Side Effect: Increased Thyroid Levels (Hyperthyroidism)

Hyperthyroidism is a condition where the thyroid gland produces an excess of thyroid hormones, primarily thyroxine (T4) and triiodothyronine (T3). This overproduction accelerates the body’s metabolism and can cause a variety of symptoms.

The appearance and symptoms of hyperthyroidism vary but often include:

• Weight loss despite increased appetite
• Sweating
• Heat intolerance
• Hair loss
• Tremors
• Bulging eyes
• Nervousness
• Anxiety
• Trouble sleeping
• Irritability
• Rapid heartbeat
• Heart arrhythmias

The condition can arise from several causes, such as Graves’ disease (an autoimmune disorder), toxic adenomas, or thyroiditis (inflammation of the thyroid). Hyperthyroidism affects individuals of all ages but is more common in:

• Women
• Adults aged 20 to 40
• Patients with other autoimmune conditions
• Family history of thyroid problems

Hyperthyroidism can also be a side effect of immune checkpoint inhibitor therapy such as:

PD-1 inhibitors:

• Pembrolizumab (Keytruda®)
• Nivolumab (Opdivo®)
• Cemiplimab (Libtayo®)
• Dostarlimab (Jemperli®)
• Retifanlimab (Zynyz®)
• Toripalimab (Loqtorzi®)

PD-L1 inhibitors:

• Atezolizumab (Tecentriq®)
• Durvalumab (Imfinzi®)
• Avelumab (Bavencio®)

CTLA-4 inhibitors:

• Ipilimumab (Yervoy®)
• Tremelimumab (Imjudo®)

Preventing hyperthyroidism can be challenging, however, some preventive measures include:

• Regular thyroid screenings
• Minimizing iodine overexposure
• Monitoring for symptoms in patients at high risk

Hyperthyroidism requires careful management. Some treatments may include:

• Antithyroid Medications
  
  • Methimazole (Tapazole®)
  • Propylthiouracil (PTU)
• Beta-blockers
  
  • Propanolol (Inderal®)
  • Metoprolol (Lopressor®, Toprol XL®)
  • Atenolol (Tenormin®)
• Radioactive iodine therapy
• Surgical removal of the thyroid