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Hyperthyroidism

Hyperthyroidism

What is thyroid gland?

The thyroid gland is a butterfly-shaped gland located in the middle of your neck. The thyroid gland produces two major hormones: thyroxine (T4) and triiodothyronine (T3). T4 is produced in a more abundant quantity. Both hormones play an essential role in regulating and balancing body metabolism.

What is hyperthyroidism/thyrotoxicosis/overactive thyroid?

Hyperthyroidism or thyrotoxicosis, in simple terms, is also called overactive thyroid. It occurs when the thyroid gland makes too much thyroid hormone. The increased amount of thyroid hormones in the blood increases body metabolism, causing different symptoms.

What are the symptoms of hyperthyroidism/thyrotoxicosis/overactive thyroid?

A person with an overactive thyroid may complain of the following symptoms:

  1. Tiredness
  2. Anxiety
  3. Difficulty in sleeping
  4. Shaking or increased tremors
  5. Palpitation
  6. Sweating
  7. Feeling warm or unable to tolerate hot weather
  8. Loose stool or increased frequency of motion
  9. Loss of weight
  10. Increased appetite
  11. In females, period irregularities
  12. In male, erectile dysfunction or breast enlargement

Symptoms can be present in any combination. That is, not all symptoms can be present in a person with an overactive thyroid. Some people may not even suffer or feel any symptoms.

If overactive thyroid is not treated, then a person can suffer heart rhythm problems called atrial fibrillation. AF increases the risk of stroke. In severe cases, a person can suffer heart failure. An untreated overactive thyroid can also weaken the bone leading to osteoporosis.

What are the causes of hyperthyroidism/thyrotoxicosis/overactive thyroid

An autoimmune condition called Graves disease is the most common cause of overactive thyroid. In this condition, the body produces antibodies against the thyroid gland. These antibodies stimulate the thyroid gland to produce excess thyroid hormones.

Another common cause of an overactive thyroid is swellings or nodules within the thyroid. These nodules can over-produce the thyroid hormone. These nodules are not cancerous and are benign. The problem can be caused by either multiple nodules (toxic multinodular goiter) or a single nodule (Toxic nodule).  Toxic means overactive.

How is hyperthyroidism diagnosed? 

Blood tests usually diagnose overactive thyroid. Your doctor will perform a thyroid function test. In overactive thyroid, T4 and/or T3 levels will be high. However, the thyroid-stimulating hormone (TSH) will be low.

Your doctor will also consider doing antibody tests. Common antibodies measured are the TPO antibody and the TSH receptor antibody. Your doctor can undertake additional scans like ultrasound or nuclear medicine scans to find the cause of overactive thyroid.

 

 

Hyperthyroidism

Hyperthyroidism

What is thyroid gland?

The thyroid gland is a butterfly-shaped gland located in the middle of your neck. The thyroid gland produces two major hormones: thyroxine (T4) and triiodothyronine (T3). T4 is produced in a more abundant quantity. Both hormones play an essential role in regulating and balancing body metabolism.

What is hyperthyroidism/thyrotoxicosis/overactive thyroid?

Hyperthyroidism or thyrotoxicosis, in simple terms, is also called overactive thyroid. It occurs when the thyroid gland makes too much thyroid hormone. The increased amount of thyroid hormones in the blood increases body metabolism, causing different symptoms.

What are the symptoms of hyperthyroidism/thyrotoxicosis/overactive thyroid?

A person with an overactive thyroid may complain of the following symptoms:

  1. Tiredness
  2. Anxiety
  3. Difficulty in sleeping
  4. Shaking or increased tremors
  5. Palpitation
  6. Sweating
  7. Feeling warm or unable to tolerate hot weather
  8. Loose stool or increased frequency of motion
  9. Loss of weight
  10. Increased appetite
  11. In females, period irregularities
  12. In male, erectile dysfunction or breast enlargement

Symptoms can be present in any combination. That is, not all symptoms can be present in a person with an overactive thyroid. Some people may not even suffer or feel any symptoms.

If overactive thyroid is not treated, then a person can suffer heart rhythm problems called atrial fibrillation. AF increases the risk of stroke. In severe cases, a person can suffer heart failure. An untreated overactive thyroid can also weaken the bone leading to osteoporosis.

What are the causes of hyperthyroidism/thyrotoxicosis/overactive thyroid

An autoimmune condition called Graves disease is the most common cause of overactive thyroid. In this condition, the body produces antibodies against the thyroid gland. These antibodies stimulate the thyroid gland to produce excess thyroid hormones.

Another common cause of an overactive thyroid is swellings or nodules within the thyroid. These nodules can over-produce the thyroid hormone. These nodules are not cancerous and are benign. The problem can be caused by either multiple nodules (toxic multinodular goiter) or a single nodule (Toxic nodule).  Toxic means overactive.

How is hyperthyroidism diagnosed? 

