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Thyrotoxic myopathy (TM) is a neuromuscular disorder that develops due to the overproduction of the thyroid hormone thyroxine.Also known as hyperthyroid myopathy, TM is one of many myopathies that lead to muscle weakness and muscle tissue breakdown.
Measurement of thyroid stimulating hormone and anti-thyroid antibodies will help decide if there is a functional thyroid disease such as Hashimoto's thyroiditis present, a known cause of a benign nodular goitre. [4] Fine needle biopsy for cytopathology is also used. [5] [6] [7] Thyroid nodules are extremely common in young adults and children.
Rarely goiters can cause compression of the airway, compression of the vessels in the neck, or difficulty swallowing. [7] Tumors, often called thyroid nodules, can also have many different symptoms ranging from hyperthyroidism to hypothyroidism to swelling in the neck and compression of the structures in the neck. [7]
The thyroid gland is extremely painful, rigid, and swollen, which can be symmetrical or asymmetrical. [2] Approximately half of affected adolescents and two-thirds of adults have widespread thyroid gland involvement. [3] [5] Thyroid nodules are seen in one-fourth of adult patients. [6] The surrounding skin is occasionally warm and erythematous.
The most common type of hyperthyroidism, Graves' disease, may additionally cause eye problems (Graves' ophthalmopathy) and skin changes of the legs (pretibial myxedema). [6] Thyroid disease may also cause muscle weakness in the form of thyrotoxic myopathy, but this is constant rather than episodic. [5]
Toxic multinodular goiter (TMNG), also known as multinodular toxic goiter (MNTG), is an active multinodular goiter associated with hyperthyroidism.. It is a common cause of hyperthyroidism [2] [3] in which there is excess production of thyroid hormones from functionally autonomous thyroid nodules, which do not require stimulation from thyroid stimulating hormone (TSH).
Graves' disease is the cause of about 50% to 80% of the cases of hyperthyroidism in the United States. [1] [7] Other causes include multinodular goiter, toxic adenoma, inflammation of the thyroid, eating too much iodine, and too much synthetic thyroid hormone. [1] [2] A less common cause is a pituitary adenoma. [1]
Fasting in healthy, euthyroid people causes reduced T3 and elevated rT3, although TSH is usually unchanged. [3] [5] [10] Even moderate weight loss can lower T3. [2] This may be primarily via reduced levels of leptin (the satisfaction hormone). Low leptin levels can downregulate hypothalamic TRH neurons and cause a reduction in TSH.