Hyperthyroidism: Symptoms, Causes & Treatment

What is hyperthyroidism?

Hyperthyroidism is known as overactive thyroid. It occurs when your thyroid gland makes and releases too much thyroid hormone. The thyroid gland is shaped like a butterfly. It is in the front of your neck, below your Adam’s apple. The thyroid makes hormones that control your body’s metabolism. It affects your heart rate and the function of your other organs. It also affects your muscles, bones, and menstrual cycles (for women).

Hyperthyroidism can be related to Graves’ disease. This is an autoimmune disease that affects the thyroid gland.

Symptoms of hyperthyroidism

Hyperthyroidism often begins slowly. Its symptoms can be mistaken for stress or other health problems. Common symptoms include:

• Unplanned weight loss
• Rapid heartbeat, abnormal heartbeat, or pounding of the heart
• Nervousness, anxiety, or touchiness
• Tremors (trembling of the hands and fingers)
• Changes in menstrual patterns, such as lighter flow or less frequent periods, in women
• Increased sensitivity to heat
• Increased sweating
• Bowel changes
• An enlarged thyroid gland (called a goiter), which can appear as swelling at the base of the neck
• Fatigue
• Muscle weakness
• Trouble sleeping
• Increased appetite

Symptoms in older adults may be subtle. Examples are increased heart rate, fatigue during normal activities, and withdrawal. Doctors may mistake hyperthyroidism for depression or dementia.

People who have Graves’ disease may have additional symptoms. One of the most common symptoms is swollen or bulging eyes. This can cause your eyes to be dry and red. You may also have:

• Tearing
• Blurry or double vision
• Sensitivity to light

What causes hyperthyroidism?

In more than 70% of cases, hyperthyroidism is caused by Graves’ disease. Normally, the immune system helps protect your body against viruses, bacteria, and other substances. An autoimmune disease causes it to attack your body’s tissues and/or organs. With Graves’ disease, the immune system stimulates your thyroid, making it produce too much hormone. Doctors think Graves’ disease may run in families. It is most common among young women.

Two other common causes for hyperthyroidism are:

• Hyperfunctioning (overactive) thyroid nodules. One or more nodules or lumps in the thyroid grow. This increases the production of the thyroid hormone.
• A problem with the immune system or a viral infection causes the thyroid gland to become inflamed. This causes extra thyroid hormone to leak into your bloodstream. Thyroiditis could lead to hypothyroidism (underactive thyroid) over time.

Consuming foods or medicines that contain high levels of iodine can also lead to hyperthyroidism. In rare cases, the cause could be a benign (noncancerous) tumor on the pituitary gland.

How is hyperthyroidism diagnosed?

Contact your doctor if you have symptoms of an overactive thyroid. He or she will check for an enlarged thyroid gland, rapid pulse, moist skin, eye changes, and a slight tremor in your fingers or hand. Your doctor also will do a blood test to measure the amount of thyroid hormone in your blood. This confirms the diagnosis.

Your doctor may do a thyroid scan to find the cause. If your entire thyroid is affected, you have Graves’ disease. Or the doctor will look for thyroid nodules or an inflammation.

Your doctor also may do a radioactive iodine uptake test. This test measures your thyroid’s ability to take up iodine. A high uptake of iodine means your thyroid gland may be producing too much hormone. This indicates Graves’ disease or a hyperfunctioning thyroid nodule. A low uptake of iodine indicates thyroiditis as the cause.

Can hyperthyroidism be prevented or avoided?

You cannot prevent hyperthyroidism. However, some people are more at risk for the condition. This includes people who:

• Were born female
• Have a family history of thyroid disease
• Are younger than 40 or older than 60
• Have certain problems, such as type 1 diabetes, pernicious anemia, or an immune system disorder
• Consume large amounts of iodine, either through food or medicine

Hyperthyroidism treatment

There are several treatments for hyperthyroidism. The best one for you depends on your age, health, cause, and the severity of your condition. The goal is to control your thyroid levels and make them normal. Doing this relieves symptoms and prevents future health problems. Treatments include:

