Hyperthyroidism: Demography and Clinical Criteria in Al – Nasiriyah City ( 2022 )

  • Mohammed K.Yosif M.B.Ch.B_ D.O.Family medicine. Thi_Qar Health Directorate
  • Olfet Jabbar Mekki Assistant lecturer, Pharmacist , Assistant lecturer, Pharmacist , Al-Ameed University -college of pharmacy.-Holly Karbala
  • Saad Khalaf Jaber Alrikabi Plastic surgeon at Al-Nasiriyah teaching hospital, burn and reconstructive unite
  • Muntathar Saad Khalaf Alrikabi 5th stage student University of Thi-qar - college of medicine


    Hyperthyroidism is a group of illnesses characterized by excessive thyroid hormone production and secretion by the thyroid gland, resulting in thyrotoxicosis, a hypermetabolic state. Diffuse toxic goiter (Graves disease), toxic multinodular goiter (Plummer disease),and toxic adenoma are the most frequent types of hyperthyroidism. Thyroid hormone levels are high in thyrotoxicosis, with or without increased thyroid hormone production.[1,2] Graves disease is the most frequent kind of hyperthyroidism in the United States, accounting for 60-80% of thyrotoxicosis cases. During a 20-year period, the annual incidence of Graves disease was determined to be 0.5 cases per 1000 population, with the peak occurrence in adults aged (20-40) years.[13] Toxic multinodular goiter (which accounts for 15-20% of thyrotoxicosis) is more common in iodine-deficient areas. Most people in the United States have enough iodine, while the incidence of lethal multinodular goiter in the US population is lower than in iodine-deficient are as of the world. Thyrotoxicosisis caused by toxic adenoma in (3-5) percent of patients. Methods: Descriptive, Cross-sectional study Retrospective study The study took place in Thiqar governate , study begun at 14thof march 2022 and ended at 11thof may 2022. The population of Thiqar about 2 million [20] , The study includes the students and staff from Thiqar university, children younger than 15 and elderly above 70 were excluded. Sample size is 430 given by the supervisor, collected through Google form–based Questionnaires published in the official websites of colleges of Thiqar University. Analysis : Qualitative data had been analyzed by using SPSS (statistical package for social science),were Reliability, frequency, percentage and chi square had been calculated. Results: A 430 patients suffer from thyroid disease, were recruited in this study that focus on different aspects of assessment, that include their sociodemography clinical character that scored according to Binned score.  


Blick C, Jialal I. Thyroid, Thyrotoxicosis. 2018 Jan. [QxMD MEDLINE Link]. [Full Text].

Doubleday AR, Sippel RS. Hyperthyroidism. Gland Surg. 2020 Feb. 9 (1):124-35. [QxMD MEDLINE Link]. [Full Text].

Bahn Chair RS, Burch HB, Cooper DS, et al. Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thy- roid Association and American Association of Clinical Endocrinologists [published corrections appear in Thyroid. 2011;21(10):1169, and Thy- roid. 2012;22(11):1195]. Thyroid. 2011;21(6):593-646.

Usui T, Izawa S, Sano T, et al. Clinical and molecular features of a TSH- secreting pituitary microadenoma. Pituitary. 2005;8(2):127-134.

Vanderpump MP. The epidemiology of thyroid disease. Br Med Bull. 2011;99:39-51.

Villanueva R, Greenberg DA, Davies TF, Tomer Y. Sibling recurrence risk in autoimmune thyroid disease. Thyroid. 2003;13(8):761-764.

Gozu HI, Lublinghoff J, Bircan R, Paschke R. Genetics and phenomics of inherited and sporadic non-autoimmune hyperthyroidism. Mol Cell Endocrinol. 2010;322(1-2):125-134.

Pearce EN, Farwell AP, Braverman LE. Thyroiditis [published correc- tion appears in N Engl J Med. 2003;349(6):620]. N Engl J Med. 2003; 348(26):2646-2655.

Schwartz F, Bergmann N, Zerahn B, Faber J. Incidence rate of symp- tomatic painless thyroiditis presenting with thyrotoxicosis in Denmark as evaluated by consecutive thyroid scintigraphies. Scand J Clin Lab Invest. 2013;73(3):240-244.

