Symptoms Of Hyperthyroidism Research Articles

Thyroid hormone analogue (Triac) therapy in resistance to thyroid hormone beta reduces hyperthyroid symptoms, lowers circulating thyroid hormones and metabolic rate effectively, without adverse effects

Thyroid hormone analogue (Triac) therapy in resistance to thyroid hormone beta reduces hyperthyroid symptoms, lowers circulating thyroid hormones and metabolic rate effectively, without adverse effects

Thyroid hormone analogue (TRIAC) therapy in resistance to thyroid hormone beta, reduces hyperthyroid symptoms, lowers circulating thyroid hormones and metabolic rate effectively, without adverse effects

Thyroid hormone analogue (TRIAC) therapy in resistance to thyroid hormone beta, reduces hyperthyroid symptoms, lowers circulating thyroid hormones and metabolic rate effectively, without adverse effects

Outcomes of thyroidectomy in symptomatic, euthyroid Hashimoto's patients: a case control study.

Hashimoto's thyroiditis (HT) is managed with thyroid hormone replacement to maintain a euthyroid state. A subset of patients have refractory symptoms, which improve with thyroidectomy (TT). There remains a reluctance to proceed with surgery due to perceptions of complications, and limited data availability regarding improvements in quality of life (QoL). This retrospective case control study aims to analyse the outcomes and QoL scores for symptomatic euthyroid HT patients who underwent TT. Thirty euthyroid patients who underwent TT for the management of HT between 2017 and 2022 were identified. An age-matched control group of patients who underwent TT for symptomatic multinodular goitre (MNG) were randomly selected. Demographics, biochemistry, histology, outcomes, and pre- and post-operative SF-36 and ThyPRO-39 scores were compared between groups. There were no surgical complications in the HT group, whilst two MNG patients had complications. There was a similar rate of parathyroid auto-transplantation in both groups, more glands were transplanted in the HT group. There was a significant difference in pre- and post-operative QoL scores for both groups. Comparison revealed a significant improvement in hyperthyroid symptoms, social life and daily life scores in the HT group. There was a significant difference in pre- and post-operative anti-TPO, anti-TG and TSH levels in the HT group. Patients with symptomatic Hashimoto's thyroiditis, despite being euthyroid, may benefit from total thyroidectomy however this remains under-utilized. This study demonstrated that thyroidectomy was associated with an improvement in validated post-operative quality of life scores and was not associated with increased complication rates for appropriately selected patients.

Understanding Hyperthyroidism ( Overactive Thyroid Gland ): Causes, Symptoms, and Treatment Options

Hyperthyroidism occurs when you have an excess amount of thyroid hormone produced by your thyroid gland. The common symptoms of hyperthyroidism include rapid heartbeat, weight loss, sweating, tremors, anxiety, irritability, fatigue, and heat intolerance. The most common cause of hyperthyroidism is Graves’ disease. It is an autoimmune condition where the body produces antibodies that stimulate the thyroid. Thyroid-stimulating immunoglobulins (TSI) are highly specific for Graves' disease and are not commonly found in other thyroid conditions, such as Hashimoto's thyroiditis or thyroid cancer. Treatment of hyperthyroidism includes antithyroid medications to decrease hormone production, radioactive iodine to destroy thyroid cells, or surgery to remove part or all of the thyroid gland.