• Radioactive iodine. You take a pill or liquid by mouth. It gets into your blood stream and destroys the overactive thyroid cells. This causes the level of thyroid hormone in your body to decrease. Symptoms often lessen in 3 to 6 months. The result is permanent low thyroid activity (hypothyroidism). This condition can be treated with thyroid supplements. Despite concerns about radioactive material, the treatment has been used for more than 60 years without any problems. Most adults in the United States who have hyperthyroidism are treated with radioactive iodine. This option is not suitable for women who are pregnant or breastfeeding.
• Anti-thyroid medicine. These drugs tell your thyroid to produce fewer hormones. Symptoms begin to improve in 6 to 12 weeks as your hormone levels adjust. Treatment can last for at least a year. This is a better option for women who are pregnant or breastfeeding. Talk to your doctor about possible side effects.
• Surgery. A thyroidectomy is when the doctor removes most of your thyroid gland. After surgery, you likely will develop hypothyroidism. You can take thyroid supplements to restore your hormone levels to normal.
• Beta blockers. These drugs slow your heart rate and reduce tremors and anxiety. They can be used with other forms of treatment. You should be able to stop taking them once your thyroid levels return to normal.

Living with hyperthyroidism

If it is not treated, hyperthyroidism can lead to other health problems. These include:

• Heart problems. A rapid heart rate, a heart rhythm disorder (called atrial fibrillation), or congestive heart failure can result.
• Brittle bones (osteoporosis). Too much thyroid hormone can prevent your body from absorbing calcium into your bones. You can get calcium in your food, or your doctor may recommend a calcium supplement.
• Thyrotoxic crisis. A sudden worsening of hyperthyroidism symptoms that leads to a fever, rapid pulse, and delirium. Signs of delirium include decreased awareness, confusion, and restlessness. See a doctor right away if this occurs.
• Infertility. Too much thyroid hormone can make it hard for some women to get pregnant. An overactive thyroid also can be harmful to the mother and baby during pregnancy. Most doctors test women’s thyroid hormone levels at this stage.

People who have Graves’ disease may develop red, swollen skin on their shins and feet. Try using over-the-counter creams with hydrocortisone for relief. You also may have eye problems due to Graves’ ophthalmopathy. To relieve these symptoms:

• Apply a cool compress to your eyes.
• Wear sunglasses.
• Use lubricating eye drops.
• Elevate the head of your bed to reduce blood flow to your head.

Questions to ask your doctor

• What is the cause of my hyperthyroidism?
• Do I have Graves’ disease?
• What types of food and medicine contain high levels of iodine?
• What is the best treatment?
• Will I need to take medicine? If so, for how long and what are the side effects?
• Will I need surgery? If so, what are the benefits and risks?
• Are there any lifestyle changes I can make to relieve my symptoms?
• Am I at risk for related health problems?

Resources

American Thyroid Association: Hyperthyroidism

National Institute of Diabetes and Digestive and Kidney Diseases: Hyperthyroidism (Overactive Thyroid)

National Institutes of Health, MedlinePlus: Hyperthyroidism

Overactive thyroid – Illnesses & conditions

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About overactive thyroids

Overactive thyroid (also known as hyperthyroidism) is a relatively common hormonal condition that occurs when there is too much thyroid hormone in the body.

Excess levels of thyroid hormones can then speed up the body’s metabolism, triggering a range of symptoms, such as:

• nervousness and anxiety
• hyperactivity – where a person can’t stay still and is full of nervous energy
• unexplained or unplanned weight loss 
• swelling of the thyroid gland, which causes a noticeable lump, known as a goitre, to form in the throat

The severity, frequency and range of symptoms can vary from person to person.

Read more about the symptoms of an overactive thyroid gland

What causes an overactive thyroid gland?

The thyroid gland is found in the neck. It produces hormones that are released into the bloodstream to control the body’s growth and metabolism. These hormones are called thyroxine and triiodothyronine.

They affect processes such as heart rate and body temperature, and help convert food into energy to keep the body going.

In hyperthyroidism, the thyroid gland produces too much thyroxine or triiodothyronine, which speeds up the body’s metabolism.

There are several possible underlying causes, the most common being Graves’ disease, in which the body’s immune system targets the thyroid gland and causes it to produce too much of the thyroid hormones.

Read more about the causes of an overactive thyroid gland

Treatment

An overactive thyroid usually responds well to treatment, and most people are able to control their symptoms.

