Hyperthyroidism doctor in Seoul, from first test to steady levels

Seeing a hyperthyroidism doctor in Seoul

Hyperthyroidism means the thyroid gland, a small butterfly-shaped gland in the front of the neck, is making too much thyroid hormone. Because thyroid hormone sets the pace of the body's metabolism, too much of it speeds many systems up at once.

Common symptoms include a fast or irregular heartbeat, weight loss despite a normal or increased appetite, tremor, sweating and feeling too hot, anxiety or irritability, poor sleep, frequent bowel movements, muscle weakness and lighter or irregular periods. Some people notice a swelling in the neck, called a goiter, or eye changes such as gritty, bulging or watery eyes.

At VEI Clinic, Dr. HyunSung Park, a board-certified internal medicine specialist, assesses and manages hyperthyroidism in adults, one-to-one in English. He has treated patients in Korea since 2010 and refers patients to hospital endocrinology departments when specialist treatment is needed.

How we assess an overactive thyroid

The assessment has two goals: to confirm whether your thyroid really is overactive, and to find out why. The cause matters because it determines which treatment is appropriate.

• History and examination: symptoms, medicines and supplements, pulse, blood pressure, tremor, the neck and the eyes
• Thyroid blood tests: TSH, which is usually low, and free T4 and sometimes T3, which are usually high
• Antibody tests such as TSH receptor antibodies, which point to Graves' disease
• Thyroid ultrasound in clinic to look at the size of the gland and any nodules
• Other blood tests, such as a blood count and liver function, as a baseline before starting medicine
• A thyroid uptake scan, arranged through a hospital referral when the cause remains unclear

Common causes and treatment options

The most common cause is Graves' disease, an autoimmune condition in which antibodies stimulate the thyroid. Other causes include one or more overactive thyroid nodules, inflammation of the thyroid (thyroiditis), which is often temporary, and taking too much thyroid hormone medicine.

Treatment depends on the cause, your age, pregnancy plans and preferences. Beta-blockers can ease a fast heartbeat and tremor while other treatment takes effect. Antithyroid medicines, usually methimazole, reduce hormone production and are often the first choice for Graves' disease; propylthiouracil may be used early in pregnancy. Thyroiditis may need only symptom relief while it settles.

For some people, radioactive iodine therapy or thyroid surgery is the better long-term option. These are carried out in hospitals, and Dr. Park can refer you to an endocrinologist or surgeon and continue to coordinate your care in English.

Day to day, a few steps help while levels come down. Cutting back on caffeine can ease palpitations and jitteriness. Avoid high-dose iodine or kelp supplements unless the doctor advises them, as extra iodine can affect thyroid function. If you smoke, stopping is especially worthwhile in Graves' disease, because smoking raises the risk of thyroid eye disease and can make it worse.

Medicine safety and who needs extra care

Antithyroid medicines are effective but need monitoring. Blood tests are usually repeated every four to six weeks at first to adjust the dose, then less often. Mild rash or itching can occur. Rarely, these medicines lower white blood cell counts or affect the liver.

Our care suits adults with new symptoms, an abnormal thyroid result from a checkup, or a known thyroid condition that needs continued monitoring after a move to Korea. Bring previous results and your medicine boxes so we can pick up where your last doctor left off.

• Sore throat with fever, or mouth ulcers, while on antithyroid medicine: stop the medicine and get an urgent blood count the same day
• Yellowing of the skin or eyes, dark urine or severe tiredness: contact a doctor promptly
• Pregnant or planning pregnancy: tell us, as medicine choice and targets change
• Over 60, or with heart disease: an overactive thyroid raises the risk of irregular heart rhythm, so early control is important
• Eye pain, double vision or reduced vision: you may need an eye specialist

Red flags: when to call 119

Rarely, hyperthyroidism becomes a medical emergency called thyroid storm, often triggered by infection, surgery or stopping treatment suddenly. Call 119 or go to an emergency room if you have high fever with a very fast heartbeat, agitation or confusion, severe vomiting or diarrhea, chest pain, breathlessness or fainting.

For everyone else, timely assessment matters too. Untreated hyperthyroidism can lead to atrial fibrillation, heart strain and bone thinning over time.

Thyroid tests ordered because of symptoms are usually covered by National Health Insurance for enrolled patients. Visitors pay directly, and we explain the cost of each test before it is done.