Hyperthyroidism of the thyroid gland. Treatment of hyperthyroidism of the thyroid gland with drugs and herbs. Drug treatment of concomitant diseases in hyperthyroidism

Endocrine disease thyroid gland, which appears systemic symptoms, called hyperthyroidism, thyrotoxicosis or toxic goiter. Pathology manifests itself as a disruption of the normal functioning of the entire body. Thyrotoxicosis is rarely an independent disease; as a rule, the disease accompanies others endocrine disorders, for example, type 1 diabetes.

What is hyperthyroidism

This is a chronic organ disease endocrine system- thyroid gland. Hyperthyroidism is manifested by an increase in the level of thyroid hormones, which contain iodine atoms. These thyroid hormones (thyroxine, triiodothyronine, calcitonin) are the most important elements of the humoral regulation of the body and take part in physiological processes, which are associated with metabolism, thermoregulation, blood pressure, etc. As a rule, women are more likely to suffer from thyroid disease.

Causes

Primary hyperthyroidism of the thyroid gland occurs due to pathological changes in the tissue itself, and secondary hyperthyroidism develops as a result of pathologies of the pituitary gland or other diseases of the body (malignant neoplasms, infections). Tertiary is called thyrotoxicosis, caused by lesions of the hypothalamus and decreased secretion of thyrotropin-releasing hormone. The main reasons due to which hyperthyroidism develops:

Autoimmune pathologies. In this condition, the synthesis of thyroid hormones remains normal, and an increase in the amount in the blood plasma occurs as a result of destructive processes in the gland tissue and the release of their contents into the bloodstream. Autoimmune hyperthyroidism leads to uncomplicated forms of thyrotoxicosis, and responds well to treatment.
Graves' disease. This disease accounts for up to 80% of all cases of thyrotoxicosis. With this pathology, specific antibodies are formed, to which the thyroid gland responds in the same way as to thyroid-stimulating hormone, i.e. intensively synthesizes thyroxine and triiodothyronine. At the same time, the organ tissue increases significantly in size.
Thyroid adenoma. A benign growth of organ tissue that produces excess hormones.
Nodular goiter (Graves' disease). In the gland tissue, separate areas are formed that excessively synthesize hormones. Toxic goiter occurs in elderly patients and people with diabetes.
Pituitary tumors. New growths in this endocrine gland lead to increased synthesis of thyroid-stimulating hormone, which stimulates the production of thyroid hormones.

Symptoms

Hyperthyroidism has various clinical symptoms, therefore, as a rule, on early stage development of pathology, making a correct diagnosis is difficult. The disease manifests itself the following symptoms:

weight loss with good appetite;
enlargement of the thyroid gland;
tachycardia;
severe hand tremors up to the development of convulsions;
hot, damp skin;
increased sweating;
muscle weakness;
frequent urination;
digestive disorders;
mental disorders;
symptoms of diabetes;
hyperactivity in children;
emotional instability;
exophthalmos;
insomnia;
swelling of the limbs;
brittle nails;
impaired potency in men;
hair loss.

Symptoms in women

Diffuse goiter and excess thyroid hormones in women, except common symptoms give rise to serious violations normal functioning reproductive system: the menstrual cycle is disrupted, up to the development of amenorrhea and secondary infertility or spontaneous abortion at early stages. The disease leaves its mark on the patient's appearance. At the first stage, the appearance does not change better side: hair becomes dull, nails peel and break, skin becomes dry and flaky.

Classification of hyperthyroidism

Diffuse toxic goiter is classified according to the severity of the course and the severity of the clinical picture of the disease. There are three stages of the disease:

Hyperthyroidism of the first degree is characterized by increased nervous excitability, decreased performance, slight weight loss, and constant tachycardia of no more than 100 beats/min.
At the second stage, the excitability of the nervous system is significantly increased, body weight decreases by 20% from normal, tachycardia from 100 to 120 beats/min, the patient complains of insomnia, confusion, memory problems, and digestive disorders.
At the third stage of the disease, the patient completely loses his ability to work, severe exhaustion(weight loss up to 40-50% of the original), arrhythmia, tachycardia, heart failure, symptoms of liver and kidney damage develop.

Thyrotoxicosis in pregnant women

Signs of hyperthyroidism in pregnant women, as a rule, are much more pronounced, so the combination of this pathology and gestation can lead to severe complications in the fetus. Hyperthyroidism in an expectant mother can lead to the development of dysfunction of all systems of the child, the occurrence of goiter, and serious damage to the central nervous system.

The thyroid gland regulates the functioning of all organs and systems, directly affects the reproductive function of a woman, increasing the level of sex hormones, which is dangerous for the fetus - the risk of spontaneous abortion or intrauterine death of the child increases significantly. A pregnant woman should visit an endocrinologist monthly and take hormone tests, strictly adhere to the prescribed treatment and proper diet.

Diagnostics

A pathological change in the functioning of the thyroid gland, hyperthyroidism syndrome, is diagnosed based on visual inspection and collecting anamnesis, as well as laboratory clinical tests, which determine the content of thyroid hormones in the blood. In addition, to clarify the cause of the development of the disease and the type of pathology, an ultrasound examination with a contrast agent and a biopsy of gland tissue are indicated.

Treatment of hyperthyroidism

For effective elimination The causes and symptoms of thyrotoxicosis are prescribed drug therapy, treatment with radioactive iodine and, if indicated, surgery. The choice of treatment method depends on many factors: the cause of hyperthyroidism, the severity of symptoms of the disease, the presence of concomitant chronic diseases organs and systems, patient age.

Treatment with drugs

Drug therapy for hypersecretion of the thyroid gland is aimed at suppressing the secretory activity of the organ, reducing the production of excess production of thyroid hormones. As a rule, thyreostatic (antithyroid) drugs are prescribed, in some cases calcium channel blockers and beta blockers. Some of the most popular drugs for drug therapy of thyrotoxicosis are:

Propylthiouracil. A drug that reduces the activity of the thyroid gland is used to treat thyrotoxicosis and prepare for surgery. The advantage of the drug is the absence of negative effects on the liver and kidneys, and the disadvantage is high risk development of side effects.
Methimazole. A medicine that acts to eliminate hypersecretion of thyroid hormones. The advantage of the medicine is fast action, and the disadvantage is a high risk of developing agranulocytosis with long-term use.