The three most widely used treatments for an overactive thyroid gland are:

• thionamides – a group of medications, including carbimazole and methimazole, that stop the thyroid gland producing too much thyroid hormone
• radioiodine treatment – a radioactive substance called iodine that helps shrink the thyroid gland, reducing its activity (the radiation contained in iodine is a very low dose and does not pose a threat to health)
• surgery – in a small number of cases surgery may be required to remove some or all of the thyroid gland, particularly if there is a large goitre

Beta-blockers may also sometimes be used to temporarily relieve many symptoms of an overactive thyroid gland, although it doesn’t target the thyroid gland itself.

It’s common for treatment to lead to the thyroid not producing enough hormones. This is known as having an underactive thyroid gland (hypothyroidism). However, an underactive thyroid is not usually serious and is easily treated.

Read more about the treatment of an overactive thyroid gland

Complications

Around 1 in 20 people with Graves’ disease will also develop symptoms affecting their eyes, such as:

• double vision
• sensitivity to light (photophobia)
• tearing (excess production of tears)

This is known as Graves’ ophthalmopathy and should be seen by a doctor who specialises in treating eye conditions (an ophthalmologist).

A rarer and more serious complication is a sudden and severe flare-up of symptoms, known as a thyroid storm. A thyroid storm can be life-threatening, as it causes severe dehydration and heart problems.

Read more about the complications of an overactive thyroid gland

Who is affected

Women are 10 times more likely to have an overactive thyroid gland than men.

It is estimated that around 1 in 50 women in England currently live with an overactive thyroid gland.

In most cases, symptoms will begin somewhere between the ages of 20 and 40, though they can start at any age, including in childhood.

An overactive thyroid gland occurs most frequently in white and Asian people, and less frequently in African-Caribbean people.

Symptoms of an overactive thyroid

An overactive thyroid (hyperthyroidism) has many signs and symptoms, although it is unlikely you would develop all of them.

Symptoms of hyperthyroidism

If you have hyperthyroidism, you may experience some of the following symptoms:

• hyperactivity
• mood swings – such as anxiety, irritability and nervousness
• difficulty sleeping (insomnia)
• feeling tired all the time (fatigue)
• muscle weakness
• needing to pass stools (faeces) or urine more frequently
• excess fats in your stools – which can make them greasy and difficult to flush down the toilet (steatorrhoea)
• sensitivity to heat and excess sweating
• unexplained or unexpected weight loss – despite having an increased appetite (though in a small number of cases, the increase in appetite can lead to weight gain)
• very infrequent or light periods, or periods stopping altogether
• infertility
• loss of interest in sex 

If you have diabetes, your diabetic symptoms, such as extreme thirst and tiredness, may be made worse by hyperthyroidism.

Signs of hyperthyroidism

If you have hyperthyroidism, you may have some of the following physical signs:

• a swelling in your neck caused by an enlarged thyroid gland (goitre)
• irregular and/or unusually fast heart rate (palpitations)
• trembling or shaking (tremor)
• warm, moist skin
• redness on the palms of your hands
• loosening of your nails in their nail beds
• hives (urticaria)
• patchy hair loss (alopecia)
• twitching in your face and limbs

When to seek medical advice

See your GP if you are experiencing any of the above. They may not be the result of an overactive thyroid gland, but they will need further investigation.

It might be useful to make a list of your symptoms, as this can often be helpful in determining the correct diagnosis.

Causes of an overactive thyroid

Overactive thyroid (hyperthyroidism) occurs when your thyroid gland produces too much of the thyroid hormones thyroxine or triiodothyronine.

Overproduction of thyroid hormones can be caused by a number of conditions, which are outlined below.

Graves’ disease

Graves’ disease is the most common cause of overactive thyroid. It can run in families and can occur at any age, although it is most common in women aged 20-40 years old. You are more likely to develop Graves’ disease if you smoke.

Graves’ disease is an autoimmune condition. This means the immune system mistakes something in the body for a toxic substance and attacks it.

In Graves’ disease, it attacks the thyroid gland, which leads to an overproduction of the thyroid hormones.

It is not known what triggers the immune system to do this. Like many autoimmune conditions, it is thought that a combination of both genetic and environmental factors could be involved.

If you have Graves’ disease, your eyes may also be affected, causing discomfort and double vision. This is known as Graves’ ophthalmopathy. You may find your eyes bulge out or appear more prominent.

For more information on Graves’ ophthalmopathy, read our page on complications of an overactive thyroid gland.

