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Manage hyperthyroidism to prevent cardiac complications: an overactive thyroid can cause several health problems, and abnormal heart rhythms are among the more serious concerns.

A diagnosis of hyperthyroidism (overactive thyroid) means having to be "hyper aware" of the potential health complications stemming from this condition. Your little thyroid gland affects almost every aspect of your health, including your metabolism and nervous system.

One other area in particular that is vulnerable to untreated hyperthyroidism is your heart. And the impacts can be felt in many different ways, says Cleveland Clinic endocrinologist Betul Hatipoglu, MD.

"One significant effect is increased heart rate," she says. "By causing the heart to pump like you are running a marathon all the time, hyperthyroidism can result in fatigue of the heart muscle and heart failure. If not treated for a long time, this can be permanent. Also, it can predispose patients to develop arrhythmias (irregular heartbeats) and a condition called atrial fibrillation (afib). This condition can cause blood clots and stroke. The good news is that all of these can be treated."

Dr. Hatipoglu says that if thyroid disease is diagnosed and treated in a timely manner, the effects of the condition are reversible. "Rarely, if the pa tients were not treated for many years, the changes to the heart muscle can be permenant," she adds.

Understand Thyroid Function

Your thyroid is located in your neck. It's a relatively small gland, and it produces two types of thyroid hormone. Thyroid hormones affect just about every system and every cell in the body. One of the problems of an overactive thyroid--one that produces too much hormone--is that it causes your system to speed up. For example, hyperthyroidism can affect your metabolism and how fast your body burns calories. It can also affect how fast food moves through your digestive system. Usually, people with hyperthyroidism lose weight, but it I can lead to weight gain in some cases.

Too much thyroid hormone can also affect your nervous system, body temperature, and muscle strength. It plays a role in how fast new cells are produced to replace dead ones, too.

A healthy thyroid helps keep your heart beating in a steady rhythm at a normal rate. But an overactive thyroid can cause palpitations and an accelerated heart rate. As Dr. Hatipoglu notes, it's also a risk factor for afib, in which the heart's upper chambers stop beating in a coordinated manner with the lower chambers and instead beat chaotically.

Diagnosis and Treatment

Diagnosing hyperthyroidism usually starts by having symptoms evaluated. You may notice a rapid heartbeat (tachycardia), sudden weight loss, a tremor, nervousness, fatigue, difficulty sleeping and brittle hair.

A physical exam and review of your t symptms and medical history are part of the diagnosis. But a blood test measuring thyroid hormone in the system can confirm hyperthyroidism. Other tests can help determine why your thyroid is overactive.

Treatment for hyperthyroidism may include medications that help reduce hormone production. Treatment with radioactive iodine can help shrink the thyroid and control symptoms. You may also be prescribed beta blockers to help control your heart rate. Surgery to remove most of the thyroid gland is done in some, but not many, cases.

The treatment usually depends on the cause of the hyperthyroidism, Dr. Hatipoglu says.

"Sometimes, indeed often, we combine these options," she explains. "We might try medications for one to two years and then go for surgery or radiation therapy for example. Other factors play in our decision as well. If someone has Graves' disease that's causing the thyroid disorder, and also they have eye disease from it, we might avoid radiation and go to surgery directly."

Anticipate Complications

"Hyperthyroidism treatment somtimes can be complicated if you are being treated for a heart condition," Dr. Hatipoglu says. "The most common issues I see is with warfarin dosing or digoxin dosing that need adjustment often."

Amiodarone, a drug to treat arrhythmias, also can affect the thyroid, and can interfere with treatment. Dr. Hatipoglu notes that thyroid treatment may also affect how amiodarone works.

"It is very important to work with your provider," she advises. "In case of hyperthyroidism, I would highly recommend patients to avoid taking any over-the-counter supplements without asking their healthcare provider. It can be really dangerous and can make things much worse. For example, taking iodine drops when you are hyperthyroid can be fuel to the fire."

The thyroid gland produces a hormone that can affect your heart rate, as well as your nervous system and other aspects of your health.
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Title Annotation:PREVENTION
Publication:Heart Advisor
Date:May 1, 2017
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