Hyperthyroidism in Nigeria: Causes, Symptoms, Diagnosis and Treatment

 

By: Doreen Udoudom. Datelinehealth Africa Volunteer Freelance Writer, with editorial support from The DLHA Team

 

 

Introduction

Hyperthyroidism simply means an overactive thyroid gland. An overactive thyroid is one that releases too much of its products into the bloodstream.

 

Before discussing what hyperthyroidism is, let us get familiar with the thyroid gland and what it does.

 

The thyroid gland is a butterfly-shaped gland located in front of the windpipe (trachea) at the base of the neck (see figure 1). It produces two hormones, namely triiodothyronine (T3) and tetraiodothyronine or thyroxine (T4). The production of these hormones are under the control of a master hormone controlling gland at the base of the brain called the anterior pituitary gland. This gland itself is also under the control of a part of the brain called the hypothalamus. There is a dynamic functional relationship between these three structures as depicted in figure 2.

 

 

The thyroid hormones are responsible for metabolic or energy-producing processes in the body.

 

They support the rate at which the body breaks down fats and carbohydrates for energy.

 

They help control body temperature and heart rate. And also help to control how much protein the body makes.

 

When there is excess production of thyroid hormones, it accelerates the body's metabolism leading to a variety of symptoms like insomnia (poor sleep duration and quality), irregular heartbeat and weight loss.

 

Hyperthyroidism can affect both males and females, but it is more common in women and people aged 60 and above.

 

This article discusses the causes, symptoms, diagnosis and treatment of hyperthyroidism.

 

 

How common is hyperthyroidism in Nigeria?

 

There is no comprehensive report to date on the prevalence of hyperthyroidism in the Nigerian population.

A small retrospective study carried out from January 2016 to January 2019 in the outpatient department of the University of Nigeria Teaching Hospital, Enugu, Southeastern Nigeria indicated a prevalence rate of 1.4% for hyperthyroidism caused by Graves’ disease. More research is needed to identify the true burden of hyperthyroidism in the Nigerian population.

 

 

What causes hyperthyroidism?

 

Hyperthyroidism can be caused by the following:

• Too much iodine in the diet.

• Inflammation of the thyroid gland.

• Presence of benign tumours in the thyroid gland.

• Medications used to treat heart disorders, e.g., Codarone, Pacerone, etc.

• Graves’ disease.

This is the most common cause of hyperthyroidism worldwide, including Nigeria.

Graves’ disease is an autoimmune condition in which there is an overproduction of TSI (thyroid-stimulating immunoglobulin). This hormone attacks the thyroid gland leading to excess production of thyroid hormones.

 

 

What may increase the chances of having hyperthyroidism? 
 

• Family history of autoimmune diseases like type 1 diabetes or Graves’ disease.

• Being female. Women have a higher risk for hyperthyroidism.

• Recent pregnancy.

 

 

What are the symptoms of hyperthyroidism?

 

Some symptoms of hyperthyroidism may mimic the symptoms of many other disorders. This makes the condition difficult to diagnose.

Some of the common symptoms of hyperthyroidism include:

• Enlarged thyroid gland (goiter).

• Unexplained weight loss.

• Changes in appetite.

• Fatigue.

• Insomnia (Sleep problems).

• Tachycardia (Racing heartbeat).

• Irregular heartbeat.

• Pounding heartbeat (Palpitation).

• Hair loss due to fine brittle hair.

• Nervousness, anxiety and irritability.

• Tremor of the hands and fingers.

• Increased sensitivity to heat.

• Excessive sweating.

• Changes in bowel habits with excessive bowel movements.

• Thinning skin.

• Brittle nails.

• Changes in the menstrual cycle.

 

 

When should one see a doctor?

 

It is very important to visit with your doctor promptly for a checkup, if you notice a swelling in front of your neck, no matter how small it is, or have any of the following symptoms like;

• unexplained tiredness,
• feeling sweaty often, 
• feeling your heart pounding (palpitations), 
• feeling a racing heartbeat, 
• losing weight without a reasonable explanation, or 
• having any of the other symptoms of hyperthyroidism.

 

Be sure to keep a diary of your symptoms so that you can provide your doctor with accurate details of your symptoms, including the time of onset, duration, severity, things that bring your symptoms up and things that make the symptoms go away even if temporarily. Also, let your doctor know about all medications that you are taking and if you have a family history of similar conditions. 

 

 

What are the adverse effects of hyperthyroidism?

 

Hyperthyroidism is not life-threatening but when left untreated, it can lead to severe adverse effects or complications. Some of these include:
 

• Stroke.

• Ventricular arrhythmia (irregular beats in a specific chamber of the heart).

• Graves’ ophthalmopathy or Thyroid eye disease (bulging red eyes with wide open eyelids).

• Osteoporosis (Thin bone).

• Infertility.

• Hypothyroidism (Underactive thyroid, due to treatment with radioactive iodine).

• Pregnancy-related problems (including hypertension, miscarriage and premature labour and birth).

• Thyroid storm. This life-threatening medical emergency can be triggered by any of the following situations:
  • Infection.
  • Pregnancy.
  • Inadequate use of thyroid medications.
  • Trauma to the thyroid gland.         

