Even if hormone levels are stabilized, the eye symptoms may persist or worsen. Patients should see an experienced ophthalmologist familiar with thyroid-associated eye symptoms. The ophthalmologist will be able to assess the symptoms and select an appropriate course of treatment. In addition, since smoking is an aggravating factor for eye symptoms, smoking cessation is necessary.
Long-term elevated thyroid hormone levels due to Basedow’s disease places an excessive burden on the heart. This can cause arrhythmia or heart failure. It should be noted that elderly patients are most susceptible to these diseases, but they may also occur in younger patients. It is vital to return thyroid hormone levels to their normal range through treatment of the thyroid gland. In addition, patients need to concurrently receive treatment for arrhythmia or heart failure.
Thyroid crisis is a condition that may occur when patients with insufficiently treated hyperthyroidism are highly stressed by events such as major surgery or a severe infection. Symptoms of thyroid crisis include confusion, fever of 38C (100.4F) or higher, tachycardia (≥ 130 heartbeats/minute), heart failure, and gastrointestinal symptoms such as diarrhea. Although treatment options have advanced, thyroid crisis can result in death. It is important to receive appropriate treatment to maintain stable thyroid function.
When thyroid hormone levels are high, patients may find themselves unable to move their limbs the morning following strenuous exercise or bouts of excessive eating and drinking. This condition is called thyrotoxic periodic paralysis. It is common in Asian men. Generally, this condition resolves spontaneously in a few hours, but occurs repeatedly unless thyroid hormone levels are normalized.
When thyroid hormone levels are high, blood glucose (sugar) levels tend to be high as well. In patients who suffer from diabetes, worsening Basedow’s disease may lead to poor control of blood glucose levels. However, with appropriate treatment to control thyroid hormone levels, previous regimens for managing blood glucose levels can be resumed.
Hyperthyroidism is known to speed up bone turnover and decrease bone density. The risk of osteoporosis further increases in postmenopausal women and elderly patients. When thyroid function is normalized by treatment of Basedow’s disease, bone turnover gradually returns to normal and bone density recovers in 1-2 years.
Conditions such as nail deformity (onycholysis), white patches on the skin, and pretibial myxedema (skin on the lower leg swells and becomes discolored) may also be associated with hyperthyroidism.