Hyperthyroidism

Hyperthyroidism, often referred to as an 'overactive thyroid', is a condition in which the thyroid gland produces and secretes excessive amounts of the free (not protein bound and circulating in the blood) thyroid hormones, triiodothyronine (T3) and/or thyroxine (T4). This is the opposite of hypothyroidism ('sluggish thyroid'), which is the reduced production and secretion of T3 and/or T4. Hyperthyroidism is a type of thyrotoxicosis, a hypermetabolic clinical syndrome which occurs when there are elevated serum levels of T3 and/or T4. Graves disease is the most common form of hyperthyroidism.

While hyperthyroidism may cause thyrotoxicosis they are not synonymous medical conditions; some patients may develop thyrotoxicosis as a result of inflammation of the thyroid gland (thyroiditis), which may cause the release of excessive thyroid hormone already stored in the gland but does not cause accelerated hormone production. Thyrotoxicosis may also occur by the ingestion of excessive amounts of exogenous thyroid hormone in the form of thyroid hormone supplements such as the most widely used supplement levothyroxine, liothyronine, in weight-reducing dietary supplements that contain thyroid hormone, synthetic forms of T4 and T3 or thyroid extract (desiccated thyroid). Excessive exogenous intake may be purposeful as part of various treatment regimens such as to suppress tumor growth in thyroid cancer or inadvertently, as in when using dietary supplements or via percutaneous absorption, as a result of topical use of cosmetic creams containing iodine or thyroid hormones. In these cases it is termed Thyrotoxicosis Factitia (L, facticius :artificial or self-induced); it is also known by other terms such as exogenous thyrotoxicosis, alimentary thyrotoxicosis or occult factitial thyrotoxicosis.

Disease management and therapy differ for thyrotoxicosis caused by hyperthyroidism and thyrotoxicosis caused by other conditions. Thyroid imaging and radiotracer thyroid uptake measurements, combined with serologic data, enable specific diagnosis and appropriate patient treatment.