Thyroid hormones, which are produced by the thyroid gland, an endocrine gland in our body, are vital for sustaining our body's metabolic processes. Thyroid hormones stimulate cells to produce proteins, which have a direct impact on our metabolism as well as the operations of different organs. As a result, our heart rate, blood pressure, digestion, appetite, mood, menstrual cycle, metabolism, and muscle control are all impacted by the level of thyroid hormones. Too much thyroid hormone (hyperthyroidism) or too little thyroid hormone (hypothyroidism) can have a substantial impact on the majority of our body's organs.

The term "hyperthyroidism" describes the thyroid gland's excessive release of thyroid hormones (T4 or T3) for a variety of causes. This causes different body organs to have faster metabolism and produces a variety of clinical symptoms.

1. Graves' disease: The most typical cause of hyperthyroidism. With autoimmune dysfunction, patients produce aberrant antibodies that assault and trigger the TSH receptor on thyroid cells, increasing thyroid hormone synthesis and secretion.
2. Toxic adenoma: Thyroid hormones are produced and secreted in an unregulated manner as a result of abnormal thyroid cell development.
3. Toxic Multinodular Goitre: Hyperthyroidism can result from a multinodular goitre that has been present for a long time.
4. Thyroiditis: Thyroiditis in its early stages results in the release of thyroid hormones from storage into the bloodstream, which leads to hyperthyroidism.
5. Causes brought on by drugs, such as the arrhythmia medicine amiodarone.
6. Excessive intake of iodine.
7. Other uncommon reasons include pituitary tumors, ovarian or testicular tumors that release thyroid hormones, etc.

Patients receive faster body metabolism as a result of high thyroid hormone release, and symptoms include:

• Rapid heartbeat
• Palpitations
• Irritability
• Depression
• Insomnia
• Increased appetite but significant weight loss
• Menstrual irregularities
• Diarrhoea
• Tremors in the hands
• Heat intolerance
• Excessive sweating

Clinical Examination

Doctors might enquire about a patient's medical history, family history, and associated symptoms during a physical examination and clinical assessment. Clinical palpation enables medical professionals to ascertain the presence of additional nodules or enlarged lymph nodes in the neck, whether the trachea is squeezed as a result of thyroid enlargement, whether the patient has thyroid enlargement, and whether the enlargement is uniform and symmetrical.

Blood Tests: Thyroid Function Tests

Blood tests can be used to determine thyroid function tests, which measure the body's thyroid hormone output. Triiodothyronine (T3), thyroxine (T4), and thyroid-stimulating hormone (TSH) are all measured during thyroid function tests.

Thyroid Ultrasound

Thyroid ultrasound is a non-invasive examination. Gel is applied to the patient's neck during the procedure, and an ultrasound probe is used to capture live thyroid images. During the examination, the doctor takes matching photos for analysis. With the use of a thyroid ultrasound, a doctor can determine the size of the thyroid, the size and type of thyroid nodules, the blood flow around the nodules, calcifications, and whether or not there are enlarged neck lymph nodes, among other things.

A potentially fatal condition is thyroid storm. When a person who has uncontrolled or inadequately treated hyperthyroidism is exposed to certain triggers, such as trauma, illness, or surgery, it happens.

High fever, a rapid heartbeat, high blood pressure, nausea, an enlarged liver, jaundice, restlessness, and trembling are all signs of thyroid storm. Without prompt medical attention, complications like cardiac failure, coma, arrhythmias, or mental confusion may develop, which might be fatal.

Patients with hyperthyroidism may also encounter the following side effects in addition to thyroid storm:

1. Eye complications: Long-term eye protrusion can cause damaged corneas, partial eyelid closure, and even blindness.
2. Psychiatric complications: Psychological side effects of hyperthyroidism include emotional instability, anxiety, sleeplessness, agitation, or depression.
3. Metabolic abnormalities: Metabolic diseases including diabetes and liver dysfunction can be brought on by hyperthyroidism.
4. Digestive problems: Patients may experience diarrhoea and indigestion.
5. Osteoporosis: Excessive thyroid hormone secretion accelerates bone resorption, increasing the risk of osteoporosis and fractures.
6. Cardiac complications: Heart failure and other cardiac problems can result from long-term hyperthyroidism-related tachycardia and arrhythmias.
7. Infertility and miscarriage: Hyperthyroidism may increase the risk of female infertility, miscarriage, and premature birth.

To avoid thyroid storm and lower the risk of consequences, it is crucial that individuals with hyperthyroidism receive the right care and management. For the illness to be adequately controlled, regular medical follow-up and adherence to recommended drugs are essential.

Before determining the appropriate treatment, the doctor must identify the underlying cause of the patient's condition.

Medical Treatment

Medication is the most common treatment for hyperthyroidism. Anti-thyroid medications suppress the production of thyroid hormones, restoring normal thyroid secretion and metabolism in the patient. Initiating medication requires close monitoring of thyroid hormone levels, and the dosage will be adjusted until thyroid hormone levels are within the normal range. Carbimazole and Propylthiouracil are two commonly used anti-thyroid pharmaceuticals.

Some patients may experience allergic reactions, such as irritation or rashes, to the medication. Other possible complications include transient liver dysfunction. In such situations, the patient may be prescribed different medication or other alternative treatment options.

It is essential for patients to adhere to their prescribed medication regimen and maintain regular follow-up appointments with their doctor so that their condition can be monitored and treated as necessary. Depending on the individual's condition and response to treatment, medication may be combined with other treatment modalities such as radioactive iodine therapy or surgery.

The thyroid glands are typically around 3 and 4 cm long and are located on both sides of the neck, below the Adam's apple. As soon as the thyroid glands reach a height of 5 to 6 cm, the neck will expand and protrude, which can be felt with the hand. As the expansion of the thyroid glands comes into contact with the collarbones, the opening of the neck becomes constricted. As the growth tissues continue to expand, they may exert pressure on the trachea and impair respiration. 

Goiter is a condition in which the thyroid gland is enlarged, patients can undergo a minimally invasive thyroidectomy to remove the growth tissues.