HYPERTHYROIDISM

This is a disease characterised by an overactive thyroid gland which produces excessive amounts of the thyroid hormone. The thyroid gland is situated in front of the neck. [1] The thyroid hormone controls the body’s metabolism, heart rate, the body’s temperature, nervous system and your breathing, which may lead to unintentional weight loss, anxiety, tremors, sweating, sleep disturbances or an irregular heartbeat. [1; 2] This is because the thyroid is overactive and is producing an  excessive amount of its hormone. [2]


RISK FACTORS [2]

  • A family history of a first-degree family member who had hyperthyroidism, specifically Graves’ disease would increase your risk.

  • A higher risk has been seen in females.

  • A history of chronic illnesses such as type 1 diabetes, pernicious anaemia, primary adrenal insufficiency may increase your risk.

 

CAUSES [4]

  • Graves disease is seen to be a cause of hyperthyroidism as it is an autoimmune disorder that causes excessive secretion of the thyroid hormone.

  • Excessive iodine as iodine controls the regulation of the thyroid hormone.

  • Inflammation of the thyroid may cause leakage of the thyroid hormone out of the thyroid gland.

  • Having a benign tumour in your thyroid or in your pituitary gland.

  • Having tumours in the testes or in the ovaries can cause hyperthyroidism.

  • Large amount of the thyroid hormone which is consumed through diet supplements or medication may cause hyperthyroidism.

 

SIGNS AND SYMPTOMS [3]

  • Experiencing mood swings.

  • Having intolerance to heat.

  • Nervousness, irritability and being anxious.

  • Large thyroid gland that makes your neck seem swollen (goitre).

  • Unintentional weight loss.

  • Palpitation or irregular heartbeat.

  • Sleep disturbances.

  • Menstrual cycle changes.

  • Rate of bowel movements increased.

  • Tremor in hands and/or fingers.

  • Having fine and/or brittle hair.

  • Thinning of skin.

  • Finding it difficult in doing everyday activities as you feel tired and/or weak.

 

COMPLICATIONS [2]

  • Heart complications may occur as hyperthyroidism can cause an increase in the heart rate, dysrhythmia such as atrial fibrillation that may increase your risk of getting a stroke or congestive heart failure.

  • Hyperthyroidism can lead to osteoporosis and excessive thyroid hormone can interfere with the process of calcium being incorporated into your bones.

  • Eye problems such as sensitivity to light, blurry or double vision, bulging or swollen or red eyes.

  • May develop red and swollen skin.

  • Hyperthyroidism may put you at risk of developing thyrotoxic crisis which can lead to a rapid pulse, fever and/or delirium. This requires immediate medical attention.

TREATMENT OPTIONS [2]

  • Radioactive iodine: reduces thyroid activity and causes the thyroid gland to shrink.

  • Anti-thyroid medications such as propylthiouracil or methimazole, prevent excess production of the thyroid hormone and thus reduce the symptoms gradually.

  • Beta blockers can ease symptoms such as palpitations, rapid heart rate and tremors.

  • Surgery: Removal of the thyroid gland may be necessary which shall be discussed with you by your doctor.

 

DIETARY TIPS [4]

  • Foods that are recommended to be consumed when you have hyperthyroidism.

    • Low iodine foods such as teas (without milk or dairy/soy creamers), egg whites, non-iodised salt, oats, fresh fruit, potatoes or honey.

    • Vegetables such as broccoli, cassava, brussels sprouts, kale, collard greens or cauliflower.

    • Iron containing foods such as dried beans, lentils, green leafy vegetables, nuts(unsalted), poultry or whole grains.

    • Foods containing selenium such as couscous, mushrooms, chia seeds, poultry and red meats.

    • Foods containing zinc such as chickpeas, coco powder, cashews(unsalted), mushroom seeds or pumpkin seeds.

    • Foods that contain calcium and vitamin D such as Spinach, okra, white beans, calcium and vitamin D fortified orange juice or cereals, beef liver, fatty fish or mushrooms.

    • Healthy fats such as olive oil, avocado oil, flaxseed oil, avocado, unsalted seeds and nuts.

    • Spices which have been seen to have anti-inflammatory properties such as turmeric, green chillies and black pepper.

  • Foods to avoid.

    • Food with excessive iodine such as seafoods, milk and other dairy, egg yolks, iodised salt and water or food colourings.

    • Supplements and medication that contain iodine such as cough syrups, amiodarone, medical contrast dyes, herbal or vitamin supplements.

    • Nitrate containing foods such as celery, lettuce, beetroots, parsley, leeks, processed meats (bacon salami, sausages, etc.), cucumber, pumpkin or turnip.

    • Gluten containing foods such as wheat, rye or barley.

    • Soya based foods.

    • Caffeine containing foods can make your hyperthyroid symptoms worsen.

  • Speak to a dietician before you attempt to change your dietary intake.

REFERENCES

  1. Aleppo G [Internet]. Hyperthyroidism overview. New Jersey: endocribe web; {updated 2019 Jul 10; cited 2019 Aug 12]. Available from: https://www.endocrineweb.com/conditions/hyperthyroidism/hyperthyroidism-overview-overactive-thyroid.

  2. Mayo Clinic Staff [Internet]. Hyperthyroidism (Overactive thyroid). America: Mayo Clinic; [updated 2018 Nov 03; cited 2019 Aug 13]. Available from: https://www.mayoclinic.org/diseases-conditions/hyperthyroidism/symptoms-causes/syc-20373659.

  3. WebMD [Internet]. What is Hyperthyroidism? What are the symptoms?. America: WebMD LLC; [updated 2019 May 09; cited 2019 Aug 13]. Available from: https://www.webmd.com/a-to-z-guides/overactive-thyroid-hyperthyroidism.

  4. Healthline [Internet]. Hyperthyroidism. America: Health Media; [updated 2016 Jun 29; cited 2019 Aug 13]. Available from: https://www.healthline.com/health/hyperthyroidism.