The Thyrotoxicosis Or thyroid crisis is that clinical state in which the thyroid hormone is secreted in excess (in fact, well above the high levels that are recorded in hyperthyroidism).
It is caused by the intake of the same in abusive amounts, but also by the inflammation of this endocrine gland, among other causes. This disease can have many variants and affects thousands of people a year.
Thyrotoxicosis differs from hyperthyroidism in that the former is a specific disease, while the latter is rather a diverse group of diseases in which there is a high level of thyroid hormone in the blood.
Its symptoms and the severity of these always depend to a great extent on what causes this disorder and the patient's age, although there may be tachycardia, heat intolerance and weight loss.
Thyrotoxicosis has been documented to be more common in women than in men (the statistical ratio is 7: 1, respectively), and that this condition occurs between 30 and 40 years of age. It also affects 2 in 1,000 pregnancies, (1%), which is known as fetal thyrotoxicosis.
Causes of thyrotoxicosis
75% of patients diagnosed with thyrotoxicosis are due to Graves disease , Which is more likely to contract when a medical checkup finds that the person smokes, has a family history of the same problem or has autoimmune disorders in his or her body.
Among its risk factors are people with Goiter , Low levels of iodine in the blood, elevated levels of stress, postpartum or antiretrovirals.
Regardless of the causes and risk factors, it is common for all variants of thyrotoxicosis to have several common pathological features, starting with the most basic of all is the intolerance of tissues to the hormones triiodothyronine (T3) and thyroxine (T4 ).
Added to this is a rapid increase in thyroid hormone levels in the blood and the cells pick it up on a larger scale than they usually do.
In the case of gestational thyrotoxicosis, this occurs in the first three months of pregnancy, since the thyroid hormone is secreted in excess.
In these circumstances, the use of various medications can in many ways stimulate the disease, such as lithium, antiretroviral therapy, iodine, interferon, levothyroxine, amiodarone, and any tyrosine kinase inhibitor. Accordingly, this condition may also be of pharmacological origin.
Signs
The clearest signs of thyrotoxicosis are usually, in the majority of patients diagnosed, the presence of:
- Tremors
- tachycardia
- Goiter
- Thyroid murmur
- Ophthalmologic pathologies
- Abnormal increase in muscle movements
- Retraction of the eyelids
- Weakness in muscles
- Tachycardia, high blood pressure
- Hot and wet skin
- Hyperreflexia (excessive reflexes)
- weightloss
- heart failure
- And sweating in the palm of the hands, among others.
symptom
For its part, the most common symptoms of this disease are:
- Palpitations
- Increased appetite
- Defecation and excessive sweating
- Difficulty breathing (shortness of breath)
- Menstrual problems
- nervousness
- fatigue
- weakness
- Decreased libido
- Heat intolerance
- anxiety
- Alteration in mental functions
- Muscle paralysis
- fever
- And weight loss (low weight, or below average weight).
It should be noted that patients with thyrotoxicosis do not fully develop all of the above symptoms nor do they have all the signs listed listed.
In itself, many of the cases studied at the clinical level have shown that they can have as little as 3 symptoms of the many that are.
This undoubtedly means that there is no reason to assume that the patient suffers from this disease simply by having, for example, hands full of sweat.
Diagnosis
The doctor will determine the best way to know if the patient has thyrotoxicosis. But it will not be enough to see its symptoms and signs, but it will go to a series of deep physical and laboratory studies, in which will examine in depth if the thyroid hormones behave in an unusual way through values that rise or fall In an unusual way.
In addition, the person will see their family history and their reactions with radioactive iodine.
Treatment
Any treatment of thyrotoxicosis closely follows the clinical picture detected in the diagnostic phase, which has taken into account the patient's symptoms and signs, as well as the results of the medical tests.
In general, thyrotoxicosis is combated when dealing with Graves' disease (if any) and correcting hyperthyroidism with medications such as methimazole and propylthiouracil, in order to prevent the thyroid hormone from being secreted too much.
Likewise, there may be support measures such as the use of multivitamins, glucose replacement and fluid therapy. The use of both methods, as well as their doses, is something that the doctor will decide according to the patient's chart.
The presence of additional health problems, such as goiter, can make treatment more complex and follow-up is stricter, in order to have a better quality of life and have no relapses in the future.
Prevention
There are no preventive measures against thyrotoxicosis, although it is recommended that the affected person conforms to the doctor's instructions, in accordance with the diagnosis and the treatment that indicates his condition. Surveillance of thyrotoxicosis should be done on the patient, more specifically on thyroid hormone levels.
Attention should also be paid to risk factors that may increase the chances of having this disease.
[Warning of caution to the reader: if the thyrotoxicosis is caused by a health problem, consult the doctor so that it obtains of this one a certain diagnosis that leads to an effective treatment of its suffering.
Keep in mind that this article only complies with the duty to inform, so you should not use it as a substitute for the diagnosis or remedy of your clinical condition, much less as a means to resolve doubts that you should ask a specialist in the matter.]
References
- Arellano Hernández, Noe (2017). Thyrotoxicosis. San Miguel de Allende, Mexico: Educational Resources in Spanish for Emergency Medicine. Retrieved from reeme.arizona.edu
- Ball, Jane W., Stewart, Rosalin W. et al (2011). Mosby's Guide to Physical Examination, 7th edition. Missouri: Mosby.
- Blanco Sánchez, T.; Sanz Fernández, M. et al (2014). "Factitious thyrotoxicosis and eating disorder". Anales de Pediatría, 80 (2), pp. 133-134.
- Brent, Gregory A. (editor, 2010), Thyroid Function Testing, 1st edition. New York: Springer.
- Hansen, John T. (2014). Netter's Clinical Anatomy, 3rd edition. Amsterdam: Elsevier Health Sciences.
- LeBlond, Richard; DeGowin, Richard and Brown, Donald (2004). DeGowin's Diagnostic Examination, 8th edition. New York: McGraw-Hill Professional.
- Siraj, Elias S. (2008). "Update on the Diagnosis and Treatment of Hyperthyroidism". Journal of Clinical Outcomes Management, 15 (6), pp. 298-307.
- Valdés R., Enrique; Pilasi M., Carlos and Núñez U., Tatiana (2003). "Gestational thyrotoxicosis: life-threatening pathology". Chilean Journal of Obstetrics and Gynecology, 68 (1), pp. 54-57.