Surgical

Surgical intervention is indicated for the patient when conservative therapy does not give positive results. Surgical treatment consists of complete or partial removal glands. A direct indication for surgery is the presence of nodes in the tissues of the organ ( nodular goiter) or the growth of a separate area with increased secretion. The remaining part of the cells after resection functions normally. At complete removal thyroid gland and the patient must receive pharmacological replacement therapy with hormonal drugs throughout his life.

Treatment of hyperthyroidism with radioactive iodine

The method of treatment with radioactive iodine (radiiodine therapy) involves the patient taking a capsule or solution of radioactive iodine. The medicine is taken once. After radioiodine is delivered into the bloodstream, it penetrates the thyroid tissue, accumulates and destroys them over several weeks. For maximum effectiveness, the procedure is repeated after 2-3 months.

As a result of this process, the size of the organ decreases, the secretion of thyroxins and their level in the blood plasma decrease. Radioiodine therapy is prescribed simultaneously with drug treatment. After treatment with radioactive iodine, thyrotoxicosis becomes unexpressed, i.e., stable remission occurs. Remember that the cause of the disease in this case is not eliminated and a relapse may occur.

Treatment with folk remedies

To eliminate the symptoms of the disease you can use folk recipes treatment. However, they must be taken in combination with drug therapy and, if necessary, surgical treatment. By effective means when fighting the disease, tinctures and decoctions of some medicinal plants:

Persimmon tincture. Freshly squeezed fruit juice should be mixed with vodka or cognac in a 4:1 ratio and left for 5-7 days in a cool, dark place. It is recommended to take the tincture 3 times a day, a tablespoon on an empty stomach, for a month. If necessary, repeat the course of treatment after 1.5-2 months.
Tincture of hawthorn fruits. Two tablespoons of dried fruits must be poured into 0.5 liters of vodka and left to infuse for 1.5 months. The tincture should be taken 3-4 times a day, a teaspoon after meals.
Decoction of blueberry leaves. Mix crushed dry blueberry leaves with bay leaves. Pour the mixture with water, put on fire, bring to a boil and keep on fire for 3-5 minutes, then leave for several days. Then strain and take 1-2 tablespoons 2-3 times a day for two weeks.
Balm made from dandelion and blueberry flowers. Mix 20 g of dried blueberries and rose hips, 10 g of dandelion flowers. Pour a glass of alcohol, add 1-2 tbsp. flower honey, close the lid tightly and place in a dark place for 7-10 days. Use a teaspoon of balm three times a day for a week, diluting it in a glass of water or iced tea.

Consequences

If the course of the disease is unfavorable, a thyrotoxic crisis may develop - a condition that threatens the patient’s life, an exacerbation of the clinic diffuse goiter: fever, severe tachycardia (more than 150 beats/min), heart failure, impaired liver and kidney function, worsening eye symptoms. Can provoke a crisis severe stress, infection, prolonged physical activity.

Prevention

To prevent the development of the disease, the following recommendations must be followed:

diet;
taking iodine-containing drugs;
undergo regular preventive examinations with an endocrinologist;
avoid stress and emotional turmoil;

Video

Thyroid hyperthyroidism is a disease caused by hyperfunction of the thyroid gland, when there is an increased concentration of thyroid hormones in the blood serum - thyroxine (T4) and triiodothyronine (T3). Depending on the level of origin of the violation, the following are distinguished:

primary hyperthyroidism – thyroid,
secondary hyperthyroidism – pituitary gland,
tertiary hyperthyroidism – hypothalamus.

In practice, in most cases it is primary hyperthyroidism that occurs as a consequence of a disease of the thyroid gland itself.

Causes of hyperthyroidism of the thyroid gland

When excessive production of thyroid hormones occurs, malfunctions occur internal organs, and they are most often expressed in the form of intoxication. In this case, hyperthyroidism is called thyrotoxicosis. Thyrotoxicosis is accompanied by diseases such as diffuse toxic goiter (or Graves' disease, Graves' disease), toxic thyroid adenoma (nodular, multinodular goiter), early stages of autoimmune thyroiditis.

So, let's look at when thyroid hyperthyroidism occurs:

diffuse toxic goiter is the most common cause (occurs in 80% of cases). This autoimmune disease, most often hereditary, is observed at the age of 20 - 40 years (can be found at more younger age, even in newborns). The thyroid gland is constantly active, producing a large number of hormones, the concentration of which in the blood increases, causing hyperplasia of the gland.
benign formations of the thyroid gland:

multinodular toxic goiter (about 20% of all cases) - increased function of the thyroid gland and its nodular enlargement. Observed high level T3 hormone and a slight increase in T4 hormone.
thyroid adenoma (up to 5% of all cases) produces an excess amount of thyroid hormones. Most often, after removing this formation and eliminating thyrotoxicosis, the secretion of the hormone TSH is restored and the thyroid gland begins to function normally.

subacute thyroiditis is an inflammatory condition of the thyroid gland caused by viral infection(adenovirus, influenza). The thyroid gland is moderately enlarged and inflamed. In this case, weakness, fever, and pain in the thyroid gland appear.
pituitary adenoma.
tumors of the female genital area.
Excessive intake of iodine from food can lead to increased synthesis of thyroid hormones T3 and T4. High iodine content is found in seafood.
artificial hyperthyroidism - overdose of hormones. This can happen in two cases:

uncontrolled use of hormones for weight loss;
overdose of substitutes in therapy oncological diseases thyroid gland.

by-effect medicines. Some medications used in treatment cardiovascular diseases, contain a significant amount of iodine.
stress and neuropsychic disorders.
postpartum thyroiditis (very rare).

