OTHER NAMES

• Goiter
• Goiter hiperfuncionante

DEFINITION

The hipertiroidismo is a situation in which there takes place an excessive quantity of circulating thyroid hormones, generally due to one thyroid gland that gland works more of the due thing.

Gland thyroid gland and thyroid hormones

The thyroid hormones produce in the gland thyroid gland to themselves. The gland thyroid gland is located in the previous part of the neck, under the Adam's apple. It has form of butterfly and embraces to the trachea. It is formed by 2 more or less equal lobes that join in the center.

The thyroid hormones are essential for the function of any cell of the organism. They regulate the growth and the metabolic valuation of the body. The gland thyroid gland uses iodine to make the thyroid hormones. The 2 most important thyroid hormones are the tiroxina (T4) and the triyodotironina (T3). T4 has 4 iodine molecules, while T3 only it takes 3. The necessary iodine to make thyroid hormones is in fish and seafood, in the bread and in the iodized salt of table. More than 99 % of all the thyroid hormones is joined to proteins in the inactive blood and is (they cannot interact with the cells of the body). Only one smallest portion of the thyroid hormones they are free, not joined to proteins, and this small fraction is the important one in the regulation of the cellular metabolism. Normally, the production of thyroid hormones is controlled by the gland hypophysis located in the base of the brain, across a called hormone "thyroid stimulating hormone" or TSH. When excess of thyroid hormones exists, the hypophysis stops segregating TSH, and vice versa, what supports a relatively constant level of circulating thyroid hormones.

The hipertiroidismo usually owes to an excessive functioning of the gland thyroid gland to himself, in whose case the TSH level in blood is very low. In less frequent cases, the hipertiroidismo owes to himself to an excess of production of TSH for the gland hypophysis (and in these cases the TSH level in blood is high).

CAUSES OF HIPERTIROIDISMO

• Illness of Serious (poisonous diffuse Goiter).

Illness in which the whole gland is increased of size of diffuse form, and that associates three classic components: hipertiroidismo, protrusión of the (exoftalmos) eyes and injuries of the skin. The exoftalmos can precede or accompany to the hipertiroidismo development, and can lead to the entire loss of vision.

The illness of Serious can happen of familiar form. The factors that can unleash it include the stress, the tobacco, the radiation in the neck, different medications (like her interleukina-2 and the interferon - alpha), and some viruses. The illness of Serious is diagnosed by the triad typical of hipertiroidismo, protrusión of the (exoftalmos) eyes and injuries of the skin (exanthema in the previous face of the legs), and is confirmed by a thyroid gammagrafía, and hormones determinations in blood, including levels of the antibody TSI (Thyroid Stimulating Immunoglobulin), abnormally high place in the illness of Serious. [Not to confuse with the hormone hipofisaria "thyroid stimulating hormone" or TSH, whose levels are always low in the illness of Serious, as it has already been said].

• Poisonous nodules.

The gland thyroid gland sometimes contains nodules. A nodule can become hyperactive and produce an excess of thyroid hormones. If the nodule is only, it is called a poisonous adenoma, and if there are great the hyperactive nodules, poisonous multinodular goiter.

• Thyroid hormones.

An overdose of thyroid hormones can cause hipertiroidismo.

• Iodine.

The gland thyroid gland uses iodine to make the thyroid hormones. An iodine excess can cause so hipertiroidismo, especially if a previous abnormal thyroid gland existed, as for example, a goiter (= increase of size of the thyroid gland). Iodine is in big quantities in some medicines, like the amiodarona (Trangorex ®) that is used to treat cardiac arrhythmias.

• Tiroiditis.

Inflammation of the gland thyroid gland, which can happen after a pregnancy or a viral enfemedad. In both cases it can take the temporary state of hipertiroidismo, after which the patient usually remains with hipotiroidismo, that is to say, with a low function of the gland.

SIGNS AND SYMPTOMS

The patients with hipertiroidismo set sail they may have no symptom. The symptoms become more important as the illness deteriorates, and generally they are related to an increase of the corporal metabolism.

Frequent symptoms are a nervousness, quakes, loss of weight in spite of an appetite increase, sudoración, palpitations, intolerance to the heat, and tendency to the diarrhea. Other hipertiroidismo symptoms include weariness, weakness, insomnia, and loss of hair. The women can present menstrual alterations.

TREATMENT

The hipertiroidismo can talk each other, and must talk each other, since if it does not talk each other, it can lead to serious illnesses of the heart, as well as to the most serious situation that is called a hyperthyroid crisis, tireotoxicosis or thyroid thunderstorm. 3 props of the treatment of the hipertiroidismo are the surgery, the medicines and the radioactive iodine.

• SURGERY.

The entire or partial eradication of the thyroid gland (or tiroidectomía) it removes the source of production of thyroid hormones, to obtain a normal hormones level. His principal complications are the hipotiroidismo, that is to say, a too low function of the gland; the vocal cords palsy; and the accidental eradication of the glands parathyroids (located behind the gland thyroid gland), what it gives like turned out a descent of the blood calcium (the glands parathyroids regulate the calcium).

• RADIOACTIVE IODINE.

It is administered at once in the shape of capsule; it removes straight the thyroid textile, destroying it. After this treatment, the patient recovers a normal thyroid function between 8 and 12 weeks later. It is contra-indicated in pregnancy and lactation.

• MEDICINES.

The antithyroid medicines block the hormones production for the gland thyroid gland. The most secondhand are metimazol and propiltiouracilo. Also medicines are used szlig;-bloqueantes to fight the effects of the thyroid hormones.

In the current moment, the treatment of election of the illness of Serious is the radioactive iodine, the surgery being reserved for special cases, like pregnant women. The poisonous adenoma usually talks each other with surgery. The multinodular goiter can talk each other of one or another form. In all the cases there will be necessary the antithyroid medicines of temporary or permanent form. The hipertiroidismo in the tiroiditis, to the being a transitory problem, it is a question of different form, generally with medicines ß-bloqueantes and anti-inflammatory.

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