Thyroid nodules

It is possible for lumps to develop in your thyroid gland. These are known as nodules. It is not known why nodules develop, but they are usually non-cancerous (benign).

However, the nodules can contain abnormal thyroid tissue, which affects the normal production of thyroxine or triiodothyronine, causing an overactive thyroid. Nodules that contain abnormal thyroid tissue are described as toxic.

Toxic thyroid nodules account for about 1 in 20 cases of hyperthyroidism.

Iodine supplements

Iodine contained in the food you eat is used by your thyroid gland to produce the thyroid hormones thyroxine and triiodothyronine. However, taking additional iodine in supplements can cause your thyroid gland to produce too much thyroxine or triiodothyronine.

This is known as iodine-induced hyperthyroidism – sometimes referred to as Jod-Basedow phenomenon. It usually only occurs if you already have nodules in your thyroid gland.

Amiodarone

Amiodarone is a type of medication known as an anti-arrhythmic, which helps to control an irregular heartbeat (atrial fibrillation). If you have non-toxic nodules in your thyroid gland, taking amiodarone can cause hyperthyroidism because it contains iodine. 

Amiodarone can cause a type of hyperthyroidism usually more severe and difficult to treat through a harmful effect on thyroid tissue. This type of hyperthyroidism is called amiodarone-induced hyperthyroidism.

Follicular thyroid cancer

In rare cases, you may develop an overactive thyroid as a result of thyroid cancer that starts in your thyroid follicles. This can occur if cancer cells in your thyroid gland begin to produce thyroxine or triiodothyronine. This is also known as functioning thyroid cancer.

Diagnosing an overactive thyroid

See your GP if you think you may have an overactive thyroid gland (hyperthyroidism).

A diagnosis will be based on your symptoms and the results of blood tests that assess how well your thyroid gland is working. These are known as thyroid function tests.

Thyroid function tests

Your GP will take a sample of your blood and test it for levels of:

• thyroid-stimulating hormone (TSH)
• thyroxine and triiodothyronine (the thyroid hormones)

TSH is made in the pituitary gland in your brain and controls the production of thyroxine and triiodothyronine.

• When the level of thyroxine and triiodothyronine in your blood are normal, your pituitary gland releases a normal level of TSH. When thyroid hormone production becomes excessive, the pituitary gland stops releasing TSH.  
• When the level of thyroxine or triiodothyronine drops, the pituitary gland produces more TSH to boost it.

If you have an overactive thyroid, the thyroid function test will show that levels of TSH in your blood are consistently lower than normal. Low levels of TSH mean your thyroid gland is overactive and likely to be making excessive thyroid hormones. This is the first part of the thyroid function test.

Your GP will then test your blood for levels of thyroxine and triiodothyronine. If you have an overactive thyroid, you will have higher than normal levels of both these hormones.

Subclinical overactive thyroid gland

In some cases, tests may show you have normal thyroid hormone levels, but low or suppressed levels of TSH.

This is known a subclinical overactive thyroid gland. If you are diagnosed with subclinical overactive thyroid, you may not need treatment.

In most cases, the reduced level of TSH in your blood returns to normal within a couple of months and your subclinical hyperthyroidism will resolve by itself.

However, you will need a further thyroid function test so your condition can be monitored.

Determining the underlying cause

If tests confirm an overactive thyroid gland, you may be referred for further tests to determine the underlying cause.

An additional test that may be used is an isotope thyroid scan. This involves swallowing small amounts of a radioactive substance (an isotope), usually technetium, in capsule or liquid form.

A scan is then used to measure how much of the isotope has been absorbed by your thyroid gland.

If your thyroid gland absorbs a high amount of the isotope, it is likely the underlying cause is either Graves’ disease or thyroid nodules.

If the amount is low, the underlying cause could be due to:

• swelling (inflammation) of the thyroid gland (thyroiditis), often caused by your immune system mistakenly attacking thyroid tissue or, less commonly, by infection
• having too much iodine in your diet
• in rare cases, thyroid cancer

Treating an overactive thyroid

If you are diagnosed with an overactive thyroid gland (hyperthyroidism), your GP will refer you to a specialist in hormonal conditions (endocrinologist) to plan your treatment.

The most widely used treatments for an overactive thyroid are outlined below.

Thionamides

Thionamides, such as carbimazole and propylthiouracil, are a common treatment. They are a type of medication that stops your thyroid gland producing excess amounts of thyroxine or triiodothyronine.

