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Home > Glands & Hormones > Thyroid > How to Tell if You Have Hyperthyroidism (Overactive Thyroid)

How to Tell if You Have Hyperthyroidism (Overactive Thyroid)

August 14, 2020 - Updated on January 9, 2023
7 min read
By Amy Freeth, MD | Endocrinologist
Medically Reviewed by Theresa Marx-Armile, MD, FACE | Endocrinologist

In this article:

  • Causes of Hyperthyroidism
  • Signs and Symptoms of Hyperthyroidism
  • How Is Hyperthyroidism Treated?
  • How Is Hyperthyroidism Diagnosed?
  • Follow-Up Post Diagnosis
  • Risk Factors
  • What Are the Complications of Untreated Hyperthyroidism?
  • When to See a Doctor
  • Expert Answers (Q&A)
  • Final Word

The thyroid is a small butterfly-shaped gland that releases a hormone involved in the regulation of the body’s energy and metabolism.

hyperthyroidism

An overactive thyroid gland causes elevated levels of thyroid hormones which can affect the entire body and can result in dizziness, fluctuations in weight, feeling hot, increased blood pressure, increased heart rate, and fatigue. This condition is known as hyperthyroidism.

Hyperthyroidism occurs in about 1.3% of the US population and is more likely to occur in women, especially those over 60 years old. A timely diagnosis of an overactive thyroid is imperative to stabilize the condition and prevent future complications.

Causes of Hyperthyroidism

common causes of hyperthyroidism

Common causes of hyperthyroidism include the following:

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1. Graves’ disease

Graves’ disease is an autoimmune disease where the immune system sees part of the thyroid as a foreign body, like a bacteria or virus, and makes an antibody to combat it. Graves’ disease normally affects women between the ages of 20 and 40 years.

2. A toxic nodule or toxic multinodular goiter

A toxic nodule or toxic multinodular goiter is another cause of hyperthyroidism due to inappropriate thyroid hormone secretion. As women age, they are more likely to suffer from a toxic nodule or toxic multinodular goiter.

3. Thyroiditis

Often, hyperthyroidism occurs when the thyroid gland becomes inflamed and the stored thyroid hormone is released all at once. This condition is called thyroiditis. Thyroiditis is a transient condition that resolves on its own or can lead to hypothyroidism.

4. Other causes

Other causes of hyperthyroidism include excessive intake of thyroid hormone, excessive intake/exposure to iodine, abnormal secretion of TSH, and rarely tumors in the testes or ovaries.

Signs and Symptoms of Hyperthyroidism

symptoms of hyperthyroidism

It is important to remember that in the very early stages of hyperthyroidism, often called subclinical hyperthyroidism, a person may not have any noticeable symptoms at all, or they may be very subtle and nonspecific.

Hyperthyroidism can be indicated by various symptoms such as:

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  • Fatigue or muscle weakness
  • Sleep troubles
  • Irregular heartbeat (arrhythmia)
  • Rapid heartbeat (palpitations)
  • Unintentional weight loss
  • Nervousness or irritability
  • Diarrhea or more frequent loose stools
  • Increased sensitivity to heat
  • Mood swings
  • Hand tremors
  • Profuse sweating
  • Twitching in the face and limbs
  • Fragile nails that may become loose
  • Red palms
  • Protruding eyes in some cases
  • Changes in the menstrual cycle or irregular menstruation
  • Fine, brittle hair and hair loss
  • Skin thinning
  • Goiter, which involves an enlarged thyroid gland that gives a swollen appearance to the neck

How Is Hyperthyroidism Treated?

The best treatment option for hyperthyroidism depends on the cause and severity of the hyperthyroid state. The standard treatment methods are as follows.

1. Radioactive iodine

Radioactive iodine is used to curb the excessive production of hormones through the destruction of the thyroid gland.

It may take up to 6 months to see the full effect of the treatment. This will result in hypothyroidism in most cases, requiring thyroid hormone supplementation. Rarely, a second treatment dose may be needed.

Besides hypothyroidism, other side effects of radioactive iodine treatment include nausea, a metal taste in the mouth, and swollen salivary glands.

2. Medications

Two oral medications for hyperthyroidism are available, namely, methimazole and propylthiouracil (PTU). These medications interfere with how the thyroid makes the thyroid hormone.

Oral medications can be used to treat hyperthyroidism but do not normally offer a permanent cure. The most common side effects of antithyroid medications are hives, itching, and rashes. If antithyroid medications are needed in the first trimester of pregnancy, PTU is recommended. (1)

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Sometimes, your doctor will give a beta-blocker to help treat the symptoms of hyperthyroidism. Beta-blockers slow down the heart rate, lower the blood pressure, and reduce the shaking of the hands (tremors) that are so common with hyperthyroidism.

3. Surgery/thyroidectomy

Surgical removal of the thyroid gland (thyroidectomy) is sometimes recommended. Occasionally, just the overactive/hyperfunctioning nodule or one lobe of the thyroid is removed. In other cases, subtotal or total thyroidectomy is performed.

Depending on the extent of the surgery, permanent hypothyroidism may result, requiring lifelong thyroid hormone supplementation.

How Is Hyperthyroidism Diagnosed?

diagnosis of hyperthyroidism

The diagnosis of hyperthyroidism includes a study of your medical history and a physical exam. This is followed by blood tests to check your TSH, T3, and T4 levels. The normal range of T4 is suggested to be 77–155 nmol/l, T3 to be 1.2–2.8 nmol/L and TSH to be 0.3–4 mU/l. (2)

Hyperthyroidism is indicated by:

  • Higher than normal levels of T3 and T4
  • Lower than normal levels of TSH

Occasionally, other laboratory tests such as thyroid ultrasound, antibody test, and scans are needed, especially if thyroiditis or one of the rarer causes of hyperthyroidism is suspected:

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Follow-Up Post Diagnosis

Once you have been diagnosed with hyperthyroidism, your doctor is likely to recommend a treatment method suitable for your condition.

