Can hyperthyroidism be cured

Hyperthyroidism

Hyperthyroidism (Hyperthyroidism): Excessive production and release of the thyroid hormones T4 (thyroxine) and T3 (triiodothyronine) with the result of increased metabolic processes.

80% of hyperthyroidism affects women. In older women (mostly over 60) the autonomic adenoma is usually the cause of the goiter, in younger women (mostly under 60) mostly Graves disease. Once discovered, the hyperthyroidism should always be treated in order to normalize the quality of life again, but also to prevent complications. People with an overactive thyroid are particularly threatened by taking iodine, which can trigger a thyrotoxic crisis.

Thyrotoxic crisis: The ingestion of iodine-containing medication or iodine-containing X-ray contrast media can be life-threatening: an extreme hyperthyroidism threatens within 1–4 weeks after iodine intake. The thyrotoxic crisis ("thyroid poisoning") can lead to a coma and is fatal in 50% of cases despite intensive medical treatment.

Leading complaints

  • Restlessness, nervousness, tremors, insomnia
  • Psychological abnormalities
  • Bad exposure to heat
  • Sweats, warm and clammy skin, high temperature
  • Weight loss (despite cravings)
  • diarrhea
  • Increased heart rate
  • Brittle hair and nails
  • Protrusion of the eyeballs (in Graves' disease).

When to the doctor

In the next few days if there was strong inner restlessness, combined with palpitations and increased body temperature, as well as diarrhea and weight loss that did not improve.

The illness

In ~ 30% of the cases, the overactive thyroid is caused by thyroid autonomy of isolated thyroid cell areas that elude hormone regulation and produce thyroid hormone uninhibited ("autonomous") (autonomous thyroid adenoma, mostly only Autonomous adenoma called).

Behind this is iodine deficiency, which means that the thyroid gland cannot produce enough hormones. She tries to compensate for this with increased growth: a goiter develops, possibly with the formation of knots.

In ~ 70% of cases, the hyperthyroidism is caused by an autoimmune disease called Graves disease (Graves disease, Graves disease). The immune system "falsely" forms antibodies (TSH receptor antibodies = TRAK), which induce the thyroid cells to produce uninhibited thyroid hormone. Graves' disease occurs in families, sometimes together with other autoimmune diseases such as Addison's disease or diabetes mellitus. Endocrine orbitopathy is found in two-thirds of those suffering from Graves' disease: Here the "incorrectly" formed antibodies of the immune system are also directed against the tissue behind the eyeballs and make them stand out in a characteristic manner, which doctors call exophthalmos.

Emphasis on the left side of the eyeball (exophthalmos, right in the picture) in a 41-year-old man with Graves' disease. In addition to the protruding eye, there is conjunctivitis on both sides, easily recognizable by the reddened outer sides of the eyeball.
Georg Thieme Verlag, Stuttgart

All other causes of an overactive thyroid are much rarer: These include inflammation of the thyroid gland such as Hashimoto's thyroiditis, thyroid cancer, pituitary adenomas with increased TSH release, a drug overdose of thyroid hormones or a strong excess of iodine, for example from iodine-containing contrast media.

The prognosis is good, with the exception of tumors. However, lifelong medication is often necessary.

The doctor does that

Diagnostic assurance. The examinations correspond to those of the clarification of a goiter. The TSH is decreased, T3 and T4 are increased. Ultrasound and scintigraphy show characteristic changes and areas of enrichment. If Graves' disease is suspected, the TSH receptor antibodies responsible for the disease are determined in the blood. Any eye involvement must be clarified by the ophthalmologist and, if necessary, treated with cortisone, radiation therapy and / or surgery.

Therapy. Any hyperthyroidism is treated with drugs that slow the thyroid gland (anti-thyroid drugs) until normal thyroid blood values ​​are reached again. Autonomous adenoma cannot be achieved with these drugs cured , which is why radioiodine therapy or partial surgical removal of the thyroid gland is necessary after pretreatment with anti-thyroid drugs.

During the operation, the functioning thyroid tissue is reduced to such an extent that the remainder is no longer sufficient to flood the body with too much thyroid hormones. If the remaining thyroid tissue is no longer sufficient for the normal production of hormones after the operation and radioiodine therapy, the result is hypothyroidism, which requires thyroid hormones to be taken for life (hormone replacement therapy). Graves' disease is also operated on if the overactive thyroid flares up again after stopping the medication.

Special text: Thyreostatika (drugs against hyperthyroidism)

Radioiodine therapy. The Radioiodine therapy is a very targeted radiation therapy with low radiation exposure. It is carried out in the case of an autonomic goiter, thyroid cancer, hyperthyroidism and patients with an increased risk of surgery or if thyroid surgery is refused.

Radioactive material is used 131Iodine, which, like normal iodine, is almost entirely absorbed by the cells of the thyroid tissue and - in the case of thyroid cancer - also by iodine-storing metastases. The radioactive iodine now emits beta rays with a range of a few millimeters, which destroys the surrounding thyroid cells - but spares neighboring organs. Since autonomous areas store the radioactive iodine much more than the other cells, this therapy is particularly suitable for autonomous areas that are scattered in the thyroid gland. Radioiodine therapy can also be used in younger patients who wish to have children, but pregnancy must first be ruled out and reliably prevented for up to six months after the examination.

The success rate of radioiodine therapy is ~ 90%. However: Inflammation of the salivary glands or the stomach (gastritis) are possible as temporary consequences of radiation treatment. As a late side effect, after years and decades, 1% of all cases threaten cancer, most often acute leukemia or thyroid cancer.

Aftercare. Each of these therapies requires regular, often lifelong, check-ups of the thyroid hormone level in the blood (thyroid laboratory check).

Complementary medicine

Only a few medicinal plants influence the human hormonal system, one of which is Wolfstrapp. In phytotherapy and homeopathy, both the North American Wolfstrapp (Lycopus virginicus) and the European (Lycopus europaeus) are used to treat mild hyperthyroidism. Their medicinal effects are mainly attributed to certain phytochemicals: flavonoids and phenol carboxylic acids. Studies suggest that they can inhibit iodine transport and the thyroid stimulating hormone (TSH), thereby alleviating symptoms of mild hyperthyroidism.
Nevertheless, preparations containing wolftrapph should only be taken after consulting a doctor and in the dosage prescribed by the doctor. If the dose is too high over a long period of time, the thyroid gland can enlarge. Consider contraindications. Under no circumstances should Wolfstrapp be used if the thyroid is underactive or if the thyroid is enlarged without functional impairment. Simultaneous use of thyroid hormones and use during pregnancy, breastfeeding or in children is also contraindicated. It should also be noted that drugs containing wolftrapph falsify the results of a thyroid examination (scintigraphy).

Authors

Kristine Raether-Buscham, Dr. med. Arne Schäffler in: Gesundheit heute, edited by Dr. med. Arne Schäffler. Trias, Stuttgart, 3rd edition (2014). Revision and update: Dr. med. Sonja Kempinski | last changed on at 17:06


Important note: This article has been written according to scientific standards and has been checked by medical professionals. The information communicated in this article can in no way replace professional advice in your pharmacy. The content cannot and must not be used to make independent diagnoses or to start therapy.