00:01
The symptoms of
hyperthyroidism are numerous.
00:05
They include heat intolerance, palpitations,
dyspnea or shortness of breath, tremulousness,
menstrual irregularities and increase
in the frequency of stool and diarrhea,
weight loss and increased appetite.
00:21
In the rest of the body there may
be proximal muscle weakness,
patients may manifest fatigue
and difficulty sleeping.
00:28
They may also have mood
disturbances and be very irritable.
00:31
In all the patients, the classic
symptoms tend to be absent.
00:35
However, cardiac manifestations
are much more prominent.
00:38
Patients may present with abnormal
heart rates or atrial fibrillation
and may eventually develop heart failure.
00:47
The patterns of abnormal thyroid
function tests are as follows:
The initial evaluation is always based
on the clinical signs and symptoms.
00:56
Check her TSH alone initially to gauge
whether the patient is hyper or hypothyroid.
01:02
In the setting of suppressed TSH, then
go on and check her T4 and T3 level.
01:08
The typical pattern of
hyperthyroidism seen in this case
is a low TSH and an elevated
T4 and/or elevated T3.
01:18
This is the hallmark of
primary hyperthyroidsm.
01:22
A word on terminology.
01:24
Thyroid hormone excess from different sources.
01:28
First of all, endogenous thyroid
disorders will cause thyrotoxicosis
which is the clinical syndrome
of thyroid hormone excess
manifesting with the
symptoms described above.
01:40
Pituitary tumors can also cause an increase
secretion of thyroid stimulating hormone,
which again, will lead
to a hyperthyroid state.
01:49
This, however, is very very rare.
01:52
You can also have thyrotoxicosis
from taking exogenous levothyroxine.
01:57
So patients with a low thyroid who are
over medicating themselves with thyroxine
may manifest symptoms of thyrotoxicosis.
02:06
Hyperthyroidism is the more specific term
to describe thyroid gland overactivity.
02:13
The most common causes though, are
Graves' disease and toxic adenomas.