Hyperthyroidism is a hormonal disease that is characterized by high level of thyroid hormone in blood that occur because of abnormal activity of thyroid hormone or various factors.

1. Hyperthyroidism
OVERACTIVE THYROID GLAND LEAD TO INCREASE SECRETION OF
THYROID HORMONES

2. CAUES:
 Graves Disease
 Thyroid Adenoma

3. Graves Disease:
 Pathophysiology:
Autoimmune disease in which thyroid stimulating immunoglobulin (TSI)
formed against TSH receptors.
TSI bind with TSH
induced large secretion of hormone lead to hyperthyroidism
(Effect of TSI remain as far as 12hrs as compared to 1hr of TSH)
TSH= Thyroid stimulating hormone which is secreted by pituitary gland.

4. Thyroid Adenoma:
 Tumor of gland leads to large secretion of hormones.
Adenoma in a part of gland secretes large amount of hormones
Secretion of other portion of gland is suppressed
large level of thyroid hormone in blood
lead to inhibition of TSH
TSH level in blood decreases

5. Symptoms:
 Intolerance to heat ( more sweating)
 Mild to Extreme weight loss
 Varying degree of Diarrhea
 Muscle weakness
 Extreme fatigue and inability to sleep
 Dyspnea
 Tachycardia (due to increase cardiac output)
 Negative Nitrogen balance
 Goiter ( hyperplasia of gland)
 High state of excitability like anxiety and nervousness

6.  Exophthalmos (edematous swelling of retro orbital tissue and degenerative
changes in intraocular muscles.
In some patient immunoglobulin (TSI) react with eye muscle and in this case
TSH and TSI levels in blood is high.
Consequences:
 Protrusion of eyeballs stretch optic nerve enough to damage nerve.
 Eyelids will not completely close when blink or asleep.
 Epithelium will be dry and ulceration of cornea can occur.

7. Diagnostic Test:
TEST Result of Person with Hyperthyroidism
BMR Test (body metabolic rate test) Increased (+30 to +60)
TSH level Decreased or suppressed
TSI level • Concentration high in case of
thyrotoxicosis
• Concentration low in case of adenoma
Free level of T3 or T4 Increased
 TSI TSH or Free T4 OR T3 levels are measured by radioimmunoassay.

8. Treatment:
 Beta blocker are recommended
 Propylthiouracil (PTU)
 Surgical Removal of gland (but before surgery high level of iodine is
given to prevent iodine deficiency )
 Radioactive iodine treatment for hyperplastic thyroid gland.
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