Symptoms of hyperthyroidism of the thyroid gland

In patients with hyperthyroidism of the thyroid gland there are various symptoms and complaints. Main symptoms:

The skin is thinned, prone to fever and sweating.
Discomfort, pain on the front surface of the neck.
Hair and nails. Some of the most noticeable symptoms of hyperthyroidism are thinning hair and split nails.
Eyes. The most noticeable eye symptom is enlargement and protrusion of the eyeball - exophthalmos. The patient's eyelids are swollen, hyperpigmented, and there are no disturbances in eye movements.
Cardiac dysfunctions. Symptoms such as tachycardia, atrial fibrillation, increased blood pressure, and heart failure are observed.
Respiratory system. Patients experience shortness of breath and decreased lung volume.
Gastrointestinal tract. Patients have an appetite disorder: it either increases or decreases. Nausea, vomiting, and diarrhea are observed, which leads to weight loss.
Musculoskeletal system. Noted increased fatigue, muscle pain, development of osteoporosis.
Frequent urination.
High nervous excitability, tearfulness, mood changes, finger tremor.
Sexual function. Hyperthyroidism in men causes a decrease in sexual desire, potency (erectile failure), and the possible development of gynecomastia. Women experience irregularities in the menstrual cycle.
An increase in blood glucose levels is the development and formation of thyroid-induced diabetes.

Many patients also note a feeling of irreconcilable heat in the body, internal trembling, and do not tolerate exposure to the sun and stuffiness.

Diagnosis of hyperthyroidism

First of all, when diagnosing hyperthyroidism, clinical, symptomatic manifestations. The patient is prescribed laboratory diagnostics:

general blood analysis,
blood serum analysis for thyroid hormone levels.

Also required for diagnosis are an ultrasound examination of the thyroid gland and an electrocardiogram. An endocrinologist can also prescribe a computed tomography scan - layer-by-layer images of the thyroid gland, which clearly determine the exact location of the pathology.

The form of hyperthyroidism is determined using a special scan and establishing the iodine accumulation function, calculating the amount of radioactive iodine accumulated in the thyroid gland per day. The patient is given an injection or allowed to take radioactive iodine, the next day, a scan of the gland is performed using a special sensor. Since iodine is the main component of thyroid hormones, it will therefore be localized in the nodes that produce it in excess.

Treatment of hyperthyroidism of the thyroid gland

Hyperthyroidism is treated using three methods:

conservative, medicinal method,
treatment with radioactive iodine,
surgical intervention.

The choice of treatment method depends on many factors: the age of the patient, concomitant diseases, the cause of occurrence, the amount of hormone produced and others. IN in some cases it is possible to combine types of treatment.

For mild hyperthyroidism, antithyroid drugs are prescribed. If a patient has nodes in the thyroid gland that produce excess amounts of thyroid hormone, the endocrinologist prescribes radioactive iodine.

It should be especially noted that radioactive iodine is not prescribed in the following cases:

patient under 20 years of age,
pregnant and nursing mothers,
with thyroiditis or other transient forms of hyperthyroidism.

During and after treatment, the patient must regularly undergo blood tests to monitor the level of thyroid-stimulating hormone (TSH), thyroid hormones T3, T4. These studies will help determine the effectiveness of the treatment.

If the use of antithyroid drugs and radioactive iodine does not produce significant results, surgical intervention is used - surgery- removal of part or all of the thyroid gland (thyroidectomy).

After treatment with radioactive iodine, patients often develop hypothyroidism, when there is little thyroid hormone. In this case, another treatment is prescribed that contains thyroid hormones and iodine (for example, iodomarin). It should be remembered that iodomarin is contraindicated for hyperthyroidism, like many other drugs containing iodine.

If hyperthyroidism of the thyroid gland is not treated or treated inadequately, a serious complication may occur - a thyrotoxic crisis, in which all the symptoms of thyrotoxicosis sharply worsen.

There are other methods of treatment: hydrotherapy, dietary nutrition, treatment folk remedies, acupuncture, etc. But it should be remembered that any treatment method must be carried out under the supervision of an endocrinologist.

Hyperthyroidism, its treatment and necessary medications This is a fairly broad topic that is dealt with by endocrinologists. The complexity of this syndrome is due to the fact that disruption of the levels of the hormones T4-thyroxine, T3-triiodothyronine and TSH, the thyroid-stimulating hormone secreted by the pituitary gland, leads to very dangerous consequences.

Drugs for the treatment of hyperthyroidism are prescribed only after diagnosis accurate diagnosis and assessing the severity of consequences hormonal imbalance. In addition, therapy includes a number of other activities. From therapeutic diet, before surgical intervention. In this regard, it is necessary to become familiar with all aspects of thyrotoxicosis.

With hyperthyroidism, a person develops quite recognizable manifestations:

First of all, the signs of thyrotoxicosis are reflected in the human psyche. He becomes overly emotional and irritable. Sleep disturbances lead to sudden mood swings; activity can suddenly give way to deep apathy and vice versa.
A person gets tired quickly due to a malfunction of the thyroid gland.
The patient experiences an increase in appetite and is rapidly losing weight.
The patient does not tolerate changes in air temperature well. Especially the heat. His sweating increases, his hands and whole body begin to tremble slightly.
The patient's heart begins to beat at double the rate.
Blood pressure rises.
There is a disturbance in the gastrointestinal tract, manifested by diarrhea.
In women, the cyclicity of menstruation is disrupted, up to their complete disappearance.
In men it occurs impotence, teaches sexual desire and erection.
Against the background of thyroid disease, a person may develop diabetes mellitus.
Signs of thyrotoxicosis are reflected in appearance person, namely before his eyes. They protrude from the eye sockets, the sclera turns red, the eyes themselves constantly water, and the clarity of vision is impaired.
Hair and nails become thinner and brittle.

The variety of symptoms is explained by the fact that the hormones T3, T4 and TSH are involved in almost all processes of the body and, naturally, a violation of their levels affects the most different systems and human organs.

Causes of hyperthyroidism

There are several reasons for the occurrence of thyrotoxicosis:

First, elevated T3 and T4 can result from thyroid disease. Namely, the occurrence of diffuse toxic goiter, toxic multinodular goiter, and thyroid adenoma.
Secondly, thyroid cells may begin to break down, releasing accumulated hormones. The cells are called thyrocytes and the condition is thyroiditis. It can be chronic, autoimmune, when antibodies begin to attack cells own body and postpartum.
Thirdly, the cause of thyrotoxicosis may be a tumor of the pituitary gland that secretes TSH. At the same time, its secretion decreases, which leads to an increase in T3 and T4.
Fourthly, the result of a malfunction of the thyroid gland may be an overdose of a number of medical supplies, for example containing iodine or reducing heart rate. That is why such medications are taken only as prescribed by a doctor.

