Overactive thyroid (hyperthyroidism)

In the case of an overactive thyroid (hyperthyroidism), the concentration of TSH in the blood is reduced and the thyroid hormones T3 and T4 are increased or normal. Hyperthyroidism can be caused by Graves' disease, autonomous adenoma or inflammation of the thyroid gland (thyroiditis). But some drugs or X-ray contrast media can also trigger an overactive thyroid. Hyperthyroidism manifests itself with a racing heart, tremors, sweating, weight loss and a general restlessness and nervousness.

There are three treatment strategies available for the treatment of an overactive thyroid: A therapy with so-called thyreostatics (thionamides or sodium perchlorate) can be started. These prevent the incorporation of iodine into the thyroid hormones and as a result fewer hormones are released. Another therapy option is a (subtotal) thyroidectomy, i.e. a partial removal of the thyroid gland.

This option is used if the overactive thyroid (hyperthyroidism) cannot be controlled with medication, or not sufficiently, or if complications from the disease that cannot be treated with medication are to be expected (e.g. exophthalmos in Graves' disease). For the operation, the patient should be treated with thyreostatics for 6 weeks beforehand in order to normalize the patient's metabolism.

An alternative to surgery is radio-iodine therapy. Here radioactive iodine is administered which is absorbed by the thyroid gland. The radiation emitted by the radioactive material causes thyroid cells to perish.