پرکاری تیروئید؛ تپش قلب، لاغری، اضطراب و لرزش دست دکترعلی جمشیدی‌فرد فوق تخصص غدددرون‌ریزومتابولیسم

Hyperthyroidism; Heart palpitations, weight loss, anxiety, and hand tremors Heart palpitations, unwanted weight loss, anxiety, excessive sweating, and hand tremors may be signs of hyperthyroidism; but does every heart palpitation or weight loss mean hyperthyroidism? How are TSH, T4, and T3 tests interpreted, and when can this disease be dangerous for the heart, bones, and eyes? In this interview with Dr. Ali Jamshidifard, a specialist in endocrinology and metabolism at Erfan Niayesh Hospital, we discuss the symptoms, causes, diagnosis, and treatment of hyperthyroidism. What is hyperthyroidism? The thyroid is a small, butterfly-shaped gland in the front of the neck. Thyroid hormones play a role in regulating metabolism, body temperature, heart rate, and the function of many organs. Hyperthyroidism occurs when the thyroid gland produces more hormones than the body needs; As a result, many body activities speed up. What are the symptoms of hyperthyroidism? Possible symptoms include palpitations or increased heart rate, weight loss despite normal or high appetite, anxiety and restlessness, irritability, fine hand tremors, excessive sweating, heat intolerance, muscle weakness, fatigue, sleep disturbance, increased bowel movements, thinning hair, and menstrual changes. Some patients develop goiter. Graves' disease may also cause redness, dryness, bulging eyes, or double vision. In the elderly, the disease sometimes manifests itself more with weakness, weight loss, or heart rhythm disorders. These symptoms are not specific and may also be seen in anxiety, anemia, heart disease, taking certain medications, and other problems. Therefore, diagnosing hyperthyroidism based on symptoms alone is not possible and requires a doctor's evaluation and blood tests. Does hyperthyroidism always cause weight loss? Increased thyroid hormones can cause weight loss, but not all patients lose weight. Some people, especially those with an increased appetite, may lose little or no weight. Unintentional weight loss should be investigated and should not be attributed to the thyroid without testing. What causes hyperthyroidism? Graves' disease, an autoimmune disorder, is a major cause of hyperthyroidism. An overactive thyroid nodule or nodules may also produce hormones independent of the body's needs. Inflammation of the thyroid can cause stored hormone to enter the blood, causing a temporary period of hyperthyroidism. Taking too much thyroid medication, taking too much iodine, and some medications can also contribute to this condition. What do TSH, T4, and T3 tests show? In most cases of hyperthyroidism, TSH levels are low and free T4 or T3 are high. TSH is secreted by the pituitary gland, and when thyroid hormone is high in the blood, the pituitary gland reduces TSH secretion. Low TSH alone is not always enough to diagnose the cause of the disease and must be interpreted in conjunction with T4, T3, the patient's symptoms and condition. To diagnose the cause, your doctor may order thyroid antibody tests, a scan and thyroid uptake assay, or in some cases an ultrasound. The choice of these tests is not the same for all patients. What are the complications of hyperthyroidism? Untreated or uncontrolled hyperthyroidism can cause increased or irregular heartbeats, including atrial fibrillation, worsening of heart disease, decreased bone density, muscle weakness, and problems with fertility or pregnancy. Thyroid eye disease can also occur in people with Graves' disease. Thyroid storm is a rare but very dangerous condition. High fever, very fast heartbeat, severe restlessness, confusion, vomiting, or decreased level of consciousness in a person with hyperthyroidism requires immediate emergency care. How is hyperthyroidism treated? Treatment depends on the cause of the disease, the severity of symptoms, age, heart condition, pregnancy, and the individual's condition. Drugs that inhibit thyroid hormone production, radioactive iodine, and surgery are the main treatments. Sometimes drugs that control heart rate and tremor are prescribed to reduce symptoms, but these drugs do not treat the underlying cause of hyperthyroidism. Radioactive iodine is not used during pregnancy and breastfeeding, and the choice of medication during pregnancy also has special considerations. Some treatments may later cause hypothyroidism and the need for hormone replacement. Antithyroid medications should be taken exactly as prescribed by the doctor. If a fever, severe sore throat, yellowing of the skin or eyes, dark urine, or abdominal pain develops while taking these medications, the patient should contact a doctor or medical center immediately. Do not start, stop, or increase the medication arbitrarily. If you have persistent palpitations, unwanted weight loss, hand tremors, excessive sweating, heat intolerance, bulging eyes, or abnormal thyroid test results, see your doctor to determine the cause. Chest pain, shortness of breath, fainting, di...