Diagnosis of hyperthyroidism

After the first signs of the disease appear, the patient is sent to a series of diagnostic measures, in order to clarify the diagnosis and establish the severity of the pathology. There are three degrees of severity:

In the subclinical form, T3 levels, etc.; remain normal, while TSH is slightly reduced. This is the mildest form of pathology.
In the manifest form of the disease, there is a violation of T3 levels. T4 and TSH. This form considered to be of moderate severity.
Thyrotoxicosis is already a severe form, it clearly has severe symptoms, including Basedow's disease and diffuse goiter.

Abnormalities in hormone levels are detected by blood tests. During this procedure, not only the amount of hormones in the blood is determined, but also the presence of antibodies to TSH receptors.

An instrumental method for examining the thyroid gland is also used. Its complex includes ultrasound equipment, a tomograph, and in some cases, biopsy samples are examined.

Treatment of the disease

Treatment for thyroid hormone disorders depends on the severity of the pathology. As a rule, it is very long, up to several years, and includes a variety of techniques.

Medication method

Various medications are used for this disease. What they all have in common is the dosage method - at the very beginning of therapy, it is maximum, and towards the end of treatment it decreases to a minimum.

During this treatment, the patient takes hormone replacement drugs to restore the functions of internal organs and systems.

If therapy is carried out using medicinal methods, then the drugs are prescribed by an endocrinologist. He also calculates the dosage and dosage regimen individually for each individual patient. Tablets and medications are used depending on the situation:

Anaprilin. Available in tablets, it is indicated for coronary heart disease, thyrotoxicosis, liver cirrhosis, and in the postpartum period. The drug is not recommended for use in diabetes mellitus or with kidney disease. This medicine, can cause dizziness, spasms respiratory tract, general weakness or heart failure. Prescribed by a doctor.
Mercazolil. The drug has an antithyroid effect, iodizes thyroid hormones of the thyroid gland. Prescribed for diffuse toxic goiter, thyrotoxic crisis, and also used together with radioactive goiter preparations. It is used for the treatment of both children and adults; the dosage of the drug is prescribed on an individual basis. TO side effects include such conditions as disruption of the gastrointestinal tract, liver, central nervous system - causes severe headache. Not recommended for use by pregnant women and breastfeeding mothers.
Microiod. The drug has a beneficial effect on human metabolism, reduces thyroid hormones, has sedative effect, restores normal sleep. The drug cannot be used for tuberculosis, kidney diseases, neuroses, furunculosis, acne, urticaria and during pregnancy. To avoid overdose, the drug is prescribed by a doctor.
Propycyl. Has a reducing effect on active forms iodine, which blocks the peroxidase system. Used for diffuse and toxic goiter. Side effects include itching, paresthesia, alopecia, anorexia, nausea, and vomiting. Overdose can lead to hypothyroidism. Therapy with this drug is not recommended during pregnancy and lactation.
Timrozol. By using this drug Violation of thyroid hormone levels is treated. Excess iodine is removed from the thyroid gland. Due to slow absorption, the medicine is taken once every 24 hours or even less often. Contraindicated for liver disease. During pregnancy, the drug is allowed to be taken, but in extremely small doses.

Surgical method of treatment

Involves removing part of the thyroid gland. In a particularly severe form of the disease, the organ can be completely removed. After the operation, the patient undergoes a rehabilitation period and takes hormone replacement medications throughout his life.

Special diet

The patient's diet is determined by a nutritionist. It includes sea fish, shellfish, shrimp, seaweed. Fruits: persimmons, apples, blueberries. Milk and cheese without spices are very healthy. You can eat pasta, beans, rice, buckwheat, millet, chicken eggs. All these products contain natural iodine, which normalizes the functioning of the thyroid gland. Fatty fried meats should be excluded from the patient's diet. Black coffee and tea are prohibited. You should absolutely not drink alcohol.

Phytotherapy

Normalization of the thyroid gland can occur as a result of treatment with infusions and decoctions of various herbs. This method therapy cannot be considered as the main one, it is used more as a preventive measure. The herbs used in this method of treatment are valerian officinalis, jaundice herb, lemon balm, wormwood, rowan, strawberry, plantain, yarrow, sage and others. If you choose a herbal treatment method, you still need to consult a doctor before doing so.

Disease prevention

In order not to encounter thyroid diseases, it is necessary to follow a number of preventive recommendations:

Maintaining an active lifestyle. It is extremely important to regularly engage in any sport, and it is not the time and intensity of training that plays a role, but regularity. That is, you can simply take a walk or jog every day.
Proper nutrition. You need to eat more fresh fruits and vegetables. At the same time, you cannot refuse meat food, the main thing is that the meat is boiled and not fried. All lovers of mono-diet, vegetarians and fruitarians and raw foodists, are at risk, since with such a diet, the body will not receive enough animal proteins and fats.
Visit to an endocrinologist. To prevent thyroid diseases, you need to check your thyroid gland at least 2 times a year and donate blood for analysis of T3, T4, TSH and antibodies to TSH. Also, if symptoms of the disease appear, you should immediately contact a specialist. In this case, the treatment will be easy and quick.
You need to dress appropriately for the weather, protect your body from hypothermia, overheating, and especially from excessive exposure to the sun.

Pathology cannot be left without treatment. Once every six months you should visit a sanatorium with an emphasis on cardiovascular diseases.

This gland is responsible for the secretion of thyroid hormones, which contain iodine atoms. As you know, iodine is an essential element in the body and takes part in various processes related to metabolism, thermoregulation, blood circulation and others. As a rule, hyperthyroidism affects more women than men (8:1). If the function of the thyroid gland is impaired, patients experience regression of the reproductive process up to infertility.

