Description and Implication of Hyperactive Thyroid

A hyperactive thyroid gland is as dangerous as an underactive one; but the clinical picture and other factors vary greatly. A hyperactive thyroid denotes that the thyroid gland is too agitated and hence secretes excessive amounts of thyroid hormones. These excessive amounts of thyroid hormones cause multisystem disorders collectively known as Hyperthyroidism.

Causes of Hyperactive Thyroid

• Grave’s disease- This is an autoimmune disorder
• Solitary or multinodular goiters that are toxic in nature
• Tumors in the ovary that secrete Thyroid hormone
• Molar pregnancy
• Choriocarcinoma
• Consumption of excessive amounts of Iodine in food
• Consumption of meat, especially beef that has been injected with Thyroid hormones

Symptoms and Clinical Picture of Hyperactive Thyroid

• Excessive Palpitations
• Excessive perspiration
• Inordinate weight loss
• Development of swelling of thyroid gland (goiter)
• Intolerance of heat and aggravation from it
• Diarrhea and loose motions
• Dryness of the eyes
• Sexual difficulties like erectile dysfunction in men
• Menstrual cycles turn irregular in women
• Prominently protruded eyeballs
• Excessive Fatigue
• Frequent desire to pass urine
• Anxious disposition
• Tremors of the hands
• Cardiac abnormalities, irregular activity of heart

When hyperactive thyroid symptoms become very severe, it can be life threatening and was indeed 100 % fatal until the latest improvements in medical care of this crisis were developed. Such an emergency situation is termed as a ‘Thyroid Storm’. The clinical picture of Thyroid storm is different than that of hyperactive thyroid.

Symptoms and Clinical Picture of Thyroid Storm

• High fever
• Nausea, vomiting and even fainting
• Confusion and disorientation of mind
• Circulatory failure
• Very high temperature of the body called as hyperthermia.
• Cardiac abnormalities with risk of developing a cardiac arrest or total failure
• Weakness, with tendency to progress to unconsciousness
• Loose stools

Treatment of Hyperactive Thyroid

• Anti thyroid medications like propylthiouracil and carbimazole
• Severe cases may require surgical removal of a part or entire thyroid gland. If the entire thyroid gland is removed, then patients need to be sustained on artificial thyroid hormone supplements all through their life.
• Radioactive Iodine may also be used to kill thyroid tissue that is secreting excessive amounts of thyroid hormone

Treatment of Thyroid Storm

• Patient has to be treated in an ICU as the condition is highly life threatening
• Intensive measures to restore cardiac and circulatory failure like administering I-V fluids, propanolol etc
• High dose propylthiouracil (PTU) is given to counteract the effect of excessive thyroid hormones
• Administering Lugol’s Iodine or Potassium Iodide
• Glucocorticoids
• Plasmapheresis is used only as a last resort and is very rarely used as treatment for Thyroid storm

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