Focus on hyperthyroidism

What is hyperthyroidism? Hyperthyroidism is a medical condition characterized by the overactivity of the thyroid gland, which results in the production of an excessive amount of thyroid hormones. This hormonal imbalance can lead to various health issues due to the thyroid's crucial role in regulating numerous bodily functions.

The thyroid gland is a butterfly-shaped organ located at the front of your neck. It plays a vital role in the endocrine system by releasing hormones that help manage your metabolism, which is the process by which your body converts food into energy. Additionally, the thyroid influences several other important bodily functions, including breathing, heart rate, the nervous system, weight management, body temperature regulation, and more. When the thyroid becomes overactive, as in the case of hyperthyroidism, it accelerates the body's processes. This can lead to symptoms such as nervousness, anxiety, a rapid heartbeat, hand tremors, excessive sweating, unintentional weight loss, and sleep disturbances, among other issues.

The signs and symptoms of hyperthyroidism can vary widely among individuals but generally include a range of physical and emotional indicators. Common symptoms include:

• Fatigue or muscle weakness: Many individuals with hyperthyroidism report feeling unusually tired or experiencing weakness in their muscles, which can affect daily activities.
• Hand tremors: A noticeable trembling or shaking of the hands is a common symptom that can occur even when the hands are at rest.
• Mood swings: Individuals may experience significant fluctuations in their mood, which can lead to irritability or emotional instability.
• Nervousness or anxiety: Heightened feelings of anxiety or nervousness are frequently reported, contributing to a sense of unease.
• Rapid heartbeat: An increased heart rate, known as tachycardia, can occur, making individuals feel their heart racing.
• Heart palpitations or irregular heartbeat: Some may experience sensations of their heart skipping beats or beating irregularly.
• Skin dryness: Despite excessive sweating, some may also notice that their skin becomes dry and less supple.
• Trouble sleeping: Insomnia or difficulty falling and staying asleep is a common complaint.
• Weight loss: Unintended weight loss can occur even when appetite remains normal or increased.
• Increased frequency of bowel movements: Some individuals may notice a change in their bowel habits, leading to more frequent trips to the bathroom.
• Light periods or skipping periods: Women may experience changes in their menstrual cycle, including lighter periods or missed cycles altogether.

Possible causes of hyperthyroidism can be attributed to several underlying conditions. Some of the most common causes include Graves' disease, toxic adenoma, Plummer's disease (also known as toxic multinodular goiter), and thyroiditis. Each of these conditions affects the thyroid gland in different ways, leading to the overproduction of thyroid hormones.

Graves' disease is an autoimmune disorder where the immune system produces antibodies that mistakenly target the thyroid gland, causing it to become overactive. In some cases, these antibodies may also affect the tissue behind the eyes, leading to a condition known as Graves' ophthalmopathy. Signs and symptoms of Graves' ophthalmopathy can include:

• Protruding eyeballs: A noticeable bulging of the eyes can occur.
• Red or swollen eyes: Inflammation can lead to redness and swelling around the eyes.
• Excessive tearing or discomfort in one or both eyes: Individuals may feel discomfort, along with increased tearing.
• Light sensitivity, blurry or double vision, inflammation, or reduced eye movement: Many may experience visual disturbances or difficulty moving their eyes.
• Hyperfunctioning thyroid nodules: These are noncancerous lumps in the thyroid that can also contribute to the overproduction of hormones.

This particular form of hyperthyroidism often arises when one or more adenomas, which are benign lumps within the thyroid gland, produce excessive amounts of the hormone T4. These adenomas can cause an enlargement of the thyroid, known as goiter.

Thyroiditis is another condition that can lead to hyperthyroidism. In this scenario, the thyroid gland becomes inflamed for reasons that are not always clear. This inflammation can cause the thyroid to release stored hormones into the bloodstream, leading to an excess of thyroid hormones circulating in the body.

