Presentation
Hyperthyroidism duration positively correlated with thyroid peroxidase autoantibody (TPOAb) levels at presentation (r = 0.729, p = 0.002). [ncbi.nlm.nih.gov]
Entire Body System
- Goiter
Unlike the classical diffusely enlarged, lobular, bruit-associated goiter that is described with classical Graves disease the goiter is small, diffuse and often firm in these cases. [thetrp.net]
(plunging) (substernal) E04.9 ICD-10-CM Diagnosis Code E04.9 Nontoxic goiter, unspecified 2016 2017 2018 2019 Billable/Specific Code Applicable To Goiter NOS Nodular goiter (nontoxic) NOS lymphadenoid E06.3 Hashimoto's disease or thyroiditis E06.3 Hashitoxicosis [icd10data.com]
Diffuse nontoxic goiter is caused by an increased production of TSH from an enlarging thyroid gland, thus resulting in multi-nodular goiters. [hyperthyroidismsymptomsx.com]
Over time the thyroid may enlarge, forming a painless goiter. Some people eventually develop hypothyroidism with accompanying weight gain, feeling tired, constipation, depression, and general pains. [wikivividly.com]
- Weight Gain
It can cause a number of symptoms, such as poor ability to tolerate cold, a feeling of tiredness, constipation, depression, and weight gain. Occasionally there may be swelling of the front part of the neck due to goiter. [wikivividly.com]
Weight gain Sluggish and tired Pain in muscles and joints Pale skin Puffy skin, especially in the face Constipation Cold all of the time Pregnancy hard to come by Depression Low sex drive The problem is at first symptoms may not appear right away. [hashitoxicosis.com]
Also I have gained 2 stone in weight in the past year, this is really depressing me as I am an active person. [healthunlocked.com]
gain Pale, puffy face Feeling cold Joint and muscle pain Constipation Dry, thinning hair Heavy menstrual flow or irregular periods Depression A slowed heart rate Problems getting pregnant Hashimoto’s Disease diagnosis If you have symptoms of Hashimoto [thyroid.com.au]
- Heat Intolerance
He initially presented with complaints of increased appetite, heat intolerance, fatigue, and sweating. On a physical exam, he had mild exophthalmos with lid lag and a fine tremor in the hands. [mendeley.com]
Brittle or thin nails Low motivation Low sex drive Dry ridges down nails Dizziness Difficulty in swallowing Sensation of cold Hearing loss Weakness Cold skin Rapid heart rate Vague body aches & pains Decreased sweating Pounding heart beat Muscle pain Heat [dailystrength.org]
- Thyroid Nodule
An MRI with and without contrast revealed “heterogeneous in intensity and multiple small nodules.” There was also a 1.2x1.4x1.5 cm nodule at the thyroid isthmus. [healio.com]
Topics covered include the following: thyroid synthesis and physiology; hyperthyroidism; hypothyroidism; thyroid nodules; goiter; differentiated thyroid cancer; subacute, silent, and postpartum thyroiditis; thyroid and pregnancy; thyroid and the elderly [books.google.com]
Thyroid Cancer –Development of malignant thyroid tissue or nodules. [hyperthyroidismsymptomsx.com]
nodule on an ultrasound can give an idea as to whether a nodule is malignant or benign. [naturalendocrinesolutions.com]
- Fever
The hallmark symptoms of a thyroid storm is a fever which can go as high as 40.5 - 41.1 C (105 - 106 F). [medhelp.org]
Case 33: Headache Case 34: Vision loss Case 35: Heartburn Case 36: Fatigue Case 37: Skin changes Case 38: Ankle pain Case 39: Shoulder pain Case 4: Vaginal bleeding Case 40: Dizziness Case 5: Nausea Case 6: Pelvic pain Case 7: Toddler with a cough and fever [amboss.com]
Exacerbations with sudden enlargement and tenderness of the thyroid gland and general features of inflammation (elevated C-reactive protein [CRP] levels and erythrocyte sedimentation rate [ESR], rarely with fever) are very rare; they may be accompanied [empendium.com]
[…] body, manifested by fever and sore throat); * Propylthiouracil (PTU) "can cause serious liver damage. [drllynch.com]
Gastrointestinal
- Increased Appetite
appetite ), anxiety, intolerance to heat, fatigue, hair loss, weakness, hyperactivity, irritability, apathy, depression, polyuria, polydipsia, delirium, and sweating. [research.omicsgroup.org]
He initially presented with complaints of increased appetite, heat intolerance, fatigue, and sweating. On a physical exam, he had mild exophthalmos with lid lag and a fine tremor in the hands. [mendeley.com]
