Does an enlarged thyroid gland mean hyperthyroidism?

An enlarged thyroid gland, commonly known as hyperthyroidism, can cause patients to experience symptoms such as excitement, palpitations, tachycardia, insomnia, and weight loss. It is sometimes accompanied by problems such as bulging eyes and edema of the eyelids. Therefore, it is important to pay attention to the cause and clinical manifestations.

1. Causes

Causes of hyperthyroidism include diffuse toxic goiter (also called Graves' disease), inflammatory hyperthyroidism (subacute thyroiditis, painless thyroiditis, postpartum thyroiditis, and Hashimoto's hyperthyroidism), drug-induced hyperthyroidism (levothyroxine sodium and iodine-induced hyperthyroidism), hCG-induced hyperthyroidism (transient hyperthyroidism due to vomiting of pregnancy), and pituitary TSH tumor hyperthyroidism.

Clinically, more than 80% of hyperthyroidism is caused by Graves' disease, which is an autoimmune disease of the thyroid gland. The patient's lymphocytes produce thyroid-stimulating immunoglobulin-TSI. Clinically, the TSI we measure is the thyrotropin receptor antibody: TRAb.

The cause of Graves' disease is currently unclear. It may be related to factors such as fever, lack of sleep, and mental stress, but clinically the cause of the disease cannot be found in the vast majority of patients. Graves' disease is often combined with other autoimmune diseases, such as vitiligo, alopecia, type 1 diabetes, etc.

2. Clinical manifestations

Thyroid hormones promote metabolism and the body's redox reactions. Hypermetabolism requires the body to increase food intake; gastrointestinal activity is enhanced, and the frequency of bowel movements increases; although food intake increases, the oxidation reaction is enhanced, the body's energy consumption increases, and patients experience weight loss; increased heat production manifests as heat intolerance and sweating, and some patients experience low fever; increased thyroid hormones stimulate sympathetic nerve excitement, and clinical manifestations include palpitations, tachycardia, insomnia, sensitivity to surrounding things, mood swings, and even anxiety.

If patients with hyperthyroidism do not receive proper treatment for a long time, they will suffer from weight loss and hyperthyroid heart disease. Patients who are emaciated are often more susceptible to acute infectious diseases, which can lead to disability or death. Hyperthyroidism heart disease causes heart enlargement, arrhythmia, atrial fibrillation and heart failure, causing patients to lose their ability to work and even die.