     Symptoms of thyroid storm include:

• Excessive sweating.
• High body temperature (High fever)
• Yellow discolouration of the skin and eyes (jaundice).
• Racing heartbeat.
• High blood pressure.
• Agitation and confusion.
• Loss of consciousness 

 

If you or anyone you know suffers any of the symptoms listed for thyroid storm, take the person to a hospital or doctor immediately to get the urgent treatment they need.

 

 

How do doctors diagnose hyperthyroidism?

 

If you notice you have symptoms like an enlarged thyroid gland and fear that you have hyperthyroidism, talk to your doctor.

You will be physically examined and asked questions about your medical history, family history and other symptoms you've experienced.

For a more accurate diagnosis, you may be asked to undergo the following:
 

• A blood test to check the levels of T3 and T4 in your body.

• Thyroid ultrasound: Your doctor may use an ultrasound to examine the thyroid gland for any changes.

• Thyroid antibody test.

• Radioiodine scan.

• Fine needle biopsy of the thyroid gland.

 

 

What are the treatments for hyperthyroidism?

 

If your healthcare provider diagnoses you with hyperthyroidism, they may recommend these types of treatments to you:

• Antithyroid medication like propylthiouracil and methimazole.

• Radioiodine therapy.

• Beta-blockers.

• Thyroidectomy. This is the surgical removal of the thyroid gland.

 

The treatment option that you will likely get depends on the availability of care resources and health insurance in your healthcare environment, the severity of your illness, the presence of contraindications to a particular treatment modality, and your treatment preference.

 

 

Is hyperthyroidism preventable? 

 

Prevention of hyperthyroidism will be discussed at public and individual levels.

At the individual level, hyperthyroidism is not preventable, but mild symptoms due to the condition can be reduced by engagement in the following activities:

• Exercising regularly: Living a sedentary lifestyle isn't healthy.  Maintaining an active lifestyle can help prevent hyperthyroidism. Walking, running and cycling are simple exercises that can be done daily.

• Eating healthy foods: Eating healthy foods, especially foods that are healthy for your thyroid can help prevent hyperthyroidism. Examples of such foods are fish, eggs and liver. Also, reduce the intake of sugar and junk food.

• Drinking lots of water.

• Managing stress.

• Avoiding smoking.

• Avoiding alcohol intake.

 

At the public level, hyperthyroidism is also not preventable, but the following interventions will go a long way to identify and provide the population at risk of the condition with the care that they need.

• Research. National governments in African countries should support research on thyroid disorders to understand the details of their occurrence, causes and risk factors so that better policies and prevention strategies can be developed to tackle them. 

• Increased access to healthcare. National governments should also make thyroid screenings easily accessible to everyone, especially those in low-income areas.

• Awareness raising. Radio programs, television shows, podcasts and street theatres, etc., should be used to create awareness about hyperthyroidism so that people with suspected symptoms can access healthcare to be screened and treated for the condition early.

 

 

The economic impact of Hyperthyroidism in Nigeria

 

The economic impact of hyperthyroidism in Nigeria is significant. This disorder can lead to reduced productivity due to some of its symptoms and complications if it is not detected early.

For those who require treatment with antithyroid medication or surgery, the money may not be readily available.

To deal with the economic impact of hyperthyroidism in Nigeria, it is important to create awareness about the disorder and put measures in place to promote healthy living and access to care.

 

 

Summary

Hyperthyroidism is a condition caused by the overproduction of thyroid hormones into the bloodstream.

Early diagnosis and appropriate treatment are important for managing symptoms, preventing adverse effects and maintaining a healthy life.

With the right treatments and aftercare, people with hyperthyroidism can effectively manage their condition and lead healthy lives.

 

Related:

 

 

 

Goitre in Nigeria: What you need to know.

 

 

 

 

Sources

Abdulslam K, Yahaya IA. Prevalence of thyroid dysfunction in gestational hypertensive Nigerians.  Sub-Saharan Afr J Med 2015; 2:19-27.

De Leo S, Lee SY, Braverman LE. Hyperthyroidism. Lancet. 2016 Aug 27;388(10047):906-918. doi 10.1016/S0140-6736(16)00278-6.

Okafor EN, Ugonabo MC, Chukwukelu EE, Okonkwo IN, Ezigbo E, Odurukwe O. Prevalence and Pattern of Thyroid Disorders among Patients Attending University of Nigeria Teaching Hospital, Enugu, Southeastern Nigeria. Niger Med J. 2019 Mar-Apr;60(2):62-67. doi: 10.4103/nmj.NMJ_34_19.

Okpara HC, et al. Spectrum of Thyroid Dysfunction among Patients Evaluated by Thyroid Function Tests at a Tertiary Clinical Laboratory in Calabar, Nigeria.  Ann Med Health Sci Res. 2017; 7: 411-417.

Pokhrel B, Aiman W, Bhusal K. Thyroid Storm. In: StatPearls. Treasure Island (FL): StatPearls Publishing; Updated Oct. 6, 2022. Accessed May 13, 2023.

 

 

 

Published: May 17, 2023

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