Blood tests usually diagnose overactive thyroid. Your doctor will perform a thyroid function test. In overactive thyroid, T4 and/or T3 levels will be high. However, the thyroid-stimulating hormone (TSH) will be low.

Your doctor will also consider doing antibody tests. Common antibodies measured are the TPO antibody and the TSH receptor antibody. Your doctor can undertake additional scans like ultrasound or nuclear medicine scans to find the cause of overactive thyroid.

 

 

Carbimazole: Understanding its Uses and Benefits

Carbimazole

How does Carbimazole work?

Carbimazole is converted to an active agent called methimazole in the body. Methimazole acts on thyroid gland and reduces its overactivity. [1]

 

How is Carbimazole taken?

The treatment dose is usually prescribed by your doctor, depending on the thyroid blood test. It is started at high doses ranging between 20 to 60 mg per day.  Carbimazole is to be taken once a day. It is preferable to take the tablet at the same time every day. The dose is kept at these high levels until thyroid activity returns to normal. Then the dose is progressively reduced till it is stopped. Usually, total duration of treatment is approximately 18 months. [2]

 

What are the side effects?

In general, Carbimazole is safe, but some patients can develop side effects. These include; [3]

  1. Headache, nausea, joint pains, and stomach upset.
  2. Skin rash. This can occur in 1 in 50 cases. Contact your doctor if this happens.
  3. In rare cases, Carbimazole can reduce the activity of bone marrow. This can reduce the production of protective body cells. This can lead to infection. Usually, this presents a severe sore throat, mouth ulcers, and fever. If any of these symptoms develop, contact your doctor immediately and stop the medication. The doctor will do your blood count. Bone marrow activity will recover in 1 to 2 weeks.

 

Can Carbimazole be used in pregnancy or breastfeeding?

Yes, Carbimazole can be used in pregnancy and breastfeeding. However, it is advised to discuss with your doctor if you are planning a pregnancy or as soon as you know that you are pregnant. In the first trimester, it is preferred to change Carbimazole to another anti-thyroid tablet called Propylthiouracil. Carbimazole can cross the placenta and, in very rare cases, can affect the skin or nails or finger of the baby in the first trimester. Carbimazole is usually continued in the second and thirst trimester as it is safe for both mother and baby. In general, the lowest possible dose of Carbimazole is taken. It is preferable to keep the dose of Carbimazole below 20 mg. However, the doctor will decide with you the best possible dose, given the risk and benefits. [4]


References and Further Reading

  1. DrugBank. (2005, June 13). Carbimazole.
  2. National Health Service. (n.d.). Carbimazole.
  3. National Health Service. (n.d.). Side effects of carbimazole.
  4. National Center for Biotechnology Information. (2024, August 15). Carbimazole.

Carbimazole: Understanding its Uses and Benefits

Carbimazole

How does Carbimazole work?

Carbimazole is converted to an active agent called methimazole in the body. Methimazole acts on thyroid gland and reduces its overactivity. [1]

 

How is Carbimazole taken?

The treatment dose is usually prescribed by your doctor, depending on the thyroid blood test. It is started at high doses ranging between 20 to 60 mg per day.  Carbimazole is to be taken once a day. It is preferable to take the tablet at the same time every day. The dose is kept at these high levels until thyroid activity returns to normal. Then the dose is progressively reduced till it is stopped. Usually, total duration of treatment is approximately 18 months. [2]

 

What are the side effects?

In general, Carbimazole is safe, but some patients can develop side effects. These include; [3]

  1. Headache, nausea, joint pains, and stomach upset.
  2. Skin rash. This can occur in 1 in 50 cases. Contact your doctor if this happens.
  3. In rare cases, Carbimazole can reduce the activity of bone marrow. This can reduce the production of protective body cells. This can lead to infection. Usually, this presents a severe sore throat, mouth ulcers, and fever. If any of these symptoms develop, contact your doctor immediately and stop the medication. The doctor will do your blood count. Bone marrow activity will recover in 1 to 2 weeks.

 

Can Carbimazole be used in pregnancy or breastfeeding?

Yes, Carbimazole can be used in pregnancy and breastfeeding. However, it is advised to discuss with your doctor if you are planning a pregnancy or as soon as you know that you are pregnant. In the first trimester, it is preferred to change Carbimazole to another anti-thyroid tablet called Propylthiouracil. Carbimazole can cross the placenta and, in very rare cases, can affect the skin or nails or finger of the baby in the first trimester. Carbimazole is usually continued in the second and thirst trimester as it is safe for both mother and baby. In general, the lowest possible dose of Carbimazole is taken. It is preferable to keep the dose of Carbimazole below 20 mg. However, the doctor will decide with you the best possible dose, given the risk and benefits. [4]


References and Further Reading

  1. DrugBank. (2005, June 13). Carbimazole.
  2. National Health Service. (n.d.). Carbimazole.
  3. National Health Service. (n.d.). Side effects of carbimazole.
  4. National Center for Biotechnology Information. (2024, August 15). Carbimazole.