An Overactive Gland
- Dr Chooi Kheng Chiew
- Feb 16, 2021
- 3 min read
THE thyroid gland is small and butterfly-shaped, located in the lower front of the neck. It is crucial to the body's functions because it produces thyroid hormones to regulate the body's metabolism.
Hyperthyroidism refers to over-activity of the thyroid gland and an abnormal increase in the quantity of circulating thyroid hormones in the body.
This can cause an elevation in the body's metabolism and lead to patients experiencing unpleasant symptoms or even deterioration in health.
Consultant endocrinologist and physician, Dr Chooi Kheng Chiew says common causes of hyperthyroidism are Graves disease (an autoimmune condition where a person's own antibodies attack the thyroid gland and cause it to make excessive thyroid hormones) and nodules in the thyroid gland which produce excessive hormones.
Women are about five to 10 times more likely to develop the condition than men. People with a family history of thyroid disease are also more likely to have it.
"Patients who have a history of other autoimmune conditions like type 1 diabetes mellitus, primary adrenal insufficiency or systemic lupus erythematosus (SLE) are also more likely to be afflicted by hyperthyroidism," says Dr Chooi.
It is a relatively common condition in Malaysia, which is sometimes diagnosed late or even undiagnosed.
Dr Chooi says a large study done in Malaysia recently showed that the prevalence of hyperthyroidism was 0.6 per cent.
Thyroid hormones control the body's metabolism, or the way it uses energy. So they can affect almost every organ in the body.
Signs and symptoms of hyperthyroidism can differ from person to person but common ones include weight loss, having a fast (and possibly irregular) heartbeat, diarrhoea, feeling warm, nervousness or agitation, lethargy, muscle weakness and insomnia.
Patients can also have tremors in their hands and swelling of the thyroid gland.
WHEN TO SEEK TREATMENT
Dr Chooi says patients will often seek medical attention early if they experience troubling symptoms or if they have a family member with similar symptoms who was treated appropriately and recovered.
However, some older adults are more likely to have either no symptoms or only mild symptoms, and they may be diagnosed late.
"Recently, I have had patients who experienced significant symptoms but put off going to a doctor due to fears of exposing themselves to Covid-19 infection. Because of that, they received a late diagnosis," says Dr Chooi.
The symptoms of hyperthyroidism can interfere with a person's optimal functioning and his or her ability to work and this can be detrimental to one's quality of life.
Dr Chooi says if left ignored, it can also lead to serious and life-threatening conditions related to the heart, bones and muscles.
Most people respond well to treatment once the condition is diagnosed and managed appropriately by an endocrinologist.
Hyperthyroidism can be managed with the use of medications called anti-thyroid drugs. These medications will reduce the production of thyroid hormones. Radioactive iodine therapy is another option.
For some patients, surgery to remove the thyroid gland may be considered.
Endocrinologists will discuss the appropriate treatment options and their associated risks and benefits before coming to a decision with patients.
After initiating treatment, the symptoms of hyperthyroidism should improve and the patient's general condition should get better.
DIET AND LIFESTYLE MODIFICATION
Avoiding excessive iodine in the patient's diet can help prevent the condition from worsening.
Kelp and other types of seaweed contain a significant amount of iodine.
Some multivitamins may also contain iodine while smoking can worsen Graves disease and even lead to the development of Graves ophthalmopathy (an eye condition associated with the disease).
Getting regular exercise is helpful to improve muscle tone, maintain bone density and improve energy levels.
Regular check-ups with your endocrinologist are also crucial as your doctor needs to monitor your condition and adjust your treatment as needed.
(This article was published in the New Straits Times online)
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