Exploring the Triad of Thyroid Dysfunction, Chronic Diarrhea and Anemia

Hyperthyroidism, a disorder characterized by excessive thyroid hormone production, typically presents with many symptoms including weight loss, tremors, and heat intolerance. However, in rare instances, it can manifest solely as chronic diarrhea, posing a diagnostic challenge. This case study aims to highlight an unusual presentation of hyperthyroidism and underscore the importance of considering thyroid disease in the differential diagnosis of chronic gastrointestinal symptoms. We present the case of a fifty-year-old woman who, six months prior to her ER visit, had been experiencing severe weight loss and diarrhea along with anemia. Despite her lack of typical hyperthyroidism symptoms, a thorough investigation revealed that hyperthyroidism was the underlying cause of her gastrointestinal issues. This case illustrates that hyperthyroidism can present atypically, solely as chronic diarrhea. The patient's anemia was linked to iron deficiency, worsened by chronic gastrointestinal loss and the hyper metabolic state induced by hyperthyroidism. Treatment of the hyperthyroidism led to significant improvement in her gastrointestinal symptoms and correction of the anemia. This case underscores the critical need to include thyroid disease in the differential diagnosis for patients with chronic diarrhea and weight loss, even in the absence of typical hyperthyroid symptoms. Early recognition and appropriate management of hyperthyroidism can significantly improve patient outcomes by alleviating gastrointestinal manifestations and correcting associated anemia. Clinicians should maintain a high index of suspicion for thyroid dysfunction in patients presenting with unexplained chronic diarrhea and weight loss to ensure timely and accurate diagnosis and treatment.

Reduced serum CLCF1 levels in hyperthyroidism patients and T3-treated mice.

Characteristic symptoms of hyperthyroidism include weight loss, heart palpitation, and sweating. Thyroid hormones (TH) can stimulate thermogenesis through central and peripheral mechanisms. Previous studies have shown an association between dysfunction of cardiotrophin-like cytokine factor 1 (CLCF1) and cold-induced sweating syndrome, with recent research also indicating a link between CLCF1 and brown adipose tissue thermogenesis. However, it remains unclear whether CLCF1 and TH have synergistic or antagonistic effects on thermogenesis. This study aims to investigate the influence of thyroid hormone on circulating CLCF1 levels in humans and explore the potential possibilities of thyroid hormone in regulating energy metabolism by modulating Clcf1 in mice. By recruiting hyperthyroid patients and healthy subjects, we observed significantly lower serum CLCF1 levels in hyperthyroid patients compared to healthy subjects, with serum CLCF1 levels independently associated with hyperthyroidism after adjusting for potential confounders. Tissue analysis from mice treated with T3 revealed a decrease in CLCF1 expression in BAT and iWAT of C57BL/6 mice. These findings suggest that TH may play a role in regulating CLCF1 expression in adipose tissue.

Efficacy and safety of ultrasound-guided thermal ablation of graves’ disease: a retrospective cohort study

BackgroundUltrasound-guided thermal ablation (TA) has emerged as a robust therapeutic approach for treating solid tumors in multiple organs, including the thyroid. Yet, its efficacy and safety profile in the management of Graves’ Disease (GD) remains to be definitively established.MethodsA retrospective study was conducted on 50 GD patients treated with TA between October 2017 and December 2021. Key metrics like thyroid volume, volume reduction rate (VRR), thyroid hormones, and basal metabolic rate (BMR) were evaluated using paired Wilcoxon tests.ResultsThe intervention of ultrasound-guided TA yielded a statistically significant diminution in total thyroid volume across all postoperative follow-up intervals—1, 3, 6, and 12 months—relative to pre-intervention baselines (p < 0.001). The median VRR observed at these time points were 17.5%, 26.5%, 34.4%, and 39.8%, respectively. Euthyroid status was corroborated in 96% of patients at the one-year follow-up milestone. Transient tachycardia and dysphonia were observed in three patients, while a solitary case of skin numbness was noted. Crucially, no instances of enduring injury to the recurrent laryngeal nerve (RLN) were documented.ConclusionsOur investigation substantiates ultrasound-guided TA as a pragmatic, well-tolerated, and safe therapeutic modality for GD. It effectively improves symptoms of hyperthyroidism, engenders a substantial reduction in thyroid volume, and restores thyroid hormone and BMR to physiological levels. Given its favorable safety profile, enhanced cosmetic outcomes, and minimally invasive nature, ultrasound-guided TA is a compelling alternative to thyroidectomy for GD patients.

Gut microbiome in the Graves' disease: Comparison before and after anti-thyroid drug treatment.