As thionamides affect the production of thyroid hormone rather than their current levels, you will need to take them for several weeks before you notice an improvement (usually between four to eight weeks).

Once the production of thyroid hormones is under control, your specialist may gradually reduce your medication.

You may need to continue taking thionamides for a long time, until the condition is under control.

Around 1 in 20 people will experience side effects when they first start taking thionamides, such as:

• itchy skin rash
• joint pain

These side effects should pass once your body is used to the effects of the medication.

In rare cases (around 1 in 500), thionamides cause a sudden drop in white blood cells (agranulocytosis), which can make you extremely vulnerable to infection.  

Symptoms of agranulocytosis include:

• fever
• gum pain, swelling and bleeding 
• sore throat 
• mouth ulcers 
• persistent cough
• shortness of breath

If you are taking thionamides and you experience any of the symptoms above, call your GP immediately for advice and an urgent blood test. If this is not possible, call NHS 111 service or your local out-of-hours service.

Beta-blockers

Beta-blockers, such as propranolol or atenolol, can relieve some of the symptoms of an overactive thyroid, including tremor (shaking and trembling), rapid heartbeat and hyperactivity.

Your specialist may prescribe you a beta-blocker while the condition is being diagnosed, or until thionamide brings your thyroid gland under control. However, beta-blockers are not suitable if you have asthma.

Beta-blockers can sometimes cause side effects, including:

• feeling sick
• feeling tired all the time (fatigue)
• cold hands and feet
• trouble sleeping, sometimes with nightmares

Radioiodine treatment

Radioiodine treatment is a form of radiotherapy used to treat most types of overactive thyroid. Radioactive iodine shrinks your thyroid gland, reducing the amount of thyroid hormone it can produce.

Radioiodine treatment is given either as a drink or a capsule to swallow. The dose of radioactivity in the radioiodine is very low and is not harmful.

Radioiodine treatment is not suitable if you are pregnant or breastfeeding, and may not be suitable if you have eye problems, such as double vision or prominent (bulging) eyes.

Women should avoid getting pregnant for at least six months after having radioiodine treatment. Men should not father a child for at least four months after having radioiodine treatment.

Most people only require a single dose of radioiodine treatment. If a further follow-up dose is required, it is usually given 6 to 12 months after the first dosage.

A short course of thionamides treatment may be given a few weeks before radioiodine treatment, as this can lead to a more rapid relief of symptoms.

Thionamides or radioiodine?

In some cases, a particular treatment may be recommended based on factors such as your age, symptoms and the amount of extra thyroid hormone in your blood. However, there may be circumstances when you are offered a choice between a long-term course of thionamides or radioiodine treatment.

Both treatments have advantages and disadvantages.

Advantages of thionamides include:

• They are straightforward to take and you do not have to go to hospital to take them.
• There is less risk of getting an underactive thyroid gland (hypothyroidism) as a result of treatment.

Disadvantages of thionamides include:

• Treatment may not be as successful as radioiodine treatment.
• There is a higher risk of side effects.

Advantages of radioiodine treatment include:

• Treatment is usually very successful.

Disadvantages of radioiodine treatment include:

• There is a higher chance of your thyroid gland becoming underactive as a result of treatment.  
• Radioiodine treatment is usually not suitable for people with additional symptoms affecting their eyes (Graves’ ophthalmopathy).
• Women have to avoid getting pregnant for at least six months, and men should not father a child for at least four months after treatment.

You should discuss the potential risks and benefits of both types of treatment with the specialist in charge of your care.

Surgery

Surgery to remove all or part of the thyroid gland is known as a total or partial thyroidectomy. It is a permanent cure for recurrent overactive thyroid.

Your specialist may recommend surgery if your thyroid gland is severely swollen (a large goitre) and is causing problems in your neck.

Other reasons for surgery include:

• A person cannot be treated with radioiodine treatment as they are pregnant and are unable or unwilling to take thionamides.  
• A person has a severe form of Graves’ ophthalmopathy.
• The symptoms return (relapse) after a previous successful course of treatment with thionamides.

It is normally recommended that the entire thyroid gland is removed, as this means there will be no chance of a relapse.

However, you will need to take medication for the rest of your life to compensate for the lack of a functioning thyroid gland – these will be the same medications used to treat an underactive thyroid gland.