To help you keep track of your health, doctors recommend that you must:

  • Follow up with your doctor as recommended to assure you are responding to therapy.
  • Monitor your thyroid hormone levels by getting a blood test done every 2–6 months.

Risk Factors

The likelihood of developing hyperthyroidism is more in women than in men. While the problem may develop in women in their early 30s, it is more likely to affect women over 60.

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Other factors that can make you more prone to developing an overactive thyroid are:

  • Personal or family medical history of a thyroid disorder or goiter
  • Any autoimmune disease such as pernicious anemia, type 1 diabetes mellitus, rheumatoid arthritis, lupus, and primary adrenal insufficiency
  • Pregnancy
  • Certain heart medications that contain iodine

What Are the Complications of Untreated Hyperthyroidism?

complications of untreated hyperthyroidism

Unaddressed hyperthyroidism can have severe complications that can have serious consequences on your overall health. These complications include:

  • Graves’ ophthalmopathy
  • Atrial fibrillation, which can lead to stroke
  • Hypertension and congestive heart failure
  • Osteoporosis, increasing the risk of fracture
  • Muscle wasting, leading to difficulty in walking
  • Thyroid storm
  • In pregnant women, health complications to both the mother and the baby

When to See a Doctor

Make a note of your symptoms and consult your primary care physician or endocrinologist if you experience dizziness, rapid, irregular heartbeat, and elevated systolic blood pressure.

What you may ask your doctor
  • Will my condition improve with medication?
  • Do I need surgery?
  • What lifestyle changes do you suggest?
  • What possible side effects will I experience during the treatment?
  • Will it create complications in my pregnancy?
What your doctor may ask you
  • What medications, including supplements, are you taking?
  • What are your symptoms?
  • Does the problem run in your family?
  • Tell me about your daily schedule?
  • Have you experienced sudden weight gain?

Expert Answers (Q&A)

Answered by Dr. Tharsan Sivakumar, MD (Endocrinologist)

experts advice on measures to relieve hyperthyroidism
Can hyperthyroidism be a sign of thyroid cancer?

Thyroid cancer has been linked to hyperthyroidism in a few cases. (3) The good news is that most people who have hyperthyroidism do not have thyroid cancer. Moreover, most people with thyroid cancer do not have any symptoms.

Can high levels of stress lead to hyperthyroidism?

It is well understood that genetic factors can predispose an individual to develop hyperthyroidism, but the exact triggers are yet unknown. Extreme amounts of stress can precipitate thyroid dysfunction, but stress is not believed to be a common cause of hyperthyroidism.

Why are women more predisposed to hyperthyroidism than men?

Specifically, women are more likely to develop Graves’ disease, which is the most common type of hyperthyroidism. Therefore, it is said that women are more predisposed to hyperthyroidism than men.

Is it possible to gain weight with hyperthyroidism?

Hyperthyroidism typically causes weight loss. Hypothyroidism typically causes weight gain.

Can hyperthyroidism reduce fertility?

In women, hyperthyroidism can cause lighter periods and/or menstrual irregularity, which can reduce fertility.

In men, hyperthyroidism can reduce sperm count, which can reduce fertility. Thus, if an individual has hyperthyroidism, it is important to treat the condition and normalize the thyroid hormone levels before trying to conceive.

About Dr. Tharsan Sivakumar, MD, FRCPC: Dr. Sivakumar is the director of the Institute of Diabetes & Endocrinology and the president-elect of the American Association of Clinical Endocrinologists (AACE), Canadian Chapter.

Dr. Sivakumar is board certified by the American Board of Internal Medicine in endocrinology, diabetes, and metabolism, as well as in internal medicine. He is also a diplomate of the American Board of Clinical Lipidology. In addition, he is certified by the Royal College of Physicians and Surgeons of Canada in internal medicine as well as in endocrinology and metabolism.

Dr. Sivakumar’s areas of clinical and research interest include diabetes, lipidology, and general endocrinology. He has a number of publications in prominent peer-reviewed medical journals.

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Final Word

Hyperthyroidism can adversely affect your entire body. Often, antithyroid medications are only required when someone is extremely hyperthyroid.

Aside from the standard medications used to treat an overactive thyroid, dietary changes and yoga can be introduced into your routine to help your body stabilize the levels of thyroid hormones.

Continue Reading Continue ReadingDiet and Lifestyle Changes to Manage Hyperthyroidism
References
  1. Hackmon R, Blichowski M, Koren G. The safety of methimazole and propylthiouracil in pregnancy: a systematic review. Journal of obstetrics and gynaecology Canada: JOGC = Journal d’obstetrique et gynecologie du Canada: JOGC. https://www.ncbi.nlm.nih.gov/pubmed/23231846. Published November 2012.
  2. Veeramuthumari P, Isabel W, Kannan K. A study on the level of T(3), T(4), TSH and the Association of a/G polymorphism with CTLA-4 gene in graves’ hyperthyroidism among South Indian population. Indian journal of clinical biochemistry : IJCB. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3068763/. Published January 2011.
  3. Pazaitou-Panayiotou K, Michalakis K, Paschke R. Thyroid cancer in patients with hyperthyroidism. Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme. https://www.ncbi.nlm.nih.gov/pubmed/22334393. Published April 2012.
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