appetite), anxiety, intolerance to heat, fatigue, hair loss, weakness, hyperactivity, irritability, apathy, depression, polyuria, polydipsia, delirium, and sweating. [wikiwand.com]
- Nausea
Additionally, patients may present with a variety of symptoms such as palpitations and arrhythmias (notably atrial fibrillation ), shortness of breath ( dyspnea ), loss of libido, nausea, vomiting, and diarrhea. [research.omicsgroup.org]
Additionally, patients may present with a variety of symptoms such as palpitations and arrhythmias (notably atrial fibrillation), shortness of breath (dyspnea), loss of libido, nausea, vomiting, and diarrhea. [wikiwand.com]
Symptoms of a thyroid storm are severe and complications include fever, dehydration, rapid heart rate, irregular heart beat, nausea, vomiting, diarrhea, weakness, confusion, disorientation, heart failure, death. [medhelp.org]
- Vomiting
Additionally, patients may present with a variety of symptoms such as palpitations and arrhythmias (notably atrial fibrillation ), shortness of breath ( dyspnea ), loss of libido, nausea, vomiting, and diarrhea. [research.omicsgroup.org]
Additionally, patients may present with a variety of symptoms such as palpitations and arrhythmias (notably atrial fibrillation), shortness of breath (dyspnea), loss of libido, nausea, vomiting, and diarrhea. [wikiwand.com]
Symptoms of a thyroid storm are severe and complications include fever, dehydration, rapid heart rate, irregular heart beat, nausea, vomiting, diarrhea, weakness, confusion, disorientation, heart failure, death. [medhelp.org]
- Polydipsia
[…] release of thyroid hormone. [ 2 ] Symptoms Major clinical signs include weight loss (often accompanied by an increased appetite ), anxiety, intolerance to heat, fatigue, hair loss, weakness, hyperactivity, irritability, apathy, depression, polyuria, polydipsia [research.omicsgroup.org]
[…] resulting in excess release of thyroid hormone.[2] Major clinical signs include weight loss (often accompanied by an increased appetite), anxiety, intolerance to heat, fatigue, hair loss, weakness, hyperactivity, irritability, apathy, depression, polyuria, polydipsia [wikiwand.com]
[…] excess release of thyroid hormone. [2] Symptoms Major clinical signs include weight loss (often accompanied by an increased appetite ), anxiety, intolerance to heat, fatigue, hair loss, weakness, hyperactivity, irritability, apathy, depression, polyuria, polydipsia [ipfs.io]
[…] in excess release of thyroid hormone. [2] Major clinical signs include weight loss (often accompanied by an increased appetite ), anxiety, intolerance to heat, fatigue, hair loss, weakness, hyperactivity, irritability, apathy, depression, polyuria, polydipsia [wikivividly.com]
Jaw & Teeth
- Macroglossia
TIROIDE • I SINTOMI ED I SEGNI ALLA NASCITA INCLUDONO DIFFICOLTA’RESPIRATORIE,CIANOSI,ITTER O NEONATALE E PROLUNGATO,STIPSI,DISTURBI DELLA • SUZIONE,MACROGLOSSIA,PIANTO RAUCO,ERNIA OMBELICALE,FONTANELLE ALLARGA- • TE,DIFFICOLTA’A MANTENERE POSIZIONE ERETTA [slideshare.net]
Cardiovascular
- Palpitations
Additionally, patients may present with a variety of symptoms such as palpitations and arrhythmias (notably atrial fibrillation ), shortness of breath ( dyspnea ), loss of libido, nausea, vomiting, and diarrhea. [research.omicsgroup.org]
Additionally, patients may present with a variety of symptoms such as palpitations and arrhythmias (notably atrial fibrillation), shortness of breath (dyspnea), loss of libido, nausea, vomiting, and diarrhea. [wikiwand.com]
She came back after 11 months because of fatigue and palpitations, in the absence of neck pain. [pubmed.ncbi.nlm.nih.gov]
- Tachycardia
The second patient The second patient was a 42-year-old female presenting with tachycardia and mood swings who was diagnosed with hyperthyroidism in February 2008. [schildkliertje.blogspot.com]
The second patient was a 42-year-old female presenting with tachycardia and mood swings who was diagnosed with hyperthyroidism in February 2008. [touchendocrinology.com]
Clinically, GD can present with a firm, nontender goiter, ophthalmopathy, a peripheral tremor, tongue fasciculations, tachycardia, and/or hypertension [1]. [hindawi.com]
There were no eye changes typical of Graves' and no peripheral manifestations aside from tachycardia and brisk deep tendon reflexes. [healio.com]
Musculoskeletal
- Muscle Weakness
Symptoms may include a sudden feeling of exhaustion, nausea, headache, dizziness, inability to concentrate, trembling, muscle weakness, loss of peripheral circulation leading to numbness, lack of muscle control, slurred speech, cognitive impairment. [medhelp.org]
