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Issues with the thyroid are not uncommon be they due to hypothyroidism or hyperthyroidism. This article hopefully gives more of an insight into hyperthyroidism including symptoms and treatment.

When thyroid over activity causes severe symptoms, it is often referred to as thyrotoxicosis.

Associated symptoms can include:-

- Weight loss despite increased appetite

- Loose motions

- Rapid heart beat including irregularity especially in older people

- Breathlessness

- Increased thirst

- Heat intolerance and sweating

- Emotional lability

- Insomnia

- Light periods

- Muscle weakness and itch

This list is not exhaustive and many of the symptoms could easily be confused with other conditions.

Approximately 75% of cases of thyrotoxicosis are caused by Graves’ disease and the majority of these sufferers are female.

Clinically, the cause is the development of specific antibodies which bind to the TSH receptor on thyroid cells and driving excessive, unregulated thyroid stimulation.

Sufferers of Graves’ disease often have a strong family history of autoimmune thyroid disease be that over active or under active.

More recently, smoking has been recognised as the strong modifiable risk factor for the development of Graves’ disease.

Some 30% of Graves’ disease sufferers have non-thyroid hormone related features affecting the eyes and occasionally skin and nail changes but if any of these are present, they may confirm a diagnosis.

When diagnosed, most people begin their treatment by taking the drug Carbimazole which has been used for some 60 years.

This drug is prescribed in varying dosages and possible side effects can be serious though tend to be rare.

It is important that people taking Carbimazole are monitored closely and generally the medication is withdrawn after 12 – 18 months.

The majority of Graves’ disease sufferers relapse at some point after stopping the Carbimazole which is then re-commenced and either surgery or radioiodine therapy are often recommended.

Surgery can take the form of partial or total thyroidectomy but more recently the majority of people undergo total thyroidectomy.

This surgery results in immediate total hypothyroidism which then requires life long replacement with Thyroxine, which itself requires regular monitoring by blood tests to maintain a satisfactory dose for each individual.

The risks of total Thyroidectomy include damage to neighbouring neck structures in particular the nerves to the larynx hence affecting the voice or even airways.

There may also be damage to the parathyroid glands which regulate calcium levels in the blood.

Loss of two or even three parathyroid glands may be tolerated but more can cause serious, permanent damage. Permanent hypoparathyroidism is a serious and difficult condition to manage and for that reason the performing surgeon requires great skill and experience. For that reason such surgery should only be carried out by fully trained, often specialist endocrine surgeons.

The alternative to surgery is Radioactive Iodine which has been used for over 70 years and is proven to be remarkably safe. It is a simple procedure under the suitable direction generally of an endocrinologist and leads to progressive reduction in thyroid hormone levels between a few weeks to a few months followed by a gradual increase in Thyroxine as determined by regular monitoring of Thyroid Function Tests.

If you believe that you have been treated inappropriately and not in accordance with accepted medical practice and wish to discuss your position, at no charge, please call either Anne Scott free on 0800 8047450 or text CLAIMS to 80988.