Hyperthyroidism

Hyperthyroidism can cause nervousness, irritability, increased perspiration, intolerance to heat, fatigue, difficulty sleeping, a fast heartbeat, irregular menstrual periods in girls, and muscle weakness.

People with this problem might lose weight even though they're eating more than usual. The eyes may feel irritated or look like they're staring. Sometimes the tissues around the eyes become inflamed and swollen, and the eyes appear to bulge out, but this is less common in teens than in adults with hyperthyroidism.

Graves disease, an autoimmune disease, is the most common cause of hyperthyroidism. The condition makes a person's immune system produce abnormal types of antibodies (normally antibodies help the body fight infection). These abnormal antibodies make the thyroid gland produce more thyroid hormones.

Eventually, the thyroid gland enlarges, which can result in a goiter. For reasons that doctors don't yet understand, autoimmune thyroid diseases like Graves disease are much more common in women and are most likely to occur in teens and young and middle-aged adults.

Doctors usually diagnose Graves disease based on a person's symptoms, a physical examination, and blood tests that show high levels of thyroid hormone in the blood.

Once the diagnosis is made, a teen with Graves disease will usually start taking an anti-thyroid medication, which blocks the thyroid's production of thyroid hormones. Medication usually brings the hormone levels down to the normal range in 1 to 2 months.

However, in most cases, the disease doesn't go away. Some people continue taking medication for months or years to keep Graves disease under control, but it can be a hassle to take medication 1 to 3 times a day for a long period. So many doctors recommend a permanent treatment.

Radioactive iodine (RAI) is the most commonly recommended permanent treatment for teens with Graves disease today. It is usually given at a hospital, but doesn't require a hospital stay. RAI is considered safe for teens when given in the standard amount. It is taken in capsules or mixed with a glass of water. The thyroid gland quickly absorbs the RAI from the bloodstream and, within a few months, the gland shrinks and symptoms gradually disappear. RAI has been used to treat Graves disease successfully for more than 50 years.

The other permanent treatment for Graves disease is surgery to remove most of the thyroid gland (thyroidectomy). The operation is performed in a hospital under general anesthesia, meaning the person is asleep and feels nothing during the surgery. A small incision (cut) in the lower central part of the neck usually leaves a thin scar.

After surgery, there typically is swelling in the area of the incision. People sometimes have a sore throat and some trouble swallowing following surgery, although they should be able to eat and drink normally. These symptoms usually disappear within a few days.

After treatment for hyperthyroidism, hormone production often slows down to hypothyroid (underactive) levels, so the person needs to take a thyroid hormone replacement tablet each day. This treatment is a lot easier to manage than taking pills to control the hyperthyroidism — fewer blood tests, doctor visits, and medication adjustments are necessary.

As the body adjusts to the hormone replacement tablets, a doctor may increase or reduce the dosage until the levels of thyroid hormone in a person's blood are normal. Once the doctor finds the proper dosage, people usually feel well and free of symptoms. However, the doctor will continue to check hormone levels to make sure the dosage is right, especially for growing teens whose levels might change over just a few months.