Thyrotoxicosis: Treatment And Management

The thyroid gland is a butterfly-shaped organ located at the front of the neck. Its main function is to make hormones that aid metabolism, generating energy for the body to keep organs functioning correctly.

Hyperthyroidism is a condition associated with the excessive production of thyroid hormone. The way the body reacts after the hormones are released into the bloodstream is known as thyrotoxicosis. 

Causes of thyrotoxicosis

The following are the leading causes of thyrotoxicosis:

Nodules in the thyroid gland

These are growths that vary in size and can affect the amount of hormones produced by the thyroid gland. One hyperfunctioning nodule is referred to as a toxic nodular adenoma. Having Plummer's disease or a multinodular goiter indicates the presence of a number of these nodules.

Medication

Thyrotoxicosis can be induced by certain medications, such as Amiodarone, which may expose the body to excess amounts of iodine¹. 

Thyroiditis

Thyroiditis happens when a virus, bacteria, or specific medications cause inflammation of the thyroid gland, resulting in the overproduction of thyroid hormones getting released into the bloodstream.

Graves’ disease

Graves’ disease is a leading cause of thyrotoxicosis. This disease makes the immune system confuse the thyroid gland for foreign material and attempt to protect the body by attacking it with antibodies. It has not yet been established why this happens, but the condition tends to run in families.

Symptoms

Having excess levels of thyroid hormones in your blood can affect your normal physical functions in several ways. The following are the common symptoms of thyrotoxicosis:

• Increased heart rate

• Feeling irritable and nervous

• Diarrhea 

• Increased sweating

• Weak muscles

• Shaky hands

• Unexplained weight loss

Diagnosis

On your first visit, the doctor will ask you to describe your symptoms and consider any medications you may be using. They will also measure your heart rate and the size of your thyroid.

After that, blood tests will be carried out to measure the levels of thyroid-stimulating hormone in the blood. More blood tests may be needed to establish the root cause of your symptoms.

If necessary, the doctor may refer you for a thyroid ultrasound.

The difference between thyrotoxicosis and hyperthyroidism

Hyperthyroidism is a term used to refer to an unusually elevated thyroid function. On the other hand, Thyrotoxicosis is a term used to describe a high amount of thyroid hormones originating from any source.

Hyperthyroidism is the leading cause of thyrotoxicosis. It is important to note that even though these two terms are often used interchangeably, they are not the same condition.

Treatment and management options for thyrotoxicosis

The primary treatment and management options for thyrotoxicosis include:

Antithyroid medication

For thyrotoxicosis caused by Graves’ disease and other categories of hyperthyroidism, patients are prescribed anti-thyroid medications. These drugs regulate thyroid hormone production in the thyroid gland.

Radioactive iodine

This iodine usually comes in capsule form and can be swallowed to destroy thyroid cells.

Beta-blockers

This medication can be prescribed to fight specific symptoms such as an increased heartbeat and shaky hands.

Surgery

In advanced cases, your doctor may suggest surgical removal of your thyroid gland.

Risk factors of thyrotoxicosis

Certain factors can increase your chances of developing thyrotoxicosis:

• Being female

• Having a family history of Graves’ disease

• Suffering from underlying chronic illnesses such as type 1 diabetes

• Being over the age of 60

Prognosis of thyrotoxicosis

The outlook for patients suffering from thyrotoxicosis is mostly good. While there are many different treatment options for thyrotoxicosis, they all have advantages and disadvantages. Both you and your healthcare provider will walk through this journey together, determining the best course of treatment and making any necessary adjustments to ensure it remains the most suitable option.

Complications of thyrotoxicosis

If thyrotoxicosis is not treated in good time, it can lead to complications, such as:

Heart complications

Thyrotoxicosis leads to an increased heartbeat, increasing your chances of developing a stroke.

Weakening of bones (osteoporosis)

Excessive amounts of thyroid hormones in your blood affect the body's ability to transport calcium to the bones, making them brittle over time.

Eye problems

Those suffering from Graves’ disease will often develop eye complications such as blurred vision, double vision, or swollen red eyes.

Thyrotoxic crisis

Untreated thyrotoxicosis can cause a thyroid crisis, also known as thyroid storm. This is a sudden elevation of your symptoms, leading to a very high fever, an increased heartbeat, and sometimes, delirium. If you experience any of these symptoms, seek immediate medical care.

How will a doctor determine the best course of treatment?

As mentioned, there are many treatment options for thyrotoxicosis, and your doctor will help you select a treatment plan depending on the root cause of your condition.

The length of treatment also varies depending on the cause of the condition. If your healthcare provider treats you with antithyroid medications such as propylthiouracil, your thyroid hormone levels should return to normal within six to 12 weeks.

When to speak to a healthcare professional/endocrinologist

If you are experiencing any of the symptoms of thyrotoxicosis, it is important to discuss this with your healthcare provider to establish the cause and get personalized treatment.

If you are diagnosed with chronic thyrotoxicosis, it’s essential to maintain regular contact with your doctor to ensure your treatment continues to work well.

 To make the most of your doctor's appointment, ask the following questions:

• What has caused my thyrotoxicosis?

• What are the available treatment options?

• What are the potential side effects of my treatment plan?

• Is it possible to get thyrotoxicosis again?

• Is my thyrotoxicosis hereditary?

The lowdown

Although it may sound scary at first, thyrotoxicosis is not a life sentence, and with the proper treatment, it can be managed.

If you have noticed any symptoms of thyrotoxicosis or have certain risk factors that make you more likely to develop the condition, make sure to see your healthcare provider soon. Your doctor will run the relevant tests to check your thyroid hormone levels.