The thyroid gland and its main function

The thyroid gland is the most large gland body and is located on the front lower part of the larynx. It consists of two lobes and a narrow ligament - the isthmus. The thyroid gland is formed in the body in 3-5 weeks intrauterine development and initially serves to process hormones coming from the mother. Starting from week 10, the thyroid gland produces its own hormones. The regulation of thyroid hormone production is under the control of the hypothalamic-pituitary system. It produces thyroid-stimulating hormone from the pituitary gland, which stimulates the secretion of T3 and T4.

The main function of the thyroid gland is to produce thyroid hormones, which include T3 and T4. These are biologically active compounds that the body needs to regulate many processes. In addition to those described above, hormones contribute normal operation central nervous system and affect mental well-being.

When the function of the thyroid gland is impaired, patients develop diseases such as hypothyroidism and hyperthyroidism. The symptoms of these diseases differ from each other due to the etymology of origin. Diseases of the thyroid gland, hyperthyroidism in particular, this moment is a practically studied area in medicine because statistically this syndrome more than 70% of the population is exposed. Hypothyroidism and hyperthyroidism can be either independent diseases or acquired. Let's look at hyperthyroidism: symptoms, treatment, prognosis and other important points that the patient should know.

There are special resources to study hyperthyroidism in more detail, the forum of which is filled various reviews, complaints and advice on the treatment of this disease.

Stages of hyperthyroidism

Hyperthyroidism (thyrotoxicosis) has several stages of disease development depending on the degree of organ damage.

There are:

Primary or subclinical hyperthyroidism is most often asymptomatic and is caused only by disorders of the thyroid gland;
Secondary or overt hyperthyroidism is caused by dysfunction of the pituitary gland and is most often observed clinical picture, T3 and T4 codes are normal, but TSH is low;
Tertiary hyperthyroidism is associated with dysfunction of the pituitary gland.

TSH in subclinical hyperthyroidism will be elevated, and T3 and T4 will be within normal limits.

Thyroid hyperthyroidism: symptoms

Thyroid hyperthyroidism has confusing clinical symptoms, so it is often very difficult to make a correct diagnosis at an early stage of the disease. Patients most often experience the following symptoms:

Gradual weight loss with good appetite;
Tachycardia;
In the first stages, periodic mild tremor (trembling) of the limbs is observed. At the last stage, the tremor intensifies and occurs throughout the body;
Warm moist skin;
Increased sweating;
Muscle weakness;
Frequent urination and diarrhea;
Mental disorders, severe tolerance stressful situations;
Sharp cheerfulness, followed by prolonged fatigue;
Increased mental abilities;
Irritability, tearfulness;
Brittle nails and hair loss due to hyperthyroidism.

For more late stages signs of hyperthyroidism in patients are observed due to dysfunction of internal organ systems.

In women, the menstrual cycle is disrupted until amenorrhea occurs, constant pain mammary glands;
In men, potency gradually disappears and sexual desire decreases;
Liver function is impaired, which can develop into hepatitis;
Adrenal insufficiency;
Violations of cardio-vascular system up to heart failure.

Hyperthyroidism: causes

Hyperthyroidism can be congenital or acquired. Congenital hyperthyroidism occurs as a result of the fact that a woman suffered from this disease during pregnancy or it can be a hereditary factor.

Hyperthyroidism occurs as a result of a number of diseases related to the thyroid gland. The main cause is an autoimmune reaction to the follicles of the gland. This reaction is provoked by the following diseases: diffuse toxic goiter or Graves' disease, multinodular goiter and autoimmune thyroiditis. There have been cases when hypothyroidism of the thyroid gland was diagnosed against the background of a pituitary adenoma. Since the pituitary gland produces TSH hormone, then when a tumor occurs, secretion increases, which leads to an increase in the production of T3 and T4.

Diffuse toxic goiter

DTZ or Graves' disease is an autoimmune disease that is characterized by an enlargement of the thyroid gland, due to which the production of thyroid hormones increases. Feature This disease is the appearance of ophthalmopathy (bulging eyes). The cause is a disorder of the immune system when antibodies begin to attack the cells of the thyroid gland, which leads to its enlargement. The result is thyrotoxicosis (hyperthyroidism) as a consequence of an enlarged thyroid gland.

Multinodular goiter

This disease is caused by the formation of so-called nodes in the structure of the thyroid gland. The nodes begin to produce hormones in unlimited quantities, which leads to hyperthyroidism. As a rule, secondary hyperthyroidism caused by this disease is subject to diagnosis.

Autoimmune thyroiditis

With this disease, the structure of the thyroid gland is destroyed, but the formation of autoimmune antibodies can develop in parallel, as in Graves' disease. Since antibodies in this case still tend to destroy the thyroid gland, after its increase, it decreases. With this disease, hyperthyroidism in men is a temporary disease and develops while the gland is enlarged. Autoimmune thyroiditis can combine hypo and hyperthyroidism.

Hyperthyroidism and pregnancy

During pregnancy, thyroid secretion increases significantly, leading to hyperthyroidism. In most cases, it is not a threat and disappears over time, mainly after childbirth. But more than once there have been cases when hyperthyroidism in pregnant women with various external and internal factors developed into clinical disease requiring treatment. It is important that autoimmune hyperthyroidism does not begin to develop during pregnancy, because in this situation the woman is significantly limited in the choice of treatment method.

Drug-induced hyperthyroidism

Drug-induced hyperthyroidism occurs as a result of taking hormonal drugs, which stimulate the pituitary gland or thyroid gland.

There have even been cases where hyperthyroidism was observed in dogs and other animals. This made it possible to study this disease comprehensively and find best practices to cure hyperthyroidism. Clinic in in this case provides everything modern methods suppression of the disease.

Hyperthyroidism: diagnosis

If you experience hyperthyroidism of the thyroid gland, the symptoms of which appear from the above, you should consult an endocrinologist. Often, patients initially turn to a therapist, cardiologist, urologist and other specialists, which leads to a worsening of the disease. The endocrinologist will externally examine the thyroid gland, palpate it, arrange a detailed survey regarding the symptoms, when the first symptoms were noticed, how long they lasted, and so on. He then orders a series of tests for hyperthyroidism. The following analyzes are carried out:

Blood test for the level of thyroid hormones in the blood and TSH;
Mandatory ultrasound to examine the thyroid gland;
If necessary, an ECG is performed;
Complete history of previous treatment (if it is not primary hyperthyroidism).

