Treatment of Thyrotoxicosis

About the disease

Thyrotoxicosis is excessive production of the thyroid hormone, which circulates in the bloodstream and is responsible for the body’s metabolic processes. Thyrotoxicosis patients’ metabolism becomes extremely fast, causing rapid weight loss regardless of the amount of food consumed. In mild forms of thyrotoxicosis, patients may not experience any well-pronounced symptoms, except that their skin is always very warm and slightly wet. As the condition progresses, the patient may have an increased heartbeat, lose weight and experience changes in behaviour, including frequent mood swings. In severe stages of thyrotoxicosis, the patient may also suffer from hypertension, which then affects other organs in the body.

Thyrotoxicosis is most often caused by autoimmune diseases such as Graves disease. It can also be caused by infections and iodine exposure, when there are toxic substances in a person's body. Thyrotoxicosis is most common in women. It develops in 2% of the female population and in 0,5% of males. The most dangerous complication of this disease is a thyroid storm, which can cause the patient to fall into a coma. Nonetheless, this complication is rare, developing in only 1-2% of all patients with thyrotoxicosis.

Symptoms

• Weight loss
• Heat intolerance
• Palpitations
• Irritability
• Anxiety
• Fatigue
• Agitation
• Nervousness
• Increased metabolism
• Psychosis

Diagnosis

• A thyroid function test is the most commonly used diagnostic method for this condition. It can establish whether the patient has too much thyroid hormone in their system.
• A chest radiography can detect changes in the heart and pulmonary functions, both of which could have been affected by thyrotoxicosis.
• An electrocardiogram can determine whether the patient has chronic abnormal heartbeat.
• A blood test can detect changes in the patient’s blood count. 

Treatment

Most often, patients need to undergo conservative treatment to alleviate their condition.

• Antithyroid medications can decrease the amount of thyroid hormone produced. Symptoms will start to subside six weeks into treatment, but in order to completely eliminate thyrotoxicosis, medication will usually need to be administered for a year.
• Beta-adrenergic blocking agents are also used to control the amount of thyroid hormone produced. 
• A thyroidectomy is the surgical removal of part of the thyroid gland. It is usually recommended for patients who have contraindications to drug therapy, such as pregnant women.

Overall, patients who have been receiving drug therapy for about a year will usually be able to resume a healthy life.

Authors: Dr. Vadim Zhiliuk, Dr. Sergey Pashchenko