Graves' disease: an analysis of thyroid hormone levels and hyperthyroid signs and symptoms

Article Abstract:

Graves' disease (hyperthyroidism) is associated with hyperactivity and enlargement of the thyroid gland that produces a goiter. It has been observed that the results of thyroid function tests do not always correspond to the patient's symptoms. A minimally symptomatic patient may show highly abnormal test results, while a thyroid function test on an obviously symptomatic person may show only a modest elevation. The authors studied 25 newly diagnosed cases of Graves' disease in order to determine whether there is a correlation between patients' symptoms and thyroid function test results. The symptoms were compared to a standard Hyperthyroid Symptoms Scale (HSS), which measures 10 different hyperthyroid symptoms: sweating, heat tolerance, nervousness, hyperactivity, tremor, weakness, hyperdynamic precordium (middle third of the chest), diarrhea, increased appetite and degree of incapacitation. The authors also measured anxiety and depression since these symptoms frequently accompany hyperthyroidism. Thyroid function tests measure the level of thyroid hormones, T3, T4, RIA and FTI, in the blood. It was found that only goiter size was significantly related to the elevation of T3, RIA and FTI. Goiter size was also related to an increase in the severity of the HSS symptoms. The HSS rating significantly correlated with the patient's level of anxiety. Elderly patients showed less severe sweating, heat intolerance, hyperactivity and incapacitation. The authors conclude that, except as noted, there is no correlation between elevated hormone levels, as measured by these thyroid function tests, and the severity of the patient's symptoms.

Analysis, Measurement, Physiological aspects, Thyroid hormones, Graves' disease, Thyroid gland function tests, Thyroid function tests

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Recognition and management of cardiovascular disease related to thyroid dysfunction

Article Abstract:

Impaired function of the thyroid gland is associated with abnormalities of the cardiovascular system. Hypothyroidism, or decreased activity of the thyroid gland, may be accompanied by pericardial effusion, the accumulation of fluid in the pericardial cavity which surrounds the heart; heart failure, the inability of the heart to pump blood; and ischemic heart disease, which is caused by an insufficient blood supply to the heart muscle. Hyperthyroidism, or increased activity of the thyroid gland, is associated with atrial tachyarrhythmias, increased heart rate arising in the atria of the heart; impaired function of the mitral valve, a structure that directs blood flow from the left atrium to the left ventricle; and heart failure. These abnormalities usually occur in patients with heart disease; severe, but reversible impairment of heart function rarely develops with thyroid disease alone. Patients with common heart disorders such as cardiomyopathy, a disease of the heart muscle, and atrial fibrillation, abnormal rhythm of the atria, should be tested for thyroid function disorders, which may contribute to these heart disorders. Therapy for patients with heart failure and hypothyroidism should be directed at treating heart disease, whereas therapy for hyperthyroidism and heart failure should focus on controlling excessive levels of thyroid hormones. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cardiovascular diseases, Causes of, Complications and side effects, Hypothyroidism

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