 mU / l (normal <1)

In 90% of cases, the auto-antibodies in Basedow TRAK positive (diagnostic evidence). In autonomous adenomas (hot nodes) are the TRAK mostly negative and the thyroid is also in the ultrasound or scintigraphy visibly changed differently than Basedow.

Treatment

* Stop the thyroid medication at the end (Thyreostatikum) eg Thiamazol
* Beta blockers to reduce cardiac symptoms accompanying
* Radioiodtherapie
* Surgical removal of part of the thyroid