Symptoms may include an enlarged thyroid gland (goiter), tiredness, weight gain, and muscle weakness. You don’t need treatment if your thyroid hormone levels are normal. If you have an underactive thyroid, medicine can help. [cooperhealth.org]
Scanty flow is known as Oligomenorrhea Mood swings Muscle weakness and fatigue Nail margins uneven, nails split, nails weak, cracking Nausea, vomiting Nutrient deficiencies Onycholysis (separation of nail from its bed) Overactive libido is more common [dailystrength.org]
Symptoms may include: Goiter (benign enlargement of the thyroid gland, causing enlargement of the neck) Symptoms of underactive thyroid gland, which include: Fatigue Muscle weakness Weight gain Sensitivity to cold Depression Hair and skin changes As the [nm.org]
- Myalgia
28/01/2016 Presented with menorrhagia, dysmenorrhea & myalgia. [livingwithgravesdisease.com]
"Minor adverse reactions include skin rash, urticaria, nausea, vomiting, epigastric distress, arthralgia, paresthesias, loss of taste, taste perversion, abnormal loss of hair, myalgia, headache, pruritus, drowsiness, neuritis, edema, vertigo, skin pigmentation [drllynch.com]
Skin
- Alopecia
[…] immune system Adenoid hypertrophy Adipose tissue Adrenal gland Adrenal insufficiency African trypanosomiasis Age-related macular degeneration Aging changes Airway management and ventilation Airways and lungs Alcohol use disorder Alcoholic liver disease Alopecia [amboss.com]
In this study a new autoantigen related to this syndrome, tyrosine hydroxylase, was identified in sera from patients with alopecia areata through immunoscreening of a scalp cDNA library. [jeffreydachmd.com]
- Pruritus
[…] sclerosing cholangitis Principles of coronary heart disease Principles of dermatology Principles of medical law and ethics Progressive muscular dystrophies Prostate cancer Prostatitis Protein analysis Proteins and peptides Proteinuria Proton pump inhibitors Pruritus [amboss.com]
"Minor adverse reactions include skin rash, urticaria, nausea, vomiting, epigastric distress, arthralgia, paresthesias, loss of taste, taste perversion, abnormal loss of hair, myalgia, headache, pruritus, drowsiness, neuritis, edema, vertigo, skin pigmentation [drllynch.com]
Psychiatrical
- Loss of Libido
Additionally, patients may present with a variety of symptoms such as palpitations and arrhythmias (notably atrial fibrillation ), shortness of breath ( dyspnea ), loss of libido, nausea, vomiting, and diarrhea. [research.omicsgroup.org]
Additionally, patients may present with a variety of symptoms such as palpitations and arrhythmias (notably atrial fibrillation), shortness of breath (dyspnea), loss of libido, nausea, vomiting, and diarrhea. [wikiwand.com]
Urogenital
- Polyuria
[…] in excess release of thyroid hormone. [ 2 ] Symptoms Major clinical signs include weight loss (often accompanied by an increased appetite ), anxiety, intolerance to heat, fatigue, hair loss, weakness, hyperactivity, irritability, apathy, depression, polyuria [research.omicsgroup.org]
[…] follicles, resulting in excess release of thyroid hormone.[2] Major clinical signs include weight loss (often accompanied by an increased appetite), anxiety, intolerance to heat, fatigue, hair loss, weakness, hyperactivity, irritability, apathy, depression, polyuria [wikiwand.com]
[…] resulting in excess release of thyroid hormone. [2] Symptoms Major clinical signs include weight loss (often accompanied by an increased appetite ), anxiety, intolerance to heat, fatigue, hair loss, weakness, hyperactivity, irritability, apathy, depression, polyuria [ipfs.io]
Clinical manifestations included polyuria, polydipsia and weight loss in the vast majority of patients. Permanent insulin administration was required in 75% of the cases[ 5 ]. [wjgnet.com]
Neurologic
- Confusion
Having Antibodies For Both Graves’ Disease and Hashimoto’s If for any reason you’re confused at this point, please go back and look at the summaries listed above. [naturalendocrinesolutions.com]
I can't say I'm convinced you are dealing with Hashitoxicosis even though you feel your symptoms are confusing. [dailystrength.org]
Then my new doctor told me my antibody tests indicated that I also had Hashi's which really confused me. [thyroidboards.com]
An uncommon complication is thyroid storm in which an event such as an infection results in worsening symptoms such as confusion and a high temperature and often results in death. [wikivividly.com]
