Hyperthyroidism and hyperthyroidism symptoms occur when the thyroid gland produces too many thyroid hormones.
This small butterfly-shaped gland sits in front of the trachea (windpipe) in the neck. It produces two main thyroid hormones, triiodothyronine (T3) and thyroxine (T4).
These hormones regulate your metabolism, body temperature, and heart rate. Unfortunately, too many of these hormones disrupt the hormone balance in the body and cause symptoms to appear.
Hyperthyroidism is approximately ten times more common in women and is typically diagnosed between 20 and 40 years of age.
Common hyperthyroidism symptoms
Symptoms of hyperthyroidism can include:
- Anxiety, irritability, nervousness, and nervous energy
- Heat sensitivity
- Muscle weakness
- Sleep issues
- Feeling tired all the time
- Mood swings
- Frequent urination
- Constant thirst
Common hyperthyroidism signs
Hyperthyroidism may also cause physical signs:
- Goiter- an enlarged thyroid
- Trembling or twitching
- Heart palpitations
- Feeling warm and sweating easily
- A raised itchy rash (hives)
- Hair loss or thinning
- Weight loss despite increased appetite
- Eye problems, including redness and dryness
Common hyperthyroidism causes
A few of the conditions that can cause your thyroid to become overactive include:
Approximately three out of four with an overactive thyroid gland are diagnosed Graves’ disease.
Graves’ disease is an autoimmune disease that causes your immune system to attack your thyroid, causing it to become overactive.
Graves’ disease’s root cause is unknown, but it mainly affects young or middle-aged women and often runs in families. In addition, smoking has been linked to an increased risk of developing the disease.
Occasionally, lumps or nodules will develop on your thyroid, causing it to become overactive.
These nodules are usually benign (non-cancerous) but may contain thyroid tissue, producing excess thyroid hormones.
It’s unknown why nodules develop, but they usually affect those over 60.
Increased iodine levels in the body cause your thyroid to produce excess thyroid hormones.
This issue can happen if you’re medication contains iodine, such as amiodarone, which is used to control arrhythmia(irregular heartbeat).
A medication-related overactive thyroid will improve once the medication is discontinued, but it may take several months for your hormone levels to normalize.
Other causes of an overactive thyroid:
- A pituitary adenoma- a benign tumor in the pituitary gland (this gland located at the base of the neck affects the amount of hormone produced by the thyroid
- Thyroiditis- inflammation of the thyroid, causing excess thyroid hormones to be produced
- Thyroid cancer- a cancerous thyroid tumor can alter the production of hormones
- High levels of human chorionic gonadotrophin- this happens in early pregnancy, with multiple pregnancies or molar pregnancy (a lump of abnormal cells grows in the womb instead of a fetus)
I will note that functional and holistic doctors believe stress, environmental toxins, and poor nutrition are the main causes leading to the rise in autoimmune diseases. So I’m not just talking about the thyroid autoimmune diseases Hashimoto’s and Graves’; I’m talking about all the autoimmune diseases.
These diseases occur when your immune system can’t distinguish between your cells and foreign cells, so it attacks normal cells. In addition, many of the chemical toxins in our environment mimic our body’s hormones; the more toxins, the more attacks, and the more hormone dysfunction.
Unfortunately, if you are diagnosed with one autoimmune disease, there is a good chance you will develop other autoimmune disorders.
Common autoimmune diseases in women include:
- Type 1 diabetes- a condition where the immune system attacks the insulin-producing cells in the pancreas
- Lupus- a disease that attacks joints, skin, and organs
- Thyroid diseases- Graves’ disease occurs when the body makes too much thyroid hormone (hyperthyroidism), and Hashimoto’s thyroiditis occurs when the body doesn’t make enough thyroid hormone (hyperthyroidism)
- Psoriasis- a condition with thick, scaly areas of skin
- Psoriatic arthritis- this type of arthritis affects some people with psoriasis
- Rheumatoid arthritis- this form of arthritis attacks the joints
- Multiple sclerosis- occurs when the immune system attacks the brain and nerves
- Inflammatory bowel disease- this includes Crohn’s disease, which can affect any part of the GI tract, and Ulcerative colitis, which affects just the lining of the colon and rectum
- Addison’s disease- attacks the adrenal glands affecting the production of the hormones cortisol, aldosterone, and androgens. Cortisol affects the body’s use and storage of carbohydrates and glucose, while aldosterone deficiency leads to sodium loss and too much potassium in the blood
Autoimmune disease symptoms vary from person to person due to the varying degrees of autoimmune diseases. However, the symptoms are usually related to genetics, weight, smoking, individual health, and environmental exposures.
