A Simple Guide to Thyrotoxicosis, Diagnosis, Treatment and Related Conditions

By Kenneth Kee

This book describes Thyrotoxicosis, Diagnosis and Treatment and Related Diseases

Thyrotoxicosis is a very common disease among women in the clinic.

They are usually triggered by stress factors.

They normally present with an enlarged thyroid gland although 30 per cent do not.

They usually complained of feeling hot all the time even when there is rain and a very fast heart beat.
The other signs are loss of weight and tremors of the hands,

Sometimes the eyes are seen to be bulging.

Treatment with medications is usually effective

Thyrotoxicosis is the hyper-metabolic disorder that is featured by the many toxic symptoms induced by raised thyroid hormone levels with or without higher thyroid hormone synthesis.

Hyperthyroidism is a group of disorders that affect the excessive synthesis and secretion of thyroid hormones by the thyroid gland.

Thyrotoxicosis is often erroneously used interchangeably with hyperthyroidism which is a form of thyroid disease caused by excessive endogenous thyroid hormone production.

The medical manifestation differs, ranging from asymptomatic or sub-clinical, to life-threatening thyroid storm.

Typical symptoms are caused by the hyper-metabolic state induced by excess thyroid hormones.

Thyrotoxicosis is produced by a disorder that raises the output of thyroid hormones:

Higher endogenous secretion of thyroid hormone

Graves' disease - diffuse goiter (enlarged thyroid) produced by autoimmune antibodies stimulation of the thyroid gland to secrete more thyroid hormones.

Plummer's Disease (Toxic nodular thyroid)

Hashimoto's Disease (Thyroiditis)

Toxic thyroid adenoma causes excessive thyroid hormone production from a single nodule in the thyroid gland.

TSH-producing adenoma or pituitary adenoma is tumors of the pituitary gland that produce thyroid-stimulating hormone (TSH), which causes excess secretion of thyroid hormones (T3 and T4) by the thyroid gland

HCG-mediated thyrotoxicosis: HCG is a hormone that reaches high levels during pregnancy and is a thyroid stimulator that can produce different types of thyrotoxicosis during a pregnancy.

Drug-induced thyrotoxicosis: The drugs which may produce thyrotoxicosis are interferon, molecular-targeted agents, amiodarone, and thyroid hormone itself.

Higher exogenous secretion of thyroid hormone

Factitious thyrotoxicosis: thyrotoxicosis due to the accidental or intentional thyroxine ingestion.
Idiopathic Hyperthyroid Disease is produced by ingestion of excessive replacement therapy with levothyroxine hormone.

The most frequent cause of thyrotoxicosis is Graves' disease, accompanied by toxic multi-nodular goiter (TMNG) and toxic adenoma (TA).

Other causes are thyroiditis, sub-acute thyroiditis, and gestational thyrotoxicosis.

Rare causes of thyrotoxicosis are struma ovarii, gestational trophoblastic neoplasia, activation mutations of the TSH receptor and thyroid cancer metastases

Patients with thyrotoxicosis most often present with symptoms linked to excess thyroid hormone such as:
Weight loss with increased appetite,
Heat intolerance with raised sweating,
Palpitations,
Tremor,
Anxiety,

Thyrotoxicosis is evident by reduced TSH levels and raised T3 and T4 levels

There are 3 main treatments:
Anti-thyroid drugs
Radioactive iodine therapy
Thyroid surgery

Surgery may be needed:
a. if the thyrotoxicosis did not improve with anti-thyroid drugs
b. if the thyrotoxic women do not want radioactive iodine therapy

TABLE OF CONTENT
Introduction
Chapter 1 Thyrotoxicosis
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Graves’s Disease
Chapter 8 Thyroid Eye Disease
Epilogue

• Language: English
• Publisher: Kenneth Kee
• Release date: Feb 13, 2022
• ISBN: 9781005847135