How to register on the chronic programme If you have been diagnosed with Addison’s disease, it is essential to take the necessary steps to register for the Chronic Medicine Management Programme. Please ask your doctor to reach out to our Chronic Medicine Department at 0860 11 78 59 for assistance with your registration. A chronic medicine consultant will work closely with your doctor to discuss your treatment options. Once the diagnostic criteria are satisfied and relevant blood test results are submitted, your treatment plan will be reviewed and approved. We will inform you if your treatment is covered under the Momentum Medical Scheme formulary or if a co-payment will be required. Upon receiving authorization, you can take your prescription to your designated service provider to obtain your medication, and the claim will be processed accordingly. A designated service provider (DSP) is a healthcare professional, such as a doctor, pharmacist, or hospital, that is preferred by the medical scheme for providing diagnosis, treatment, or care for conditions that fall under Prescribed Minimum Benefits. If you choose to see a non-designated service provider voluntarily, you may incur additional co-payments. Typically, authorizations are valid for 12 months. If your medication remains unchanged, your doctor or pharmacist can contact us at 0860 11 78 59 to renew the authorization. The same procedure applies if there are any modifications or additions needed for your authorization.

For further information regarding your chronic benefits and where to obtain chronic medications and treatments, please click here.

Hospitalisation In the event that you require hospitalization due to complications arising from cardiac failure, you should log in to the Momentum App or reach out to us via the web chat feature on momentummedicalscheme.co.za. You can also email us at [e-mail], send a WhatsApp message, or call us at 0860 11 78 59 to request pre-authorization for your hospital stay. A dedicated case manager will be assigned to monitor and assist you throughout your hospitalization process.

Treatment plan Once you are successfully registered in the program, you will be provided with access to a comprehensive treatment plan. This plan may cover necessary medical tests, consultations with doctors, and other essential benefits as deemed medically necessary by your healthcare provider. Our clinical team will review these requests to ensure that they are appropriate and aligned with your health needs.

Compliance It is crucial for your health and well-being that you adhere to the following guidelines:

• Ensure that you obtain your chronic medication each month without fail.
• Take your medication strictly according to the dosage and quantity prescribed by your doctor.
• Avoid missing any doses, as this is vital for maintaining compliance and can have serious health implications.

Please ensure your claims include the appropriate ICD-10 code It is imperative that all claims submitted include the correct ICD-10 codes, which are diagnostic codes. This ensures that we can accurately identify and process your claims from the Chronic Benefit.

We may process claims from your Day-to-day Benefits if:

• The claims are submitted without the relevant ICD-10 codes.
• You have exceeded the frequency limit for consultations or tests.
• The treatment provided is not clinically appropriate.

Contact us If you have any questions or need assistance, you can reach us through the web chat feature on momentummedicalscheme.co.za, email us at [e-mail], send a WhatsApp message, or call us at 0860 11 78 59.

Glossary of terms

• Designated service providers: Momentum Medical Scheme collaborates with a network of designated service providers, including associated general practitioners and specialists, as well as state facilities, to provide diagnosis and treatment for members regarding Prescribed Minimum Benefits.
• A formulary: This is a list of medications that are covered under your specific medical plan, from which your doctor can prescribe suitable medications for your chronic condition.
• ICD-10: This refers to the International Classification of Diseases, which is the diagnosis code used for medical billing and insurance purposes.
• Prescribed Minimum Benefits: This is a set of benefits that all medical schemes in South Africa are required to cover according to the Medical Schemes Act 131 of 1998 and its regulations. To access these benefits, your medical condition must qualify and be included in the defined list of Prescribed Minimum Benefit conditions. Additionally, the required treatment must align with the treatments specified in the defined benefits, and you must utilize the Scheme’s Designated Service Providers. For further details on Designated Service Providers, please refer to the definition provided on page 2.

If you voluntarily opt to use non-designated service providers, the Scheme will cover benefits up to the Momentum Medical Scheme Rate, and relevant co-payments will apply. However, if you require non-designated service providers in emergency medical situations, this is considered involuntary, and co-payments will be waived.