While several studies have proposed a connection between the gut microbiome and the pathogenesis of Graves's disease (GD), there has been a lack of reports on alteration in microbiome following using anti-thyroid drug treatment (ATD) to treat GD. Stool samples were collected from newly diagnosed GD patients provided at baseline and after 6 months of ATD treatment. The analysis focused on investigating the association between the changes in the gut microbiome and parameter including thyroid function, thyroid-related antibodies, and the symptom used to assess hyperthyroidism before and after treatment. A healthy control (HC) group consisting of data from 230 healthy subjects (110 males and 120 females) sourced from the open EMBL Nucleotide Sequence Database was included. Twenty-nine GD patients (14 males and 15 females) were enrolled. The analysis revealed a significant reduction of alpha diversity in GD patients. However, after ATD treatment, alpha diversity exhibited a significant increase, restored to levels comparable to the HC levels. Additionally, GD patients displayed lower levels of Firmicutes and higher levels of Bacteroidota. Following treatment, there was an increased in Firmicutes and a decrease in Bacteroidota, resembling levels found in the HC levels. The symptoms of hyperthyroidism were negatively associated with Firmicutes and positively associated with Bacteroidota. GD had significantly lower levels of Roseburia, Lachnospiraceaea, Sutterella, Escherichia-shigella, Parasuterella, Akkermansia, and Phascolarctobacterium compared to HC (all p < 0.05). Post-treatment, Subdoligranulum increased (p = 0.010), while Veillonella and Christensenellaceaea R-7 group decreased (p = 0.023, p = 0.029, respectively). Anaerostipes showed a significant association with both higher smoking pack years and TSHR-Ab levels, with greater abundantce observed in smokers among GD (p = 0.16). Although reduced ratio of Firmicutes/Bacteroidetes was evident in GD, this ratio recovered after treatment. This study postulates the involvement of the gut microbiome in the pathogenesis of GD, suggesting potential restoration after treatment.

Hemolytic Anemia and Thrombocytopenia with Hyperthyroidism : A Case Report

Hemolytic Anemia and Thrombocytopenia with Hyperthyroidism : A Case Report

A Geriatric Patient with Fewer Classical Symptoms of Hyperthyroidism

A Geriatric Patient with Fewer Classical Symptoms of Hyperthyroidism

Paraneoplastic Hyperthyroidism in Advanced Testicular Non-Seminomatous Germ Cell Tumors: Prevalence and Clinical Management

Introduction: Paraneoplastic hyperthyroidism (PH) has been reported in patients with testicular germ cell tumors (GCTs), sporadically. This disorder is caused by extremely elevated serum levels of beta-human chorionic gonadotropin (bHCG). To date, little is known about the prevalence of PH, and its clinical features are poorly understood. The aim of the present study was to analyze the relative frequency and clinical features of PH in GCTs and evaluate their effects on therapeutic outcomes. Methods: A cohort of 438 patients treated for testicular GCT from 2017 to 2023 was retrospectively analyzed for histology, age, clinical stage, and presence of PH. The clinical features of the patients with PH were evaluated descriptively. The relative frequency of PH was compared among the subgroups using descriptive statistical methods. Results: Three patients with PH were identified; all had clinical symptoms of hyperthyroidism, suppressed serum levels of thyroid-stimulating hormone (TSH), and increased levels of tri-iodothyronin (fT3). All the patients had advanced, metastasized, and non-seminomatous GCTs. Serum bHCG levels ranged from 225,00 U/L to 1,520,000 U/L. The prevalence of PH was 0.7% in the entire GCT population and 60% in those with very high bHCG serum levels. All the patients received standard cisplatin-based chemotherapy along with thyrostatic treatment. The clinical symptoms of the hyperthyroidism rapidly disappeared. TSH levels normalized with decreasing bHCG levels. The PH treatment did not affect the therapeutic outcomes of the patients. Conclusion: PH may occur in 0.7% of all patients with GCT but may be present in up to 60% of patients with very high levels of bHCG. Measuring serum levels of TSH and fT3 should be performed in addition to routine diagnostic measures in all patients with poor prognosis GCTs. Thyrostatic medication is recommended for patients with the clinical symptoms of hyperthyroidism. Early recognition of hyperthyroidism and prompt intervention will reduce comorbidity and help optimize therapeutic outcomes.

