Hyperthyroidism symptoms
Symptoms of overactive thyroid
The majority of patients (70-90%) have one Thyroid goiter on:
The thyroid is enlarged; this enlargement, when it has reached a certain level, becomes visible with normal head posture and especially when the head is reclined (= head backwards).
The goiter is mobile when swallowing, which is an important criterion for differentiating it from malignant occurrences in the thyroid gland.
The stages of a thyroid enlargement are classified according to the following order:
Stage Ia:
The goiter is palpably enlarged and not visible even when the head is reclined.
Stage Ib:
The goiter is only visible when the head is tilted back.
Stage II:
The goiter is visible with normal head posture.
Stage III:
In addition to the goiter, there is a congestion of the neck veins; this indicates the displacement of structures adjacent to the thyroid gland.
The patients are often nervous, easily excitable and angry, emotionally unstable and restless. They notice their fingers trembling and report insomnia. The heart rate is increased and there may be extra heart beats (= extrasystole) or cardiac arrhythmias, which the patients usually describe as "heart stumbling".
The blood pressure is often increased with an overactive thyroid (hyperthyroidism) (arterial hypertension).
The patients suffer from diarrhea and lose weight, although they have an increased appetite and eat more food.
Half of the patients have impaired glucose tolerance, i.e. those affected have high blood sugar levels when fasting and after meals.
Patients' skin is warm and moist, they sweat more and do not tolerate heat well.
Hair loss can also be a symptom of overactive thyroid.
Another symptom is the weakness of the thigh muscles, so that many patients feel weak and lacking drive (= adynamic).
Also read the article on the topic: Hot flashes and thyroid
If the overactive thyroid (hyperthyroidism) is based on Graves' disease, the following additional symptoms exist:
The thyroid gland is inflamed and autoantibodies against the TSH receptor and increased thyroid hormone concentrations can be detected in the blood.
Endocrine orbitopathy occurs in the majority of patients:
It is defined as the protrusion of one or both eyeballs from the eye socket. This is due to an inflammatory process that affects tissue that surrounds the eye (eye muscles, fatty tissue):
Cell enlargements in the tissue around the eyeball and in the eye muscles as well as the storage of glycoproteins (= proteins with a sugar residue in the chemical structure) and the subsequent water retention cause the orbitopathy.
The patients report double vision, have a rare blink (= Stellwag sign) and dry eyes, they are shy of light and have the feeling of having a foreign body in their eyes.
If the patient looks down, the upper eyelid does not drop (= Gräfe symbol).
The patient's eyesight (= visual acuity) decreases.
In addition, twitching eyelids can occur, which are caused by the overproduction of thyroid hormones.
In a small proportion of patients with Graves' disease, the skin is affected in the form of myxedema on the front edge of the shinbone (= tibia) and the forefoot: Glycoproteins are also stored here, which attract water, so that the subcutaneous tissue in front of the shin is thickened. There are no dents when pressure is applied to the thickened skin.
The fingernails and toenails can also be affected: They detach from the nail bed (= oncholysis).
