Lesson 2: Signs and Symptoms of Hyperthyroidism
Signs and Symptoms
The signs of disease are factors or characteristics such as an elevated heart rate that a physician can objectively measure or detect. Symptoms refer to the problems that a patient notices or feels. An example of a symptom would be feeling hot or feverish.
The signs and symptoms of hyperthyroidism have a tendency to come and go, which is the typical waxing and waning that characterize hyperthyroidism. Symptoms and signs also vary in intensity and predominant symptoms may change over time. In patients with hyperthyroidism caused by Graves’ disease, certain symptoms may occur that are related to the autoimmune thyroid disorder rather than hyperthyroidism. Symptoms related to autoimmunity include eye changes, such as proptosis or bulging, swollen lymph nodes and dermal changes, such as pretibial myxedema, a condition that causes waxy lesions on the lower legs.
Symptoms typically occur as a cluster with several symptoms predominating. Common symptoms of hyperthyroidism include: irritability, weight loss, weakness, shortness of breath, palpitations, increased thirst or appetite, increased bowel movements, sensitivity to heat, increased tolerance to cold, insomnia, warm skin, moist skin, fine hair, nail changes, vitiligo, tremors, increased sweating, hyperactive reflexes, tachycardia, irregular or absent menstrual periods, enlarged breasts in males, hyperpigmentation, emotional lability, depression, and restlessness.
Signs of hyperthyroidism include: increased heart rate, increased systolic blood pressure, slightly decreased white blood cell count, enlarged lymph notes, eyelid tremor, tongue tremor, increased blood calcium levels, anovulatory menstrual periods, amenorrhea, which causes scanty or absent menstrual periods, decreased peripheral resistance, increased cardiac output and pulse pressure, increased fast wave activity on EEG, goiter, increased liver enzyme levels, redness of palms, face, neck, and elbows, and dehydration. An examination of the thyroid gland shows thrills and bruits due to increased blood flow and the gland is often enlarged.
The appearance may change in hyperthyroidism. While most patients with hyperthyroidism lose weight, usually an average loss of twenty pounds, approximately ten percent of patients gain weight. Weight gain is more likely to occur in younger patients.
Hyperthyroidism may also cause its patients to have an expression of fright or extreme anxiousness. This may be related to the peculiar eye signs characteristic of hyperthyroidism. These eye signs include eyelid retraction, a prominent staring appearance, infrequent blinking, light sensitivity and proptosis or bulging.