Patient-centered Management of Hyperthyroidism

ABSTRACT Hyperthyroidism, characterized by excessive thyroid hormone production, demands a patient-centered approach for optimal management. Treatment aims to alleviate symptoms, normalize hormone levels, and prevent complications. It encompasses education and communication of the patients, management of the symptoms of hyperthyroidism, treatment options available, shared decision-making, monitoring, and follow-up, including keeping an eye on adversity, providing psychological support, and nutritional and lifestyle modification. A patient-centered approach to hyperthyroidism management emphasizes shared decision-making, individualized care, and ongoing support to optimize treatment outcomes and enhance patient well-being.

Thyroid storm: Report of four cases in two health institutions, Barranquilla

Thyroid storm or thyrotoxic crisis is a life-threatening condition, characterized by signs and symptoms of thyrotoxicosis associated with multiorgan dysfunction, occurs as a complication of hyperthyroidism and due to its high risk of mortality, merits timely diagnosis and early treatment. Among the main causes of thyroid storm is Graves' Basedow's disease, which is associated with triggering factors such as non-adherence to medical therapy. The diagnosis is based on clinical manifestations and increased thyroid hormones, but thyroid hormone levels are not related to the severity of the condition, so sensitive scoring systems have been developed to support the diagnostic approach. In this review, we analyze a series of patients with thyroid storm in which half of the patients have a fatal outcome, demonstrating the association with high mortality.

Cushing's disease presenting with recurrent abscesses followed by post-remission hyperthyroidism.

We report a case of a 59-year-old woman with Cushing's disease who developed hyperthyroidism following treatment of hypercortisolaemia. The patient with a history of recurrent hospitalisations caused by multi-sited soft tissue abscesses was admitted with sepsis. Both her medical history and physical examination suggested Cushing's syndrome. The initial hormonal diagnostic process, conducted after sepsis treatment, brought forth conflicting results. However, hormonal assessment repeated 3 months later indicated pituitary hypercortisolaemia, which was confirmed through bilateral inferior petrosal sinus sampling and was successfully treated with transsphenoidal pituitary surgery. Three months after the surgery, the patient was readmitted to our epartment with symptoms of hyperthyroidism, which was confirmed by laboratory tests. Thyroid scintiscans indicated Graves' disease. However, the absence of anti-thyroid stimulating hormone antibodies suggested other etiologies of hyperthyroidism. Eventually, the patient underwent radioiodine therapy. Currently, her condition is improving and she has had no recurrence of abscesses, severe infections, or hyperthyroidism. In conclusion, while clinical manifestation of hypercortisolaemia might be non-specific, its treatment may trigger the development of autoimmune diseases. The presence of recurrent severe infections should prompt physicians to consider the possibility of hypercortisolaemia. Chronic hypercortisolism is debilitating and can lead to significant disability. Dexamethasone suppression testing in patients with active or recent severe inflammatory or infectious illnesses may produce misleading or confusing results. Clinicians should be aware of the potential development of autoimmune diseases following successful treatment of hypercortisolaemia.

From Hypothyroidism to Stroke … Is it Such a Short Way?

A 72-year-old patient, known in her personal medical history with essential hypertension, chronic autoimmune thyroiditis and hypothyroidism, undergoing chronic treatment with Euthyrox, shows specific symptoms of hyperthyroidism (palpitations, profuse sweating). After the tests, it appears that the patient has a thyrotoxicosis related to Graves’ disease. Treatment with Thyrozol is initiated. 10 days after the initiation of Thyrozol treatment, a severe neutropenia is noted (0 neutrophils on the peripheral blood smear). It is decided to cease the treatment with Thyrozol and start the treatment with Filgastrim, granulocyte colony stimulating factor and Dexamethasone.

