What Is Hyperthyroidism?

Highlights
1. Hyperthyroidism is a condition in which the thyroid
overproduces hormones.

2. Common symptoms of hyperthyroidism include

weakness, irregular heartbeat, and difficulty
sleeping.

3. Medication, surgery, and changes in diet are some

of the treatment options for hyperthyroidism.

Hyperthyroidism is a condition of the thyroid. The thyroid is a

small, butterfly-shaped gland located at the front of your
neck. It produces tetraiodothyronine (T4) and triiodothyronine
(T3), which are two primary hormones that control how your
cells use energy. Your thyroid gland regulates your
metabolism through the release of these hormones.

Hyperthyroidism occurs when the thyroid makes too much

T4, T3, or both. This can cause rapid heart rate, elevated
blood pressure, and hand tremors, as well as a host of other
symptoms. Diagnosis of the overactive thyroid and treatment
of the underlying cause can relieve symptoms and prevent
complications.
What Causes Hyperthyroidism?
A variety of conditions can cause hyperthyroidism. Graves'
disease, an autoimmune disorder, is the most common cause
of hyperthyroidism. It causes antibodies to stimulate the
thyroid to secrete too much hormone. Graves’ disease occurs
more often in women than in men. It tends to run in families,
which suggests a genetic link. You should tell your doctor if
your relatives have had the condition.

Other causes of hyperthyroidism can include:

 excess iodine, a key ingredient in T4 and T3

 inflammation of the thyroid (thyroiditis) that causes T4
and T3 to leak out of the gland
 tumors of the ovaries or testes
 benign tumors of the thyroid or pituitary gland
 large amounts of tetraiodothyronine taken through
dietary supplements or medication

What Are the Symptoms of

Hyperthyroidism?
High amounts of T4, T3, or both can cause an excessively
high metabolic rate. This is called a hypermetabolic state.
When in a hypermetabolic state, you may experience a rapid
heart rate, elevated blood pressure, and hand tremors. You
may also develop a low tolerance for heat and sweat a lot.
Hyperthyroidism can cause more frequent bowel movements,
weight loss, and, in women, irregular menstrual cycles.

Visibly, the thyroid gland itself can swell into a goiter, which
can be either symmetrical or one-sided. Your eyes may also
appear quite prominent, which is a sign of exophthalmos, a
condition that’s related to Graves’ disease.

Other symptoms of hyperthyroidism include:

 increased appetite
 nervousness

 restlessness

 inability to concentrate

 weakness

 irregular heartbeat

 difficulty sleeping

 fine, brittle hair

 itching

 hair loss

 nausea and vomiting

 breast development in men

The following symptoms require immediate medical

attention:

 dizziness
 shortness of breath
 loss of consciousness
 fast, irregular heart rate
Hyperthyroidism can also cause atrial fibrillation, a dangerous
arrhythmia that can lead to strokes, as well as congestive
heart failure.

How Do Doctors Diagnose

Hyperthyroidism?
Your first step in diagnosis is to get a complete history and
physical exam. This can reveal these common signs of
hyperthyroidism:

 weight loss
 rapid pulse

 elevated blood pressure

 protruding eyes

 enlarged thyroid gland

Other tests may be performed to further evaluate your

diagnosis. These include:

Cholesterol Level Test

Your doctor may need to check your cholesterol level. Low
cholesterol can be a sign of an elevated metabolic rate, in
which your body is burning through cholesterol quickly.
T4 and T3 Resin Uptake (T3RU) Tests
These tests measure how much thyroid hormone (T4 and T3)
is in your blood.
Thyroid Stimulating Hormone (TSH) Level
Test
Thyroid stimulating hormone (TSH) is a pituitary gland
hormone that stimulates the thyroid gland to produce
hormones. When thyroid hormone levels are normal or high,
your TSH should be lower.

Triglyceride Level Test

Your triglyceride level may also be tested. Similar to low
cholesterol, low triglycerides can be a sign of an elevated
metabolic rate.

Thyroid Scan and Uptake

This allows your doctor to see if your thyroid is overactive. In
particular, it can tell if the entire thyroid or just a single area
of the gland is causing the overactivity.

Ultrasound
Ultrasound can measure the size of the entire thyroid gland,
as well as any masses within it. Doctors can also use
ultrasound to know if a mass is solid or cystic.

CT or MRI Scans
A CT or MRI can show if a pituitary tumor is present that’s
causing the condition.
How to Treat Hyperthyroidism
Medication
Antithyroid medications, such as methimazole (Tapazole),
stop the thyroid from making hormones.

Radioactive Iodine
Radioactive iodine effectively destroys the cells that produce
hormones. Antithyroid medications and radioactive iodine are
common treatments. The downside is that these medications
can have severe side effects, such as low white blood cell
count. White blood cells are crucial to immune function.
Surgery
A section or all of your thyroid gland may be surgically
removed. You will then have to take thyroid hormone
supplements to prevent hypothyroidism, which occurs when
you have an underactive thyroid that secretes too little
hormone. Also, beta blockers, such as propranolol, can help
control your rapid pulse, sweating, anxiety, and high blood
pressure. Most people respond well to this treatment.

What You Can Do to Improve

Symptoms
Eating a proper diet, with a focus on calcium and sodium, is
important, especially in preventing hyperthyroidism. Work
with your doctor to create healthy guidelines for your diet,
nutritional supplements, and exercise.

Hyperthyroidism also can cause your bones to become weak

and thin, which can lead to osteoporosis. Taking vitamin D
and calcium supplements during and after treatment can
help strengthen your bones. Your doctor can tell you how
much vitamin D and calcium to take each day.

Outlook
Your doctor may refer you to a specialist called an
endocrinologist, who is knowledgeable about treating bodily
hormone systems. Stress or infections can cause thyroid
storm. Thyroid storm happens when a large amount of thyroid
hormone is released and results in a sudden worsening of
symptoms. Treatment is important to prevent thyroid storm,
thyrotoxicosis, and other complications.

The long-term outlook for hyperthyroidism depends on its

cause. Some causes can go away without treatment. Others,
like Graves' disease, get worse over time. The complications
of Graves' disease can be life-threatening and affect your
long-term quality of life. Early diagnosis and treatment of
symptoms improve the long-term outlook.