Kenneth Kee

Medical doctor since 1972. Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009. Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993. Dr Kenneth Kee is still working as a family doctor at the age of 70. However he has reduced his consultation hours to 3 hours in the morning and 2 hours in the afternoon. He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com. His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com This autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com. From which many free articles from the blog was taken and put together into 1000 eBooks. He apologized for typos and spelling mistakes in his earlier books. He will endeavor to improve the writing in futures. Some people have complained that the simple guides are too simple. For their information they are made simple in order to educate the patients. The later books go into more details of medical disorders. He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter. The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks. He does not do any night duty since 2000 ever since Dr Tan had his second stroke. His clinic is now relocated to the Buona Vista Community Centre. The 2 units of his original clinic are being demolished to make way for a new Shopping Mall. He is now doing some blogging and internet surfing (bulletin boards since the 1980's) starting with the Apple computer and going to PC. The entire PC is upgraded by himself from XT to the present Pentium duo core. The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive. He is also into DIY changing his own toilet cistern and other electric appliance. His hunger for knowledge has not abated and he is a lifelong learner. The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned. This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale. Dr Kee is the author of: "A Family Doctor's Tale" "Life Lessons Learned From The Study And Practice Of Medicine" "Case Notes From A Family Doctor"

Book preview

A

Simple

Guide

To

Thyrotoxicosis,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2022 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Thyrotoxicosis, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What You Need to Treat Thyrotoxicosis)

This e-Book is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog: http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiography account of my journey as a medical student to family doctor on my other blog: http://afamilydoctorstale.blogspot.com.

This autobiography account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

My diagnosis and treatment capability has improved tremendously from my continued education.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Thyrotoxicosis

Thyrotoxicosis is a very common disease among women in the clinic.

They are usually triggered by stress factors.

They normally present with an enlarged thyroid gland although 30 per cent do not.

They usually complained of feeling hot all the time even when there is rain and a very fast heart beat.

The other signs are loss of weight and tremors of the hands,

Sometimes the eyes are seen to be bulging.

Treatment with medications is usually effective

What is Thyrotoxicosis?

Thyrotoxicosis literally means a toxic hyperactive thyroid which is producing excessive thyroid hormones resulting in all the symptoms of excessive metabolism.

Thyrotoxicosis is a medical state of improper high levels of circulating thyroid hormones (T3 and T4) in the body from any cause.

It is often erroneously used interchangeably with hyperthyroidism, which is a form of thyrotoxicosis produced by excessive endogenous thyroid hormone production.

The medical manifestation differs, ranging from asymptomatic or sub-clinical, to life-threatening thyroid storm.

Normal symptoms are caused by the hyper-metabolic state induced by excess thyroid hormones and involve weight loss, heat intolerance, and palpitations.

If not sufficiently treated, thyrotoxicosis can cause serious complications such as delirium, altered mental status, osteoporosis, muscle weakness, atrial fibrillation, congestive heart failure (CHF), thromboembolic disease, cardiovascular collapse, and death.

What are the causes of Thyrotoxicosis?

Causes

Thyrotoxicosis is produced by a disorder that raises the output of thyroid hormones:

The source of thyrotoxicosis can be categorized into an endogenous or exogenous source of TSH.

Higher endogenous secretion of thyroid hormone

1. Graves' disease - diffuse goiter (enlarged thyroid) produced by autoimmune antibodies stimulation of the thyroid gland to secrete more thyroid hormones.

Graves' disease is more frequent in young women.

2. Plummer's Disease (Toxic nodular thyroid)

Hyperactive thyroid nodules secrete excess thyroid hormones particularly in older women.

3. Hashimoto's Disease (Thyroiditis)

Autoimmune inflammation of the thyroid gland produces production of excess thyroid hormones.

4. Toxic thyroid adenoma causes excessive thyroid hormone production from a single nodule in the thyroid gland.

The excess thyroid hormone production can no longer be regulated by the body thereby leading to thyrotoxicosis.

5. TSH-producing adenoma or pituitary adenoma is tumors of the pituitary gland that produce thyroid-stimulating hormone (TSH), which causes excess secretion of thyroid hormones (T3 and T4) by the thyroid gland

6. HCG-mediated thyrotoxicosis: HCG is a hormone that reaches high levels during pregnancy and is a thyroid stimulator that can produce different types of thyrotoxicosis during a pregnancy.

7. Drug-induced thyrotoxicosis: The drugs which may produce thyrotoxicosis are interferon, molecular-targeted agents, amiodarone, and thyroid hormone itself.

Higher exogenous secretion of thyroid hormone

1. Factitious thyrotoxicosis: thyrotoxicosis due to the accidental or intentional thyroxine ingestion.

Diagnosis of factitious thyrotoxicosis is supported by the absence of goiter, suppressed serum Tg level, reduced radioactive iodine (RAI) uptake, and excellent reaction