- Hyperactivity
[…] thyroiditis disturbing the thyroid follicles, resulting in excess release of thyroid hormone. [ 2 ] Symptoms Major clinical signs include weight loss (often accompanied by an increased appetite ), anxiety, intolerance to heat, fatigue, hair loss, weakness, hyperactivity [research.omicsgroup.org]
Hashimoto's thyroiditis disturbing the thyroid follicles, resulting in excess release of thyroid hormone.[2] Major clinical signs include weight loss (often accompanied by an increased appetite), anxiety, intolerance to heat, fatigue, hair loss, weakness, hyperactivity [wikiwand.com]
[…] thyroiditis disturbing the thyroid follicles, resulting in excess release of thyroid hormone. [2] Symptoms Major clinical signs include weight loss (often accompanied by an increased appetite ), anxiety, intolerance to heat, fatigue, hair loss, weakness, hyperactivity [ipfs.io]
Hashimoto's thyroiditis disturbing the thyroid follicles, resulting in excess release of thyroid hormone. [2] Major clinical signs include weight loss (often accompanied by an increased appetite ), anxiety, intolerance to heat, fatigue, hair loss, weakness, hyperactivity [wikivividly.com]
- Headache
Common Symptoms – Overactive Thyroid A Hashimoto’s patient may for period of time — when the thyroid is overactive — have symptoms such as: Anxiety Insomnia Diarrhea Weight loss Fast heart rate Pressure headaches This temporary Hashimoto’s hyperthyroid [autoimmune.org]
I was having a sudden exhaustion, headache, dizziness, trembling, muscle weakness, increased heart rate (at one point it was up to 134 bpm), one of my eyes was enlarged (after several days of blurred vision). [medhelp.org]
[…] temperature Depression which worse if patient moves into myxedema coma Dry coarse skin and hair Edema Emotional lability Enlarged muscle fibers with muscle weakness (Hoffman's syndrome) Eyebrows stop growing, Fatigue Feeling of being overwhelmed Goiter Headache [dailystrength.org]
Case 27: Fatigue Case 28: Weight gain Case 29: Fatigue Case 3: Abdominal pain Case 30: Sore throat Case 31: Cough Case 32: Genital lesion Case 33: Headache Case 34: Vision loss Case 35: Heartburn Case 36: Fatigue Case 37: Skin changes Case 38: Ankle [amboss.com]
- Excitement
Individuals suffering from this disorder may become excited and behave in an abnormal manner. Hyperactivity Patients tend to be abnormally active during the transient phase of hyperthyroidism. [primehealthchannel.com]
- Slurred Speech
Symptoms may include a sudden feeling of exhaustion, nausea, headache, dizziness, inability to concentrate, trembling, muscle weakness, loss of peripheral circulation leading to numbness, lack of muscle control, slurred speech, cognitive impairment. [medhelp.org]
Workup
The patient underwent a thorough medical and neurological workup. Circulating thyroperoxidase antibodies were highly elevated but thyroid function was adequately maintained with L-thyroxine substitution. [jeffreydachmd.com]
Laboratory
- Leukocytosis
Other clinical features include fever, pharyngitis and dermal erythema. 5, 9 The pain is typically worse during swallowing and radiates locally. 5, 9, 12 Tachycardia is common, along with leukocytosis and an elevated ESR level. 3, 5, 9, 12 TSH, T 4 and [aafp.org]
Studies may include "low serum cortisol, normocytic, normochromic anemia and leukocytosis (common), nonspecific electrolyte abnormalities (common), low serum cholesterol, hyperglycemia, hypercalcemia, hypokalemia (may be associated with periodic paralysis [drllynch.com]
Treatment
In the few patients with a more severe presentation, methimazole treatment was required, and definitive hyperthyroidism resolution was delayed. [ncbi.nlm.nih.gov]
Hashitoxicosis Treatment Hyperthyroidism, if left untreated for a prolonged duration, may lead to Osteoporosis in the middle-aged population. Naturally, it requires professional medical treatment. [primehealthchannel.com]
Prospective identification of the individual benefit/risk ratio would facilitate personalized treatment strategies when IFN-α treatment is planned. [wjgnet.com]
This is an alternative treatment to thyroid removal (thyroidectomy and ablation), however, if the treatment fails, once given an ample trial, thyroid removal might be recommended as a follow up treatment." [medhelp.org]
Her thyroid was growing in size, not decreasing, and this continued as she became biochemically euthyroid when treatment with thyroxine was initiated. [healio.com]
