Hyperthyroidism
Basics
Description
Description
- Hyperthyroidism is the result of inappropriate secretion of thyroid hormones by the thyroid gland
- Occurs in ∼1.2% of the population in the U.S.
- Excessive thyroid hormone production results in a continuum of disease:
- Subclinical or mild hyperthyroidism
- Thyrotoxicosis
- Thyroid storm or thyrotoxic crisis with life-threatening manifestations:
- 1–2% of patients with hyperthyroidism
- Regulation of thyroid hormone:
- Thyrotropin-releasing hormone (TRH) from hypothalamus acts on the anterior pituitary
- Thyroid-stimulating hormone (TSH) released by anterior pituitary gland and results in increased T3 and T4 from the thyroid gland:
- Most of circulating hormone is T4, which is peripherally converted to T3
- T3 is much more biologically active than T4 although it has a shorter half-life
- The causes of hyperthyroidism can be broken down into 4 categories:
- Excessive thyroid stimulation
- Inappropriate thyroid hormone synthesis
- Stores of hormones are released
- Excessive sources of hormone (endogenous or exogenous)
Etiology
Etiology
- Primary hyperthyroidism (resulting in inappropriate hormone synthesis):
- Toxic diffuse goiter (Graves’ disease)
- Toxic multinodular (Plummer disease) or uninodular goiter
- Excessive iodine intake
- Thyroiditis (thyroid inflammation):
- Postpartum thyroiditis
- Radiation-induced thyroiditis
- Subacute thyroiditis (de Quervain)
- Amiodarone-associated thyroiditis
- Chronic thyroiditis (Hashimoto/lymphocytic)
- Metastatic thyroid cancer
- Ectopic thyroid tissue (struma ovarii)
- Pituitary adenoma
- Drug induced:
- Amiodarone
- Lithium
- α-interferon
- Interleukin-2
- Iodine (radiographic contrast agents)
- Excessive thyroid hormone (factitious thyrotoxicosis)
- Aspirin overdose
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Citation
Schaider, Jeffrey J., et al., editors. "Hyperthyroidism." 5-Minute Emergency Consult, 6th ed., Lippincott Williams & Wilkins, 2020. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307218/all/Hyperthyroidism.
Hyperthyroidism. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307218/all/Hyperthyroidism. Accessed October 7, 2024.
Hyperthyroidism. (2020). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (6th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307218/all/Hyperthyroidism
Hyperthyroidism [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. [cited 2024 October 07]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307218/all/Hyperthyroidism.
* Article titles in AMA citation format should be in sentence-case
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