Clinical characteristics and outcomes of patients with TSH-secreting pituitary adenoma and Graves’ disease - a case report and systematic review

BackgroundCoexistence of TSH-secreting pituitary adenoma (TSHoma) and Graves’ disease (GD) is rare and complicates the management decision.MethodsWe present a case of the co-existence of TSHoma and GD. In addition, we systematically searched articles describing TSHoma and GD in the same patient published until 20th March 2023, using Pubmed, Scopus and Embase.Case presentationA 46-year-old man presented with symptoms of thyrotoxicosis. His thyroid function tests showed serum TSH 3.35 (reference range 0.3–4.2) mIU/L, FT3 19.7 (3.7–6.4) pmol/L, and FT4 68.9 (11-23.3) pmol/L. The serum TSH receptor antibody was 11.5 mIU/L (positive at ≥ 1.75 mIU/L). Pituitary magnetic resonance imaging showed macroadenoma compressing the optic chiasm. The patient underwent trans-sphenoidal resection of pituitary adenoma. Postoperatively, he remained on maintenance carbimazole and octreotide.ResultsFourteen articles comprising 15 patients were identified from the systemic search. A total of 16 patients (including the current case) were included in the systematic review. The mean (± SD) age at diagnosis was 41 ± 13.6 years. The majority were females (75%). The median (IQR) TSH was 1.95 (0.12–5.5) mIU/L, the median (IQR) free T3 was 11.7 (7.6–19.7) pmol/L and the median (IQR) free T4 level was 47.6 (33.3–64.4) pmol/L. Ten (76.9%) patients had positive TSH receptor antibody levels. 84.6% had pituitary macroadenoma. Pituitary surgery was performed in 12 (75%) patients. At the last follow-up, 4 (25%) patients had complete resolution of symptoms after pituitary surgery, 3 (18.7%) were on maintenance treatment with thionamides for GD, 1 (6.25%) on beta-blockers and 1 (6.25%) on somatostatin analog.ConclusionTSHoma and GD can co-exist, and it is essential to identify this rare association as it can significantly impact treatment strategies.

Retracting the thyroid matters: Who develops asymptomatic transient thyrotoxicosis after parathyroidectomy

BackgroundHyperthyroidism after parathyroidectomy is not a well-understood complication. We sought to determine the incidence and risk factors of hyperthyroidism after parathyroidectomy. Materials and methodsThis is a prospective study of 91 patients undergoing parathyroidectomy. Pre- and post-operative thyroid-stimulating hormone(TSH) and free thyroxine(T4) levels at two-week follow-ups were collected. Bivariate analyses were conducted to compare demographics, laboratory results, and intraoperative findings between patients with normal and suppressed post-parathyroidectomy TSH. ResultsTwenty-two(24.2 ​%) patients had suppressed TSH after parathyroidectomy and 2(2.2 ​%) reported symptoms of hyperthyroidism. All hyperthyroidism resolved within 6 weeks. No patients required medical treatment. Compared to the normal TSH group, the suppressed TSH group had significantly more bilateral explorations(91.0 ​% vs. 58.0 ​%, p ​= ​0.006), and superior parathyroid resections(95.5 ​% vs. 65.2 ​%, p ​= ​0.006). ConclusionTransient hyperthyroidism is common following parathyroidectomy, which is likely associated with intraoperative thyroid manipulation. Gentle retraction of thyroid glands in parathyroidectomy is warranted, especially during superior parathyroid gland resection.