Complications of an overactive thyroid

Several complications can occur with an overactive thyroid (hyperthyroidism), particularly if the condition is not treated.

Graves’ ophthalmopathy

If you have Graves’ disease, you may have problems with your eyes. This is known as Graves’ ophthalmopathy and is thought to be caused by the immune system mistakenly attacking the tissues of the eyes. It affects around 1 in 20 people with Graves’ disease.

Symptoms of Graves’ ophthalmopathy include:

• eyes feeling dry and gritty
• sensitivity to light (photophobia)
• excessive tearing
• double vision
• some loss of vision
• a feeling of pressure behind the eyes

In more severe cases, your eyes can bulge prominently from your eye sockets.

If you do develop Graves’ ophthalmopathy, you will probably be referred to an eye specialist (ophthalmologist) for treatment.

Treatment options include:

• eyedrops to ease the symptoms
• sunglasses to protect the eyes against bright lights
• corticosteroids to reduce inflammation
• radiotherapy
• surgery

Pregnancy and overactive thyroid

Some women are pregnant when they are first diagnosed with an overactive thyroid gland. Becoming pregnant can lead to a relapse of symptoms, especially in someone with a history of Graves’ disease.

Pregnant women with an overactive thyroid are at an increased risk of developing complications during pregnancy and birth, such as miscarriage and eclampsia.

They are also more at risk of going into labour prematurely and having a baby with a low birthweight.

Pregnant women will need specialist treatment, so the condition should be managed using medications that don’t affect the baby. This is likely to be a medication called propylthiouracil.

Underactive thyroid

In many cases, treatment causes the thyroid gland to release levels of hormones that are too low. This is known as having an underactive thyroid gland (hypothyroidism).

Sometimes this will only be a temporary side effect of treatment, but it can often be permanent.

Symptoms of an underactive thyroid gland include:

• being sensitive to cold
• weight gain
• constipation 
• depression 
• tiredness

An underactive thyroid gland is treated using medications to help replicate the effects of the thyroid hormones.

Read more about the treating an underactive thyroid gland

Thyroid storm

An undiagnosed or poorly controlled overactive thyroid can lead to a rare but serious reaction called a thyroid storm. It affects around 1 in 100 people with an overactive thyroid gland.

A thyroid storm is a severe and sudden flare-up of symptoms caused by the metabolism going into overdrive, often due to triggers such as:

• infection
• pregnancy
• not taking your medication as directed
• damage to the thyroid gland, such as a punch to the throat

Symptoms of a thyroid storm include:

• a very rapid heartbeat (over 140 beats a minute)
• fever (a temperature higher than 38C/100. 4F)
• dehydration, with diarrhoea and vomiting
• jaundice – a yellow tinge to your skin and eyes
• severe agitation and confusion
• hallucinations – seeing or hearing things that are not real
• psychosis – being unable to tell the difference between reality and your imagination
• excessive sweating
• chest pain
• muscle weakness

A thyroid storm is a medical emergency. If you think you or someone in your care is experiencing this complication, you need to call 999 for an ambulance.

Hyperthyroidism – causes and types of disease

Hyperthyroidism is a condition of hyperfunction of the thyroid gland, which is accompanied by excessive production of thyroxine and triiodothyronine. An increase in the level of hormones in the blood speeds up metabolic processes in the body and has a negative effect on almost all organ systems. Symptoms of hyperthyroidism reduce the patient’s quality of life.

Adequate and timely treatment can prevent complications and slow down pathological processes, up to the complete restoration of thyroid function.

Types of hyperthyroidism

There are three forms of the disease:

• Subclinical. There are no obvious symptoms, the level of T4 is normal, the level of triiodothyronine is lowered;
• Manifest. Symptoms of hyperthyroidism appear. T4 level is normal, triiodothyronine level is low;
• Complicated. Symptoms include heart failure, arrhythmias, psychosis, and other severe conditions.

According to the level of occurrence of hyperthyroidism is:

• primary – pathology of the thyroid gland;
• secondary – the pituitary gland is affected;
• tertiary – processes develop in the hypothalamus.

