Thyrotoxicosis

Ergothioneine is under investigation as a possible remedy for thyrotoxicosis... 

Hyperthyroidism (thyrotoxicosis), defined as excessive thyroid activity, causes a state of thyroid hormone excess (thyrotoxicosis) characterized by an increased metabolic rate, increase in body temperature, sweating, tachycardia, tremor, nervousness, increased appetite and loss of weight. Common causes of hyperthyroidism are toxic multinodular goiter, toxic adenoma or diffuse toxic goitre ( Graves disease). Antithyroid diugs (methimazol, carbimazole, propylthiouracil) block thyroid hormone production and are hence suitable for the treatment of hyperthyroidism. 

These drags are contraindicated in patients with an allergy to the (3 blockers, in patients with sinus bradycardia, second- or third-degree heart block, heart failure, and those with asthma, emphysema, or hypotension. The drug are used cautiously in patients with diabetes, thyrotoxicosis, and peptic ulcer. 

The symptoms of hypothyroidism and hyperthyroidism are given in Table 51-1. A severe form of hyperthyroidism, called thyrotoxicosis or tiiyroid storm, is characterized by high fever, extreme tachycardia, and altered mental status. Thyroid hormones are used to treat hypothyroidism and antithyroid... 

These drugp are contraindicated in patients with known hypersensitivity to the drug or to any constituents of the drug, after a recent myocardial infarction (heart attack), or in patients with thyrotoxicosis. When hypothyroidism is a cause or contributing factor to a myocardial infarction or heart disease, the physician may prescribe small doses of thyroid hormone... 

Insulin is a powerful anabolic hormone but it is unlikely that insulin deficiency causes skeletal muscle atrophy by direct action on muscle fibers (as opposed to neurogenic atrophy) except in chronic untreated cases. There is however a close parallel between the catabolic states induced by glucocorticoid excess and by insulin deficiency. Moreover, impaired insulin action is implicated in other endocrine myopathies as a contributory cause of muscle wasting. Both acromegaly and thyrotoxicosis are associated with insulin resistance due to a postreceptor defect, and secondary hyperparathyroidism due to hypophosphatemia also gives rise to insulin insensitivity. 

Thyrotoxicosis Pheochromocytoma Myotonic dystrophy Trigeminal neuralgia... 

Types of autoimmune diseases vary widely, from organ-specific diseases such as thyroiditis where there may be stimulation (thyrotoxicosis) by antibody against the receptor for pituitary thyroid-stimulating hormone (TSH) or inhibition (myxoedema) by cell destruction probably mediated by NK cells and autoantibody, through to non-... 

Cells possess surface receptor sites for the chemical messengers of the body. Should an autoantibody be produced against this site, it can combine with it and cause the same effect as the chemical messenger, e.g. thyrotoxicosis caused by autoantibody to the receptor site to TSH as previously described (section 4.10). 

Non-cardiac Anemia, anxiety disorders, carbon monoxide poisoning, cocaine use, esophageal reflux, peptic ulcer, pleuritis, pneumonia, pneumothorax, pulmonary embolus, pulmonary hypertension, thyrotoxicosis... 

Post-metabolic acidosis Pregnancy Severe anemia Thyrotoxicosis... 

The common causes of thyrotoxicosis are shown in Table 41-6.29,30 Thyrotoxicosis can be related to the presence or absence of excess hormone production (hyperthyroidism). Graves disease is the most common cause of hyperthyroidism. Thyrotoxicosis in the elderly is more likely due to toxic thyroid nodules or multinodular goiter than to Graves disease. Excessive intake of thyroid hormone may be due to overtreatment with prescribed therapy. Surreptitious use of thyroid hormones also may occur, especially in health professionals or as a self-remedy for obesity. Thyroid hormones can be obtained easily without a prescription from health food stores or Internet sources. 

Iodine excess (including radiocontrast, amiodarone) Thyrotoxicosis without hyperthyroidism Subacute thyroiditis Silent (painless) thyroiditis... 

Excess thyroid hormone intake (thyrotoxicosis factitia)... 

Secondary hyperthyroidism TSH-secreting pituitary tumors Trophoblastic (hCG-secreting) tumors Gestational thyrotoxicosis... 

Subclinical or mild thyrotoxicosis is defined as a low TSH with a normal FT4 level. While there may be few or no symptoms in these patients, there are several areas of concern.31,32 Many patients will progress to overt thyrotoxicosis. Patients with subclinical hyperthyroidism have been shown to suffer long-term cardiovascular and bone sequelae. In a 10-year follow-up of 2007 patients over age 60,33 patients with an undetectable TSH level had a 3.1-fold increased risk of atrial fibrillation versus those with a normal TSH. In a different 10-year follow-up study34 of... 

Treatment of thyrotoxicosis due to hyperthyroidism is similar, regardless of the underlying cause. The goals of treating hyperthyroidism are to relieve symptoms, to reduce thyroid hormone production to normal levels and achieve biochemical euthyroidism, and to prevent long-term adverse sequelae. 

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