For the diagnosis of hyperthyroidism, a blood test and imaging techniques are used. If hyperthyroidism is detected then various treatment options are available.
The symptoms that occur during hyperthyroidism often provide the first indications of the disease. By a blood test, in which the concentration of the hormone TSH and the thyroid hormones is determined, the doctor can gain further insight: If the TSH level is low, this indicates a hyperthyroidism.
In contrast, the concentration of thyroid hormones is usually increased. In Graves' disease, there is also a large amount of thyroid antibodies in the blood.
Investigation with imaging techniques
After the blood test, the attending physician can support the diagnosis by imaging techniques such as ultrasound or scintigraphy.
An ultrasound scan will help you to better assess thyroid size and structure. Optionally, tissue samples may also be taken for further examination.
If there is a suspicion that thyroid autonomy exists, scintigraphy is performed. For this, the patient gets a radioactive substance injected into the vein. This is absorbed by the areas of the thyroid, which produce a particularly high number of hormones (hot knots). In this way, when viewed through a special camera, a healthy tissue can be distinguished from diseased tissue.
Hyperthyroidism is usually first treated with medication. Often, however, such drug therapy alone is not enough to cure the dysfunction. In such cases radioiodine therapy or surgery are available as further treatment options.
Medications for hyperthyroidism
As a rule, so-called antithyroid drugs which inhibit the production of the thyroid hormones are administered at the beginning of the treatment of hyperthyroidism. Since the body initially has an increased concentration of hormones, it takes some time to improve the symptoms. If the hormone concentration in the blood has returned to normal, the treating physician must decide whether additional surgery or radioiodine therapy is necessary.
If Graves' disease is the cause of hyperfunction, the disease is first treated with antithyroid drugs. Therapy takes place over a period of about one year, as relapses often occur in the first few months of treatment. If the symptoms recur at a later date, other forms of therapy should be considered.
Thyroid autonomy almost always requires surgery or radioiodine therapy, as the drugs can not eliminate the autonomous regions.
In some cases, beta-blockers are prescribed in addition to antithyroid drugs, which slow down the heartbeat and thus reduce symptoms such as the tremor that occurs in hyperthyroidism.
Radioiodine therapy for hyperthyroidism
In radioactive iodine therapy, the patient is given radioactive iodine, which is stored in the thyroid gland. The radioactive radiation destroys the thyroid cells. It affects primarily cells that produce a particularly large number of hormones, because they take up more iodine. In thyroid autonomy, in particular the active nodes in the thyroid are reached by the radioactive iodine. In Graves' disease, however, all cells are affected.
Thyroid hypofunction may occur as an undesirable consequence of treatment - in some cases only years after radioiodine therapy. By taking thyroid hormones, however, such a subfunction can usually get a good grip. However, the medication must be taken a lifetime.
Surgery for hyperthyroidism
An operation is performed, among other things, when a thyroid autonomy is the cause of hyperfunction or when Graves' disease patients relapse despite drug therapy. In addition, surgery can also be performed if the thyroid gland is greatly enlarged and presses on the trachea or if there is a suspicion of a malignant tumor.
Surgery can not be performed until thyroid hormone levels have been normalized by medication.
Possible risks of an operation are an impairment of the neighboring parathyroid gland as well as a violation of the vocal cord nerve. Often thyroid hormones and iodide must be taken after surgery. In this way, a hypofunction is prevented and it is prevented that the remaining thyroid tissue grows again uncontrollably.
In order to prevent hyperthyroidism, a sufficient supply of iodine is particularly important. This is especially true for adolescents, pregnant women and nursing mothers, who have an increased need for iodine. For adults, a daily iodine intake of 200 micrograms is recommended.
Larger amounts of iodine are among others in the following foods:
- sea fish
- Dairy products such as butter and yoghurt
- black tea
In addition, the use of iodized salt is recommended.
Thyroid hyperfunction caused by Graves' disease can not be prevented. If thyroid problems have already occurred in your family, it makes sense to have your thyroid examined regularly.