Causes of hyperthyroidism

A number of endocrine diseases lead to thyroid dysfunction, such as:

• Graves’ disease (Basedow, Basedow-Graves) . The syndrome is autoimmune in nature. The body produces antibodies that stimulate the thyroid gland to produce an excess amount of the T4 hormone;
• Nodular goiter, toxic adenoma . These pathologies are accompanied by the formation of benign nodes in the tissues of the gland. The formations begin to produce hormones and cause hyperthyroidism. Doctors cannot yet say exactly why some adenomas synthesize T4, while others do not;
• Thyroiditis . The inflammatory process destroys thyroid cells. Hormones enter the bloodstream and cause hyperthyroidism. An autoimmune nature of thyroiditis is possible. The body produces antibodies against TSH receptors. The cells cause active growth and inflammation of the thyroid gland.

The disease is most susceptible to people with a hereditary predisposition to endocrine pathologies. Symptoms of hyperthyroidism are more common in women than in men. The development of the disease is also affected by the environmental situation, chronic iodine deficiency, and stress.

Symptoms of hyperthyroidism

The first signs of dysfunction are uncharacteristic, so the disease is often confused with other somatic conditions. Symptoms of hyperthyroidism of the thyroid gland increase as metabolic processes in the body are disturbed.

The main signs of the disease:

• loss of body weight while maintaining appetite, quantity and quality of food;
• arrhythmia, tachycardia;
• anxiety, depression;
• increased sweating;
• fine tremor of fingers and hands;
• indigestion;
• the formation of a visible goiter that changes the contours of the neck;
• increased fatigue.

A symptom of hyperthyroidism in men is a decrease in potency, libido. In women, an increase in thyroid hormone levels causes menstrual irregularities. Pregnancy may end in spontaneous abortion. A symptom of hyperthyroidism of the thyroid gland in women can also be a decrease in fertility up to infertility. During menopause, the pathology in the initial stages is asymptomatic.

Complications of hyperthyroidism

As the disease progresses, the symptoms of thyroid hyperthyroidism increase, complications may occur:

• Heart disorders . Atrial fibrillation is added to the general symptoms of hyperthyroidism. The patient does not tolerate physical activity, there is a violation of the heart rhythm. Possible development of congestive heart failure. The consequences are reversible. After the elimination of hyperthyroidism, the signs of arrhythmia are completely cured.
• Increased bone fragility . In its advanced form, hyperthyroidism causes disturbances in the structure of bone tissue. Osteoporosis develops. The reason for brittle bones is that an excess of hormones prevents calcium from being incorporated into the bone.
• Eye diseases . Graves’ disease adds Graves’ ophthalmopathy to the symptoms of hyperthyroidism. The cause of the pathology is the growth and swelling of the tissues located behind the eyeballs. The patient feels pain in the eyes, sensitivity to light, complains of double vision. Visual acuity gradually decreases. In advanced cases, blindness develops.
• Skin problems . Eye symptoms in hyperthyroidism often develop in parallel with Graves’ dermopathy. The skin swells and turns red, especially around the feet and legs.
• Thyrotoxic crisis . An increase in the level of thyroid hormones in the blood can cause a sudden feverish state, an increase in all the main symptoms. Thyrotoxic crisis is accompanied by tachycardia. In some cases, there is delirium (mental disorder). The patient requires emergency medical attention.

Diagnosis of hyperthyroidism

Endocrinologist consultation

Diagnosis of hyperthyroidism begins with an appointment with an endocrinologist. At the appointment, the doctor asks the patient questions that will help in the diagnosis: how long ago did the clinical symptoms appear, what are the dynamics of the disease, are there other patients with goiter or thyroiditis in the family. A physical examination is mandatory: palpation of the thyroid gland. With obvious hyperthyroidism, the doctor will try to probe the contours of the organ, determine its position, uniformity of structure, and pain. After the examination, the patient receives referrals for further examinations to accurately diagnose the cause of the disease.

Laboratory research

Hyperthyroidism is confirmed by blood tests for the level of thyroid hormones. Elevated thyroxine levels in the absence or minimal amount of TSH indicate hyperfunction of the gland. Blood analysis is especially important in the early diagnosis of the disease in the elderly. For example, there may be no symptoms of hyperthyroidism in menopausal women. Pathology is detected only by the results of laboratory tests.

A blood test helps confirm the condition of the endocrine organ, and additional examinations will be required to determine the cause of hyperthyroidism.

Instrumental research methods

Ultrasound. Ultrasound of the thyroid gland allows you to determine the shape, size of the lobes, assess the degree of its increase, detect nodes, cysts, and other neoplasms.