Sweeney LB, Stewart C, Gaitonde DY. Thyroiditis: an integrated approach. Am Fam Physician. 2014;90(6):389-396.

https://www.hopkinsmedicine.org/health/conditions-and- diseases/hyperthyroidism


Davies TF, Larsen PR. Thyrotoxicosis. Larsen PR et al, eds. Williams

Textbook of Endocrinology. 10th ed. Philadelphia: Saunders; 2003. 374- 421.

Varadharajan K, Choudhury N. A systematic review of the incidence of thyroid carcinoma in patients undergoing thyroidectomy for thyrotoxicosis. Clin Otolaryngol. 2020 Mar 9. [QxMD MEDLINE Link].

Fitzgerald PA. Endocrinology. In: Tierny LM, McPhee SJ, Papadakis MA, eds. Current medical diagnosis and treatment. 44th ed. New York: McGraw- Hill, 2005:1102–10.

Taylor RB. The 10-minute diagnosis manual: symptoms and signs in the time-limited encounter. Philadelphia: Lippincott Williams & Wilkins, 2000.

American Academy of Clinical Endocrinologists. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism. Endocr Pract. 2002;8:457–69.

Harper MB, Mayeaux EJ Jr. Thyroid disease. In: Taylor RB. Family medicine: principles and practice. 6th ed. New York: Springer, 2003:1042– 52.

https://premierheartandvascular.com/prevent-treat-thyroid-disease-heart- health/


Incidence of hyperthyroidism in Sweden Article in European Journal of Endocrinology • September 2011 DOI: 10.1530/EJE-11-0548 • Source: PubMed.

Carle A, Pedersen IB, Knudsen N, Perrild H, Ovesen L, Rasmussen L & Laurberg P. Epidemiology of subtypes of hyperthyroidism in Denmark – a population-based study. European Journal of Endocrinology 2011 164 801–

(doi:10.1530/EJE- 10-1155).

Brownlie BE & Wells JE. The epidemiology of thyrotoxicosis in New Zealand: incidence and geographical distribution in North Canter- bury, 1983–1985. Clinical Endocrinology 1990 33 249–259. (doi:10.1111/j.1365- 2265.1990.tb00489.x).

Phillips DI, Barker DJ & Morris JA. Seasonality of thyrotoxicosis. Journal of Epidemiology and Community Health 1985 39 72–74. (doi:10.1136/jech.39.1.72).

Buchinger W, Semlitsch G, Pongratz R, Harwalik B & Rainer F. Seasonal variations in the diagnosis of hyperthyroidism. Acta Medica Austriaca 2000 27 51–53. (doi:10.1046/j.1563-2571. 2000.00206.x)

Ford HC, Johnson LA, Feek CM & Newton JD. Iodine intake and the seasonal incidence of thyrotoxicosis in New Zealand. Clinical Endocrinology 1991 34 179–181. (doi:10.1111/j.1365-2265. 1991.tb00290.x)

Westphal SA. Seasonal variation in the diagnosis of Graves’ disease. Clinical Endocrinology 1994 41 27–30. (doi:10.1111/j. 1365- 2265.1994.tb03780.x)

Connolly RJ 1971 An increase in thyrotoxicosis in southern Tasmania after an increase in dietary iodine. Med J Austral 12:1268–1271

Sc roeder F 1989 Hyperthyreose manifestation vor und nach alimentarer jod- komplettierung. Verlaufsuntersuchungen in Brandenburg 1983–1988. Z gesa- mte Inn Med 44:229

Azizi F, Hedayati M, Rahmani M, Sheikholeslam R, Allahverdian S, Salarkia N 2005 Reappraisal of the risk of iodine-induced hyperthyroidism: an epide- miological population survey. J Endocrinol Invest 28:23–29

Roti E, Vagenakis AG 2000 Effect of excess iodide: clinical aspects. In: Braver- man LE, Utiger RD, eds. The thyroid. 8th ed. Philadelphia: Lippincott; 316 –329 25

Knudsen N, Bu ̈low I, Jørgensen T, Laurberg P, Ovesen L, Perrild H 2000 Goitre prevalence and thyroid abnormalities at ultrasonography: a compar- ative epidemiological study in two regions with slightly different iodine status. Clin Endocrinol (Oxf) 53:479–485

Pisarev MA, Ga ̈rtner R 2000 Autoregulatory actions of iodine. In: Braverman LE, Utiger RD, eds. The thyroid. 8th ed. Philadelphia: Lippincott; 85–9