Prognosis
Seizure 20(9):717–719 Article PubMed Google Scholar Zhao W, Li J, Wang J et al (2011) A case of Hashimoto encephalopathy: clinical manifestation, imaging, pathology, treatment, and prognosis. [link.springer.com]
[…] spots) FDG PET diffuse high uptake throughout the thyroid is consistent with chronic thyroiditis (or a normal variant) 14,15 superimposed focal high uptake should raise concern for a thyroid nodule including the possibility of carcinoma Treatment and prognosis [radiopaedia.org]
Prognosis Top The disease may lead to permanent hypothyroidism, which requires lifelong hormone replacement therapy (with adequate treatment, the disease causes no sequelae). [empendium.com]
If a papillary microcarcinoma is discovered incidentally in a surgically removed hyperthyroid gland, the prognosis is excellent. [frontiersin.org]
Pulmonary hypertension associated with sarcoidosis: mechanisms, haemodynamics and prognosis. Thorax 2006 ; 61 : 68 –74. ↵ Sulica R, Teirstein AS, Kakarla S, et al. [err.ersjournals.com]
Etiology
However, initial studies and the subsequent evolution of the patient, the diagnosis oriented toward a different etiology. Keywords : Hashitoxicosis; hyperthyroidism; hypothyroidism. [scielo.org.co]
Grave's disease and toxic nodular goitre are always considered as the prime etiologies in a patient with thyrotoxicosis. [ijcasereportsandimages.com]
Etiology Although there have been many theories for the etiology of Hashimoto's, no definitive causative agent has yet been identified. [med.ucla.edu]
Pathophysiology Unknown etiology: Genetic and environmental factors likely play a role. [www-amboss-com.db.rsu.lv]
Last Updated: May 11, 2022 Last Reviewed: May 11, 2022 Chapter Information Definition, Etiology, Pathogenesis Top Chronic autoimmune (lymphocytic) thyroiditis (Hashimoto thyroiditis) is a painless thyroiditis associated with antibodies against thyroid [empendium.com]
Epidemiology
1) Age of onset: occurs in all age groups, most prevalent in women aged 30–50 years Epidemiological data refers to the US, unless otherwise specified. [www-amboss-com.db.rsu.lv]
“[An epidemiological study on the relationship between selenium and thyroid function in areas with different iodine intake]” (article in Chinese). Zhonghua Yi Xue Za Zhi Vol. 83, No. 23 (2003): 2036–2039. [naturopathiccurrents.com]
EPIDEMIOLOGY Women are three to five times more likely to be affected than men. [aafp.org]
Epidemiology of childhood hyperthyroidism in France: A nationwide population-based study. J Clin Endocrinol Metab. 2018;103:2980-7. https://doi.org/10.1210/jc.2018-00273 Léger J, Oliver I, Rodrigue D, Lambert AS, Coutant R. [revistabiomedica.org]
Pathophysiology
Pathophysiology Unknown etiology: Genetic and environmental factors likely play a role. [www-amboss-com.db.rsu.lv]
Cardiovascular risk with subclinical hyperthyroidism and hypothyroidism: pathophysiology and management. J Cardiometab Syndr. 2007 Summer; 2(3): 198-206. Review. Shrier D.K. Burman K.D. Subclinical hyperthyroidism: controversies in management. [internationaljournalofcardiology.com]
GD and HT share similar pathophysiologic mechanisms but different clinical manifestations. The autoantibodies in GD and HT are different in these disorders; TRAb in GD and thyroid peroxidase antibody (TPOAb) in HT (2). [journals.aace.com]
The antibodies produced may cross-react with more than one gland [34], leading to complex pathophysiological interconnections. Chrousos highlighted that stress enhances the susceptibility to autoimmune disorders. [jmedicalcasereports.biomedcentral.com]
Pathophysiology of Hashimoto’s Hashimoto’s thyroiditis is an autoimmune disease in which the thyroid gland is infiltrated by lymphocytes which attack and destroy the functioning thyroid cells called thyrocytes. [jeffreydachmd.com]
Prevention
Beginning proper treatment for Hashimoto’s disease, even in its earliest stages, can prevent further damage to the thyroid gland and possibly prevent full-blown hypothyroidism. [holtorfmed.com]
[…] p If you can do anything to prevent it, don't have RAI done. I really, really regret it now. [forum.lowcarber.org]
[…] thyrotoxic phase of autoimmune thyroiditis can not be confirmed with certainty, i.e. if a possibility of Graves' disease is suspected, then a short course of anti-thyroid drugs may be prescribed, while cautiously watching out with periodic testing, for preventing [thetrp.net]