What is Hyperthyroidism?
The thyroid is a butterfly shaped gland which sits in front
of your windpipe, just below your Adam's apple (voice box
or larynx). Your thyroid uses iodine from your diet to
make two main chemicals called thyroid hormones, which are
carried in the blood stream to other tissues in the body where they
regulate the metabolic rate.
Hyperthyroidism is overactivity of the thyroid which occurs when
the gland makes too much thyroid hormone for the body's
needs. This speeds up your metabolic rate up and
therefore every organ in the body works faster. You may have any or
all of the following symptoms:
- Fidgety, irritable and on edge
- Increased appetite but loss of weight
- Tremor, feeling hot and sweaty
- Heart racing, palpitations
- Diarrhoea
- Irregular periods
- Some people simply feel tired.
One in twenty patients may notice changes to their eyes, usually
with puffiness of the eyelids, a gritty sensation in the front of
the eyes and sometimes a 'staring' appearance. Rarely the changes
can be more severe, making the eyes very prominent and causing
double vision. If this happens you will need to see an eye
specialist who may recommend treatment with steroids, an operation
or radiotherapy. It is known that smokers are more likely to get
eye changes than those who do not smoke.
What does this involve?
Our usual practice to use tablets to control your thyroid gland
and to quickly make you feel better. The course of
treatment varies from six to eighteen months before the
tablets are stopped to see if your thyroid has returned to
normal. If over-activity returns we would restart tablets and
then discuss either radioactive iodine treatment or thyroid surgery
as a second line treatment (see separate treatment pages for
information). The tablets that can be prescribed are:
Carbimazole (also called Neomercazole) - This tablet reduces the
amount of thyroid hormone being made by the thyroid gland and takes
two to three weeks to become fully effective. Usually a higher dose
is used at the start (20 to 40 mg once daily) and then the dose is
progressively cut down to a maintenance dose (5 to 10 mg
daily).
Very occasionally a higher dose is started and maintained
(60 mg daily). This then has to be supplemented by a thyroid
hormone tablet (Thyroxine) to maintain normal thyroid hormone
levels in the blood stream. This is called the 'block and replace'
regimen.
Propylthiouracil (also called PTU) - This acts in a similar way
to Carbimazole and is equally effective. It is used more often in
women during pregnancy or if women are breast-feeding. A 50mg
Propylthiouracil tablet is equivalent to a 5 mg Carbimazole tablet
and has to be taken two or three times daily.
Top
When will I recover?
As
mentioned, the course of tablets takes between six to eighteen
months before a pause in treatment allows other options to be
considered.
Top
What risks should I know about?
Most tablets have side effects
although in Carbimazole and Propylthiouracil
thesearerare.
They may be severe enough to lead to the tablet being
stopped:
- Skin rashes
- Aches and pains in the joints
- Bone marrow suppression - this is a very rare (less than 1 in
20,000 cases)
- Weight gain - this is often the side effect that patients
most worry about, but it is not really a side effect at
all. If you do gain weight on treatment it
probably means that the thyroid gland is getting
better and that the metabolic rate is slowing down to
normal.
Top
Circle Care
Diagnosis and treatment of Hyperthyroidism is carried out by our
specialist consultants who have the expertise to get the best
possible results. You can be sure of state of the art
facilities and the best possible care to get you well as soon as
possible.
Top