The first step in diagnosing any thyroid condition is checking your TSH levels with your primary care physician. Interestingly, most thyroid websites mention how the bloodwork results and your symptoms will diagnose thyroid disease.
However, many with thyroid disease have countless stories about how their condition is treated only by the numbers, not how their symptoms are controlled.
If your TSH levels are low, your doctor will check your T3 (triiodothyronine) and T4 (thyroxine) levels, also known as free T3 and free T4. Lower TSH levels and higher levels of T3 and T4 usually mean you have hyperthyroidism.
If hyperthyroidism is suspected, you will do another blood test looking for anti-thyroid antibodies. These antibodies will be present if you have Graves’ disease, the most common cause of hyperthyroidism.
While checking for antibodies, it’s common for another blood test called erythrocyte sedimentation rate (ESR) to be run, checking for inflammation in your body.
If there is inflammation, the excess thyroid hormones are caused by inflammation of the thyroid (thyroiditis).
You may have a thyroid scan to look for nodules (lumps) on the thyroid and to test how fast your thyroid absorbs a slightly radioactive substance.
You’ll be asked to take a small amount of a slightly radioactive substance that your thyroid will absorb. This substance can be ingested by pill or given by injection. The scan examines the shape and size of your thyroid and determines how much radioactive substance was absorbed.
The treatment options for hyperthyroidism depend on the diagnosis you have received. For example, if you have nodules or a large goiter, you may need surgery. Also, you may need surgery if you have Graves’ disease and suffer from Thyroid Eye disease.
After a Graves’ disease diagnosis, there are different treatment options available. First, surgery, as mentioned above, radioactive iodine (RAI) therapy, and anti-thyroid medications (ATD).
Patients often choose ATD treatment when diagnosed to see if the disease will go into remission, meaning the antibody is no longer present.
However, only approximately 25% of patients stay in remission.
Those whose Graves’ recurs are often told a more permanent treatment is needed, so they will have RAI or thyroid surgery. These options are considered the standard treatment plan for those who see a conventional doctor or endocrinologist.
With RAI therapy, you will be given a capsule containing iodine and a low dose of radiation, which is absorbed by the thyroid, destroying the thyroid cells and thus reducing the amount of thyroid hormone produced. The same is true for thyroid surgery; either all or part of the thyroid is removed, reducing the amount of thyroid hormone produced.
After treatment, you will be given a prescription for thyroid hormone replacement, commonly levothyroxine or Synthroid. You will need to check your hormone levels periodically to monitor the correct levels and symptoms.
A few of the complications are related to hyperthyroidism.
Thyroid Eye Disease
Problems with your eyes affect approximately one in three people with thyroid eye disease, also known as Graves’ ophthalmopathy.
These issues include:
- red eyes
- watering eyes
- sensitivity to light
- eyes feeling dry and gritty
- blurred or double vision
- bulging eyes
- red swollen eyelids
- pulled back eyelids
Most cases are mild and improve as the overactive thyroid is treated; however, about one in every twenty to thirty cases risk vision loss.
Treatment for eye problems includes eye drops, steroid medicine, and in severe cases, surgery.
Underactive thyroid or hypothyroidism
Many times treating an overactive thyroid results in hormone levels becoming too low.
These symptoms include:
- tiredness and fatigue
- sensitivity to cold
- weight gain
After surgery or RAI, you will have to have hormone replacement therapy. These procedures aim to reduce the amount of thyroid tissue, so the production of thyroid hormone is reduced.
An underactive thyroid is sometimes only temporary, but permanent and long-term treatment with thyroid hormone medicine is often needed.
An uncontrolled overactive thyroid increases the following risks:
- premature (labor and birth) before week 37 of the pregnancy
- low birth weight
Advise your doctor if you are planning a pregnancy or might be pregnant. They will want to be sure your condition is under control and may switch to medications that will not harm the baby. It’s also important to use contraception if not planning on becoming pregnant, so your treatments don’t damage the fetus.
