signs and symptoms that affect every part of your body. In the following sections I describe the major abnormalities, grouped according to the organ system of the body hyperthyroidism is affecting.
The body generally Although the signs and symptoms of hyperthyroidism seem distinctive, most occur in people who don’t have hyperthyroidism as well. For example, although palpitations occur in 75 percent of people with hyperthyroidism, they also occur in 26 percent of people who don’t have hyperthyroidism. While 73 percent of people with hyperthyroidism prefer the cold, so do 41 percent of people without hyperthyroidism. Therefore, you must use laboratory tests to confirm a diagnosis of hyperthyroidism. Hyperthyroidism can cause your body temperature to be persistently high. As a result, you may prefer wearing fewer clothes and sleeping with no covers at night. You may prefer to take your vacations in Alaska rather than Mexico. You may sweat when everyone else is comfortable. You may lose weight despite an increased appetite. The weight loss is due to the loss of lean body tissue like muscle, not a loss of fat. In rare cases, a patient gains weight because she’s eating so many calories. Hyperthyroidism can cause you to feel weak. You may feel lymph glands all over your body, because Graves’ disease is an autoimmune disease and the lymph system is a key player in autoimmunity. Your tonsils, which are part of the lymph system, also enlarge. Your face may appear to be anxious or frightened. If you lose a lot of weight, your face may be thin or emaciated. But you may also have fairly severe hyperthyroidism without any obvious change in facial appearance. Your elbows may be red. Other possible reasons, which are more serious than Graves’ disease, such as cancer in the lymph glands, may explain the enlargement of your lymph glands, so if you experience enlarged lymph glands, see your doctor.
The thyroid When Graves’ disease is the cause of hyperthyroidism, your thyroid is enlarged in a symmetrical way and the entire gland is firm. When a single overactive nodule (a bump on your thyroid) is to blame for hyperthyroidism, the nodule is large, but it often causes the rest of the gland to shrink. (See Chapter 7 for a discussion of nodules.) When a multinodular goiter is responsible (see Chapter 9), you can feel many lumps and bumps on your thyroid. Figure 6-1 shows a comparison of the size of the thyroid gland before treatment with antithyroid drugs and six weeks after