Hyperthyroidism: treatment

Treatment of thyroid hyperthyroidism involves several methods depending on the stage of the disease. There are:

Drug treatment;
Surgical treatment;
Treatment with radioactive iodine.

In addition to the above methods, doctors often advise using traditional medicine. Treatment of hyperthyroidism with folk remedies, of course, will not completely get rid of the disease, but will contribute to more quick recovery. It is also worth remembering that a specific diet for hyperthyroidism is as important as the main treatment. It includes various products cabbage genus (white cabbage, Chinese cabbage, horseradish, radish, and others), exclude all seafood from the diet, except of river origin. This fish does not contain iodine. In general, nutrition for hyperthyroidism should be discussed with your doctor.

Drug treatment involves taking hormonal drugs that suppress the secretion of the thyroid gland. It is used only at the early stage of the disease, when the disease has not progressed to other forms. Typically, drugs are prescribed for hyperthyroidism that contain beta-bolcateurs, antithyroid bodies, and anabolic hormones.

Surgical treatment is required in cases where hyperthyroidism is caused by autoimmune diseases. In this case, either the entire gland or one of its parts is removed, depending on the degree of damage.

Radioactive iodine is used for hyperthyroidism. Used capsules or in the form of an aqueous solution. It gradually destroys damaged thyroid cells that secrete excess hormones. For hyperthyroidism, one capsule is used, which is enough to suppress all neoplasms.

Folk remedies for hyperthyroidism use the following: infusions of rose hips, hawthorn, white cinquefoil. They are mainly aimed at maintaining the body and stimulating it with additional nutrients. + vitamins for hyperthyroidism are mainly consumed from food and teas like this.

It is important to understand that hyperthyroidism is a chronic disease and there is no cure. Symptoms are healed, inflammation is relieved, but relapse is always possible. Therefore, after successful treatment, it is necessary to maintain proper nutrition for hyperthyroidism of the thyroid gland, visit an endocrinologist in a timely manner, and not overdo it physical activity. To explore in more detail various diets and traditional medicine, which are resolved for the disease hyperthyroidism, reviews can be read. Patients who have survived this disease sometimes recommend useful recipes.

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Hyperthyroidism is a complex of symptoms that are caused by increased secretion and an inadequately high degree of release of thyroid hormones into the blood. A similar condition has another name – thyrotoxicosis. Literally, the name of this pathology speaks of poisoning. In the presence of hyperthyroidism, the symptoms are nothing more than a reflection of the body’s reaction to such poisoning, namely, an excess of thyroid hormone in the patient’s blood.

Against the background of oversaturation of the blood with hormones produced by the thyroid gland, the body experiences qualitative change and acceleration of all metabolic processes. Such a sharp intensification of all types of metabolism has long been characterized in medicine as a “metabolic fire.” There are often cases when the symptoms of the disease are also accompanied by damage to the adrenal glands, which leads to changes in the body’s adaptation to stress and disorders of general metabolism.

What it is?

Hyperthyroidism is clinical condition, which is characterized by increased activity of the thyroid gland in the production of the hormones T3 (thyroxine) and T4 (triiodothyronine). These substances enter all tissues of the body and greatly accelerate metabolic processes in them. An imbalance of hormones in hyperthyroidism negatively affects the patient’s condition and can lead to disturbances in energy and heat metabolism, as well as damage to the adrenal glands.

The role of the thyroid gland in the body

The thyroid gland is the largest gland in human body, located in the anterior lower region of the larynx. Endocrine organ responsible for the synthesis of thyroid hormones containing iodine atoms. Iodine is extremely necessary for the body of every person, since this substance is directly involved in the regulation of metabolic processes, thermoregulation, and affects the nervous system and psyche.

The synthesis and release of thyroid hormones occurs in the follicles of the organ in several stages. First, iodine enters the body along with food, which enters the blood in inorganic form. Thyroid cells take it up and convert it into organic iodine. After oxidation, iodine molecules attach to the non-essential amino acid tyrosine, forming compounds such as monoiodotyrosine and diiodotyrosine. Then condensation occurs and the formation of the hormones T3 and T4, which are released into the bloodstream. Blood oversaturated with hormones carries these substances to all tissues of the body, which leads to an acceleration of metabolic processes in almost all human organs.

In addition, with hyperthyroidism, hormonal changes develop due to the conversion of androgens (male sex hormones) into estrogens (female sex hormones) and the accumulation of the latter in the blood. The sensitivity of tissues to the effects of the sympathetic nervous system noticeably increases. The hypothalamus and pituitary gland take the main part in the regulation of thyroid function.

Causes

Among the most common reasons, contributing to the development of this disease can be considered:

Graves' disease or diffuse toxic goiter is considered to be the main cause of this disease. It is toxic goiter that contributes to the development of hyperthyroidism in eighty percent of cases. Usually, this pathology occurs in women. Basedow's disease is considered to be an autoimmune pathology, and all because with the development of this disease the immune system a person begins to synthesize special antibodies, which in turn help strengthen the functioning of the thyroid gland. Most often, patients with toxic goiter also experience some other autoimmune pathologies such as gastritis, autoimmune hepatitis or glomerulonephritis. Obvious signs of Graves' disease include symptoms of hyperthyroidism and goiter.
Thyroiditis. With the development of this pathology, inflammation is observed in the thyroid gland. In most cases, thyroiditis occurs against the background of viral infectious diseases.
Taking excessive amounts of thyroid hormones in the form of certain pharmaceuticals.
Thyroid adenoma or nodular goiter, in which there is increased functioning of a particular area of thyroid tissue. In medicine, these areas are called “hot spots.”

In most cases, this disease is observed in representatives of the weaker half of humanity. If you believe statistical data, in women this pathology is observed in seventeen to twenty cases out of a thousand, but in men only in two cases out of a thousand. More often this disease The working population aged from twenty to fifty years is exposed.

Classification

Classification regarding the level of changes distinguishes thyrotoxicosis (another name for the disease):

Primary, that is, one that arose as a result of changes in the thyroid gland itself;
Secondary, arising due to disturbances in the structures of the pituitary gland;
Tertiary, resulting from pathological changes in the hypothalamus.