Additional issues with hyperthyroidism
Thyroid storm- a sudden flair-up of symptoms including:
- A high temperature
- Confusion and severe agitation
- Rapid heartbeat
- Illness and diarrhea
- Loss of consciousness
- Jaundice (yellowing of skin and eyes
- Osteoporosis (weakened bones)- your bones become brittle and more likely to break
- Heart failure-the heart cannot pump blood properly
- Atrial fibrillation- a heart condition causing irregular and rapid heartbeat
Can you treat hyperthyroidism without RAI or surgery?
As I noted earlier, the standard treatment for those patients with recurrent or relapsed Graves’ disease is RAI or possible surgery. Most conventional doctors or endocrinologists will tell you the only permanent cure is RAI or, if necessary, surgery; adding that after the procedure, you will take a little pill once a day that replaces the hormones no longer produced by your thyroid.
There are a couple of flaws to this treatment plan.
- Destroying or removing your thyroid does nothing to control or heal the autoimmune disease that is causing the problems to begin with.
- The little pill that is the cure-all does not contain all the hormones your thyroid makes. It only includes the T4 hormone, which your body converts to the useable T3 hormone, but your thyroid also produces the hormone calcitonin. Calcitonin is secreted by C cells and regulates the calcium and phosphate in the blood.
Conventional doctors will tell you that hormones like calcitonin don’t matter since there are only traces of it produced and used by the body.
They will also tell you that only taking a T4 hormone works because your body converts T4 to usable T3, which is great until your body loses the ability to do the conversion. You then have symptoms of hypothyroidism due to a lack of usable T3, even though your blood work shows you are within the normal ranges for TSH.
Also, conventional doctors rarely pay attention to your symptoms; your disease is monitored by numbers only; if your numbers are within range, you’re good, regardless of any symptoms you may be experiencing.
These same doctors will also tell you that diet and stress control are unnecessary because they do not affect your autoimmune disease.
However, they won’t tell you that approximately 50% of patients after RAI don’t have most of their symptoms controlled six months after treatment.
Depending on the symptoms, they will be offered anti-depressants, anti-anxiety drugs, weight-loss drugs, cholesterol-lowering medications, and an increased dose of levothyroxine. But you won’t be offered a natural thyroid hormone because the doctors have been told it is harmful, unregulated, or ineffective, even though studies have shown symptom control is better when using a natural hormone replacement therapy. This unwillingness to try different treatments leaves many suffering from uncontrolled symptoms and searching for answers.
This lack of treatment options leads many patients to see a functional medicine or holistic doctor. These doctors focus on natural hormone replacement, stress reduction, reducing toxins in your environment and diet, and supplementing your diet with the vitamins depleted by disease. The theory of these doctors is to nourish and support the body while reducing the toxins that mimic and disrupt hormones allowing the body to heal.
Many readers have found improved thyroid function and overall better health by following a program focused on cleaning out the toxins in their body and environment and consuming a thyroid-healing diet. Many of my readers have had great results with The Hypothyroidism Solution. If you are going through menopause, The Thyroid Factor is an excellent guide to controlling all of those crazy hormones. (If you purchase from the links in this post, we may receive a commission.) Both of these programs follow the same guidelines my functional medicine doctor laid out for me when I was regaining my health. He told me that I needed to follow his recommendations if I wanted to feel better. He was right!
While researching this post, I also found a study comparing patient outcomes with recurrent Graves’ disease who had prior treatment with ATDs. This study compared patients who had received RAI or chronic ATD (anti-thyroid medication therapy.) The patients were followed an average of 6 years after their Graves’ disease relapse.
Here are the results of that study:
- Patients who continued long-term ATD therapy were more likely to have normal thyroid function (based on blood tests) than those with RAI treatment.
- Hypothyroidism was more common after RAI treatment than ATDs at a 60-month follow-up.
- Graves’ eye disease continuing to worsen was more common in those patients who chose RAI.
- Body weight was higher in patients treated with RAI versus ATDs.
- The authors stated no significant adverse effects from methimazole during follow-ups concluding that long-term ATD therapy was a safe and effective treatment for Graves’ disease.
- The study concluded that chronic low-dose ATD therapy could be a treatment option for those who had a relapse after initial therapy.
- In addition, the patients treated with methimazole were more likely to have normal thyroid function than those treated with RAI.
- Methimazole therapy may be an alternative to surgery for Graves’ eye disease patients.
If you are facing a Graves’ disease diagnosis, please remember there is no “one size fits all” treatment for thyroid disease. Take your time when figuring out what treatment will be best for you, and if you are not comfortable with the doctor, see another one. Because having your thyroid destroyed or removed is not a decision to rush into!