The tortuous diagnosis of one case of neonatal hyperthyroidism

ObjectiveTo outline the clinical signs, diagnosis, and course of care for a single case of neonatal hyperthyroidism while also summarizing common diagnostic errors related to this condition.MethodsMedical records of the neonate of hyperthyroidism were collected and analyzed in combination with literature.ResultsThe neonate’s mother had thyroid disease, but her thyrotropin receptor antibody (TRAb) levels were not monitored during pregnancy. The neonate exhibited typical symptoms of hyperthyroidism on the day of birth but was not diagnosed until 15 days later. Impaired liver (cholestasis, elevated liver enzymes) and cardiac function (pulmonary hypertension, right heart enlargement) are the main manifestations. Treatment with methimazole (1.0 mg /kg·d) and propranolol (2.0 mg /kg·d) led to recovery, and the neonate stayed in the hospital for 27 days before being discharged with medication. The diagnosis was temporary hyperthyroidism, and the medication was discontinued at 72 days of age.ConclusionIt is important to strengthen the management of high-risk pregnant women with thyroid disease. Monitoring TRAb levels in both mothers and neonates should be done dynamically to enable early prediction and diagnosis of neonatal hyperthyroidism. Most neonates with hyperthyroidism have a good prognosis when timely and appropriate medical treatment is provided.

Effect of thyroid-stimulating hormone suppression on quality of life in thyroid lobectomy patients: interim analysis of a multicenter, randomized controlled trial in low- to intermediate-risk thyroid cancer patients (MASTER study).

Current clinical practices favor less or no thyroid-stimulating hormone (TSH) suppression for low- to intermediate-risk thyroid cancer patients who receive thyroid lobectomy. The association of TSH suppression on health-related quality of life (HR-QoL) in patients after thyroid lobectomy is not well studied. This study aimed to evaluate the effect of TSH suppression on patient HR-QoL after thyroid lobectomy. This study included patients enrolled in an ongoing, multicenter, randomized controlled study investigating the effects of TSH suppression. Patients were randomized to either the low-TSH group (TSH target range, 0.3-1.99 µIU/mL) or the high-TSH group (TSH target range, 2.0-7.99 µIU/mL). The HR-QoL, hyperthyroidism symptom, and depression symptom questionnaires performed preoperatively and 2 weeks and 3 months postoperatively were evaluated. Total of 669 patients (low-TSH group, 340; high-TSH group, 329) were included. Although total HR-QoL score changes were not different between the 2 groups, the high-TSH group had a significantly higher score in the physical domain at postoperative 3 months (P = 0.046). The 2 groups did not have significant differences in hyperthyroidism and depression scores. In the short-term postoperative period, the physical HR-QoL scores in thyroid lobectomy patients were better when they did not receive TSH suppression. This study suggests the importance of considering HR-QoL when setting TSH suppression targets in thyroid lobectomy patients.

Atrial Fibrillation and Associated Factors Among Hyperthyroidism Patients Attending at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.

The most prevalent heart symptom of hyperthyroidism is atrial fibrillation. Other than sinus tachycardia, which occurs with hyperthyroidism, atrial fibrillation is the most prevalent cardiac arrhythmia. Hyperthyroidism results in excess mortality from increased incidence of circulatory diseases and dysrhythmias. The aims of the study was prevalence and associated factors of atrial fibrillation among hyperthyroidism adult patients attending the University of Gondar Referral Hospital, Northwest Ethiopia. This study aimed to determine the prevalence and associated factors of atrial fibrillation among adult hyperthyroid patients attending the University Of Gondar Referral Hospital, Ethiopia. Using a consecutive sampling technique, 228 patients with hyperthyroidism participated in an institution-based cross-sectional study. A standardized questionnaire that had been pretested was used to gather the data that was designed to include socio-demographic data, clinical presentation, biochemical profile, and electrocardiography findings through chart review and interviews. The data were manually curated. Atrial fibrillation was present in 32 (14%) patients, with a 95% CI of 9.6 to 19.2. The identified predictor variables were age >61 years (Adjusted Odd Ratio = 4.2, 95% CI = 1.5-11.7), female sex (Adjusted Odd Ratio = 4.0, 95% CI = 1.4-12.0), and high serum FT4 >23.9 pmol/l (Adjusted Odd Ratio = 8.0, 95% CI = 2.1-30.0). The prevalence of atrial fibrillation among hyperthyroidism patients was 14%. Being female, being older, and having high serum FT4 levels were significantly associated with AF in hyperthyroid patients.