Hyperthyroidism can be complicated by severe cardiovascular disease, neurological and psychiatric manifestations that may require hospital admission or urgent treatment. Untreated hyperthyroidism especially puts elderly people at a higher risk for atrial fibrillation, cardiovascular disease, thyroid eye disease, hip fracture, decreased bone mineral density and adversely affects their quality of life.
Health risks of hyperthyroidism
About 85% of patients with hyperthyroidism develop cardiovascular symptoms. In particular, there is an increased incidence of mitral valve prolapse in patients with Graves’ disease.
Rhythm disturbances. The most common cardiac complication of hyperthyroidism is tachycardia which is a rapid heart beat with about 90% of patients who have resting heart rate over 90 beats per minute.
Atrial fibrillation or irregular heart beat occurs in 5 to 15% of hyperthyroid patients and is more common in men than in women. Its incidence significantly increases after age 40 and is found in 25% of elderly hyperthyroid patients. Interestingly, the risk of atrial fibrillation in patients with subclinical hyperthyroidism is the same as in patients with clinical hyperthyroidism.
Heart failure. Due to hyperthyroidism the heart functions at its full capacity even in a resting state. The majority of hyperthyroid patients double or triple the cardiac output and have above normal contractility of the blood vessels without showing any symptoms of heart failure. A small percentage of patients, mainly elderly, who have atrial fibrillation or underlying heart disease, develop heart failure.
Hypertension. About one third of people with hyperthyroidism, mainly the elderly, experience systolic arterial hypertension. This partly occurs due to the inability of the vascular system to respond to the increased blood volume. These changes could be completely reversed with restoration of the thyroid function.
Osteoporosis. Osteoporosis is characterized by low bone mass, deterioration of bone structure, increased bone fragility and susceptibility to fracture. Thyrotoxicosis is an important but under recognized cause of osteoporosis. Even though T4 and T3 thyroid hormones are essential for skeletal development and bone maintenance in adults, their role in the contributing to osteoporosis has been largely overlooked. In fact, thyrotoxicosis increases bone turnover, accelerates bone loss and causes osteoporosis.
Bone fractures. Even minor or transient disturbances of thyroid function increase risk of bone fracture. According to studies of postmenopausal women, suppressed TSH from any cause is associated with a 3.6 fold increased risk of hip and 4.5 fold risk of vertebral fracture. Over replacement with thyroid hormone in postmenopausal women is an underestimated contributor to the osteoporosis.
Conventional treatment of hyperthyroidism
Anti-thyroid drugs are often used to treat hyperthyroidism in people with Grave’s disease and toxic multinodular goiter to reduce the hormone production by the thyroid gland. Skin rash and itching, fever, liver inflammation and low white blood cell counts are the side effects of the treatment and indicators to discontinue with the medication that usually causes the recurrence of hyperthyroidism.
Radioactive iodine is a radioactive isotope of I-131 that is taken in a liquid form or as a pill. The thyroid gland takes up the radioactive iodine which causes the destruction of some thyroid cells. These cells stop functioning and producing thyroid hormones. As a result of the treatments most patients become hypothyroid.
There are some concerns regarding the radioiodine treatment:
- It can worsen thyroid eye disease which often accompanies Grave’s disease.
- Combined with anti-thyroid drugs it increases the probability of persistent or recurrent hyperthyroidism and the need for further treatment.
- Small amounts of radioactive iodine could also be taken up by salivary glands, ovaries/testicles and cells of the stomach that can cause such side effects as dryness of the mouth, temporary test impairment, salivary gland swelling, sore throat, nausea, vomiting and upset stomach.
- It is unknown if radioiodine treatment increases the risk of thyroid and other types of cancers. According to World Health Organization, the risk of radioactive iodine induced thyroid cancer in adults over 40 is extremely low. The low probability of thyroid cancer in adults likely explains why physicians often use I-131 therapy to ablate the thyroid gland in patients with Graves disease.
Thyroidectomy is a surgery with a total or partial removal of the thyroid gland. Most people become hypothyroid after the procedure and need lifelong thyroid hormone replacement.
Alternative treatments
Overactive thyroid can be managed nutritionally with a special hyperthyroid diet. Certain foods can make a significant impact on the thyroid function if included or excluded from the diet reducing the production of thyroid hormones and hyperthyroid symptoms.
Grave’s disease is an autoimmune condition where the immune system over reacts and initiate an inflammatory process. Certain types of oil are proven to reduce inflammation and adding it to the diet can be beneficial for a successful hyperthyroid treatment. Use of herbs and natural preparations is an effective and safe alternative to the conventional treatment methods without serious side effects.
Most herbal preparations for hyperthyroidism suppress thyroid function decreasing the secretion of thyroid hormones. One of many herbs called Bugleweed (Lycopus virginicus) has been used in Europe for a long time as a natural remedy for hyperthyroid symptoms, over reactive thyroid and balancing of the immune system.
Bugleweed inhibits the iodine uptake by the thyroid gland reducing the hormone production and decreases the levels of thyroid antibodies responsible for Graves’ disease. It can be used in combination with other herbal preparations or in addition to anti-thyroid drugs or alone on the early stages of the disease and mild conditions.
To learn about natural treatments for hyperthyroidism and Grave’s disease in a comprehensive report click here.
P.S.
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References:
1. Hyperthyroidism (primary), Clin Evid (Online). 2008 Mar 25;2008. pii: 0611.
2. Hyperthyroidism and the heart. Hellenic J Cardiol. 2008 May-Jun;49(3):169-75.
3. Thyroid hormone excess rather than thyrotropin deficiency induces osteoporosis in hyperthyroidism. Mol Endocrinol. 2007 May;21(5):1095-107. Epub 2007 Feb 27.
4. World Health Organization. Guidelines for iodine phrophylaxis following nuclear accidents (update 1999). Geneva: WHO/SDE/PHE/99.6, 1999