There is also a division of hyperthyroidism into several forms:

Manifest or in other words - explicit. There are characteristic symptoms of the disease. There is an increased amount of triiodothyronine, as well as a decrease in TSH levels;
Subclinical. It is implied that explicit clinical signs there is no disease, but the amount of TSH is reduced, and the concentration of T4 is normal;
Complicated. A form in which problems with the cardiovascular system may also occur in the form of atrial fibrillation, failure of the heart muscle. Renal dysfunction will be present ( renal failure), dystrophy of organs, mainly consisting of parenchyma, deviations from the nervous system (psychosis). Body weight will noticeably decrease.

Hyperthyroidism symptoms

In women, the symptoms of hyperthyroidism are caused by the acceleration of all processes in the body and are manifested by increased work of human systems and organs. The manifestation of symptoms of hyperthyroidism depends on the severity and duration of the disease, as well as on the degree of damage to organs, systems or tissues.

Excess hormones produced by the thyroid gland affect the human body in the following ways:

The cardiovascular system. Heart rhythm disturbances - difficult to treat and persistent sinus tachycardia, atrial fibrillation and flutter. Increasing the gap between the upper and lower pressure readings due to an increase in systolic and a simultaneous decrease in diastolic blood pressure. Increased heart rate, increased volumetric and linear velocity of blood circulation. Heart failure.
Central nervous system. Increased excitability, emotional instability, irritability, causeless anxiety, fear, rapid speech, sleep disturbances, hand tremors.
Gastrointestinal tract. Increase or decrease in appetite, in elderly patients - to complete refusal of food. Digestion and bile formation disorders, paroxysmal abdominal pain, frequent loose stools.
Ophthalmology. Ophthalmological symptoms consist of the previously noted manifestation, which is exophthalmos (in which eyeball undergoes protrusion when it is displaced forward and with a simultaneous increase in the palpebral fissure). In addition, swelling of the eyelids, double vision of objects in the field of vision and rare blinking are noted. It should be emphasized that due to the characteristic compression in this case, against the background of which dystrophy also develops optic nerve, the possibility of absolute loss of vision by the patient cannot be ruled out. Also among the current ophthalmological symptoms can be identified severe dry eyes and pain in the eyes, increased tearing, the development of corneal erosion, bags under the eyes, the inability to concentrate on a specific object, etc.
Respiratory system. Vital capacity lungs decrease as a result stagnation and edema, persistent shortness of breath develops.
Musculoskeletal system. Thyrotoxic myopathy develops, in which the characteristic symptoms become chronic weakness and muscle fatigue, muscle wasting (muscle condition caused by insufficient intake nutrients into the body or insufficient absorption). There is also trembling of the limbs and the body as a whole, osteoporosis (a chronic progressive disease or clinical syndrome(in this case), characterized by a decrease in the inherent density of bones with a simultaneous violation of microarchitecture and with increased fragility, which is relevant due to a number of damaging processes). Against the background of the listed symptoms, difficulties arise that are noted during long walking (especially when climbing stairs), as well as when carrying heavy objects. The possibility of developing muscle paralysis, which in this case is reversible, cannot be ruled out.
Metabolism. Acceleration of metabolism - weight loss, despite increased appetite, development of thyroid diabetes, increased heat production (fever, sweating). As a result of the accelerated breakdown of cortisol, adrenal insufficiency occurs. Liver enlargement, with severe cases hyperthyroidism - jaundice. Extreme thirst, frequent and copious urination (polyuria) due to impaired water metabolism. Thinning of skin, hair, nails, early gray hair, swelling of soft tissues.
Reproductive system. Characteristic changes are also observed in this area. Thus, against the background of disturbances in the secretion of gonadotropins, infertility may develop. As described earlier, men may develop gynecomastia and potency decreases. As for the impact on the female body of processes relevant to the disease, here, in particular, disruptions of the menstrual cycle are noted. The manifestation of menstruation is characterized by pain and irregularity, the discharge is meager character, as accompanying signs – severe weakness(which can reach fainting), severe headaches. In extreme cases, disruptions in the menstrual cycle reach amenorrhea, that is, complete absence menses.

Symptoms of hyperthyroidism, if present, may be absent in older people - the so-called masked or latent hyperthyroidism. Frequent depression, lethargy, drowsiness, and weakness are a typical reaction of the body of older people to excess thyroid hormones. Disruption of cardio-vascular system in elderly people with hyperthyroidism it is observed much more often than in young people.

Thyrotoxic (hyperthyroid) crisis

This complication manifests itself as a result of the lack of treatment for thyrotoxicosis or when treatment is prescribed that is not appropriate in reality. necessary measures. A crisis can also be triggered by mechanical manipulations performed during examination of a patient or during surgery that in one way or another affects the thyroid gland. The possibility of a crisis developing due to stress cannot be ruled out.

In general, a hyperthyroid crisis manifests itself by reaching a peak with symptoms characteristic of hyperthyroidism. It begins acutely and its course is lightning fast. Patients experience severe mental agitation, and it is often accompanied by hallucinations and delusions. The trembling of the hands intensifies, in addition, the trembling spreads to lower limbs and throughout the body as a whole. Falls sharply arterial pressure, muscle weakness appears with general lethargy of the patient. Vomiting manifests itself in an indomitable form, accompanied by elevated temperature (signs indicating the relevance of the infection are absent in this case), diarrhea, and rapid heartbeat (reaching 200 beats per minute). When you urinate, you can detect the characteristic acetone odor in your urine. Temperature (up to 41 degrees) and pressure rise.
In some cases, jaundice develops as a result acute form fatty degeneration, which is relevant for the liver, adrenal insufficiency can also develop.

It is important to note that the lack of provision timely assistance can cause the death of the patient due to the transition of the crisis to a coma. Death can occur as a result of an acute form of fatty liver disease or due to adrenal insufficiency.

Complications

In the absence of treatment or severe course thyrotoxicosis there is a risk of complications. Most often this is a thyrotoxic crisis; as a rule, a crisis occurs with severe concomitant diseases or untreated Graves' disease. During a thyrotoxic crisis, the signs of hyperthyroidism sharply intensify, symptoms worsen, and disturbances in the functioning of other organs rapidly develop. More often, the complication occurs in women; in 70% of cases, the crisis develops in an acute, severe form.

Diagnostics

Hyperthyroidism is diagnosed by external manifestations, are based on data from laboratory and instrumental studies.

Basic methods:

Laboratory blood tests to determine TSH level, T3, T4 and antibodies.
The ECG graphically records minimal deviations in heart rate caused by high blood pressure due to hyperthyroidism.
Ultrasound examination and CT scan The thyroid glands help determine the location, number and size of nodes, as well as the presence of inflammatory infiltration.
A biopsy of the nodular formation makes it possible to conduct a histological examination.
Scintiography of the thyroid gland allows one to determine its activity using radioisotopes.
Ophthalmological tests and ophthalmoscopy to check vision.

Signs of hyperthyroidism such as characteristic change appearance and a number of complaints give rise to an in-depth examination of the patient.

Treatment of hyperthyroidism

In women, treatment of hyperthyroidism involves first of all reducing the efficiency of the thyroid gland to required norm. In this case apply pharmaceuticals, which tend to block the production of thyroid hormones. In some cases, surgery is also performed, during which surgeons remove one of the parts of this organ.

The dosage and course of taking medications is prescribed individually.

Beta-blocker drugs - Betaxolol, Anaprilin, Bisoprolol, Nibivolol, Atenolol, Talinolol, Metoprolol, Egilok, Egis, Corvitol, etc. The drugs themselves have no effect on the development of hyperthyroidism, their prescription is due to the effect of weakening symptoms - they reduce signs of tachycardia and pain manifestations in the heart, gently normalize blood pressure and arrhythmic conditions.
With a slight increase in the thyroid gland, drugs that suppress hormonal synthesis are prescribed - “Tyrozol”, “Tiamazol”, “Metizol”, “Mercazolil”, “Carbimazol” or “Propylthiouracil”. It is an overdose of these drugs that can lead to the opposite effect.
Absolutely essential appointment sedatives- “Valoserdin”, “Persen” or “Novo-passit”. This will help normalize sleep, alleviate nervousness and prevent psychological breakdowns.
The drug "Endonorm" is prescribed to maintain the functions of the gland in the initial period of the disease.
In case of exhaustion, accompanied by intoxication symptoms and diarrhea, anabolic drugs - Methandriol or Methandienone - may be recommended.
In case of autoimmune genesis (with ophthalmopathy and adrenal insufficiency syndrome) of hyperthyroidism, glucocorticoid drugs are prescribed - Prednisolone or Dexamethasone.

When treating hyperthyroidism in women, the factor of a nervous system that is more labile than in men is taken into account. Additionally, hypnotics, axiolytics, which reduce emotionality, and tranquilizers are prescribed.

Radioactive iodine

Treatment with radioactive iodine (radiiodine therapy) involves the patient being prescribed radioactive iodine in an aqueous solution or capsule. After the substance enters the thyroid cells, collects there and begins to act, this leads to their destruction. As a result, the thyroid gland becomes smaller in size, the composition and secretion of hormones in the blood decreases.

Radioiodine therapy is carried out together with drug treatment. Final recovery does not occur in patients; hyperthyroidism remains, but is not very pronounced, so there is a need for a second course of treatment. In most cases, after radioiodine therapy, hypothyroidism is observed for a month or years, so therapy is carried out in which the patient takes thyroid hormones for life.

Operation

In order to make a decision to carry out surgical operation, the patient is offered different types treatment, and it is also necessary to determine the volume and type of surgery, if intervention is required.

The need for surgery is not indicated for all patients and it consists of partial removal of the thyroid gland. Surgery is needed for patients in whom a single nodule or an enlarged area of the thyroid gland has increased secretion. After surgery, the remainder of the thyroid gland will function normally.

Unlike the United States, in Russia surgical treatment of hyperthyroidism is used quite widely. Operations are indicated, in particular, due to oncological alertness in patients with nodular or diffuse toxic goiter, as well as in the case of diffuse toxic goiter that has not been cured with antithyroid products within 4-6 months. Frequency malignant neoplasms The thyroid gland has increased significantly since the Chernobyl disaster: tumors are found in 8-10% of patients who have undergone surgery on the thyroid gland.

Folk remedies

Herbal treatment of hyperthyroidism is possible, but only in consultation with a doctor and as an additional remedy to the main conservative therapy.

Medicinal herbs are mixed. For mild forms of hyperthyroidism, 1 tablespoon of the mixture is brewed in an enamel bowl with 200 grams hot water(600) and infused for 2 hours, after which it is filtered and taken in three equal doses 10 minutes before meals. At severe forms An infusion of the mixture of 3 tablespoons is recommended.

For these purposes, you can prepare an infusion of herbs:

common wormwood, or Chernobyl, used for nervous disorders as a sedative - 2 tablespoons;
rhizome of the evasive peony, or Maryin root, which calms the nervous system, reduces headaches and also has an anti-inflammatory effect - 1 tablespoon;
European grasshopper, which has an anti-inflammatory effect and a pronounced sedative effect, superior to motherwort and valerian root - 3 tablespoons;
crushed burdock root, which is intended to reduce intoxication - 1 tablespoon;
curly thistle; it has a mild sedative and anti-inflammatory effect - 2 tablespoons.

However, you should always remember that in the presence of hyperthyroidism, treatment with folk remedies is aimed only at normalizing (to some extent) the function of the nervous system and improving sleep, but not at treating the disease itself. The use of medicinal plants is possible only after the recommendations of an endocrinologist!

Prevention

To prevent hyperthyroidism, you should undergo regular examinations with an endocrinologist. Hardening has a beneficial effect on strengthening the thyroid gland. The diet should be rich in vitamins and minerals. Iodine intake should be reasonably controlled, and the consumption of iodine-containing products should be balanced.

Should be taken in moderation and sunbathing, sunbathe, visit the solarium. Often, myths about the usefulness of certain procedures and products lead to disturbances in the functioning of the thyroid gland, which have serious consequences.