Radioisotope scintigraphy . The patient is injected intravenously with a special solution. The drug contains radioactive isotopes of iodine, which are actively captured by the thyroid gland. After some time, the doctor assesses the degree of saturation of the tissues and draws a conclusion about their functionality. A large amount of radioiodine indicates an excess production of thyroxine, which develops, in particular, in Graves’ disease.

If, with severe symptoms of thyroid hyperthyroidism in a woman or a man, there is a minimum amount of isotopes in the gland, then the probable cause of the pathology is thyroiditis. The radioactive iodine capture test helps in the differential diagnosis.

Fine needle biopsy . Under the control of an ultrasound sensor, the doctor takes samples of thyroid tissue for examination. Biopsy materials allow to establish the nature of neoplasms: benign or malignant. The results of the study also provide information about autoimmune processes that can cause hyperthyroidism.

Treatment of hyperthyroidism

The approach to therapy depends on the cause of hyperthyroidism, the age and condition of the patient.

Conservative methods of treatment:

• Radioactive iodine preparations . Isotopes accumulate in the tissues of the thyroid gland, suppressing compensatory mechanisms. The organ decreases in size, the symptoms of hyperthyroidism gradually weaken. Treatment takes several months. It is important that radioactive iodine suppresses the function of the gland, therefore, over time, the patient may develop hypothyroidism, which is compensated by hormone replacement therapy.
• Antithyroid drugs . Medicines suppress the production of thyroid hormones. Symptoms decrease within a few weeks after taking the drugs in the correct dosage. The course of treatment is up to 1 year or longer. In some cases, hyperthyroidism is cured completely, sometimes there are relapses. It is important that antithyroid drugs can cause allergies, individual intolerance, and can reduce immunity. The impact of this group of drugs cause disturbances in the liver. You can take drugs only under the supervision of a doctor.
• Symptomatic treatment . Depending on the severity of the manifestations of hyperthyroidism, the doctor may prescribe medications to lower blood pressure, maintain heart rate, etc. Symptomatic treatment is continued until the patient’s general well-being improves.

In the case of severe hyperthyroidism, accompanied by a significant increase in the thyroid gland, multiple neoplasms in the functional tissue, as well as medullary cancer, surgical intervention is indicated. The doctor partially or completely removes the endocrine organ. After the operation, the patient is selected the dosage of hormones that are taken for life.

Prevention of hyperthyroidism

People with aggravated heredity, menopausal women and elderly men need to undergo an annual examination by an endocrinologist, take a blood test for the level of thyroid hormones.

It is recommended to balance nutrition according to BJU, introduce foods rich in vitamins A, B, C and minerals into the diet. Diet and hydrotherapy help not only in the prevention of hyperthyroidism, but also in the rehabilitation of patients after treatment. Regular visits to specialized sanatoriums help maintain and improve the health of the endocrine system.

Diagnosis and treatment of hyperthyroidism

In the Alfa Health Center clinic, you can make an appointment with an endocrinologist at a convenient time, undergo all the necessary examinations and start treatment under the supervision of a doctor. We work seven days a week.

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Thyroiditis: symptoms and treatment

Thyroiditis is an inflammatory disease of the thyroid gland. In an acute state, abscess formation is possible. The characteristic symptoms of thyroiditis in the early stages are a feeling of squeezing and pain in the neck, hoarseness. The progression of the disease causes dysfunction of the gland. The prognosis for timely diagnosis and treatment is favorable.

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Autoimmune thyroiditis: symptoms, treatment

Autoimmune thyroiditis is an inflammatory disease of the thyroid gland caused by the attack of specific proteins on the functional cells of the body. Pathology is genetic in nature.

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Hypothyroidism: symptoms and treatment

The difficulty of diagnosing hypothyroidism is that the disease, characterized by a violation of the production of thyroid hormones, often occurs hidden. It has several varieties and stages, including latent, when the symptoms of hypothyroidism are mild or not at all manifested. Because of this, it is difficult to detect pathology on your own, without contacting a specialized specialist and an appropriate examination. At the same time, with early diagnosis, the prognosis of treatment is favorable.

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Hyperthyroidism – causes, symptoms, treatment and prevention

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Endocrinologists of the Hadassah Medical Moscow clinic treat hyperthyroidism with advanced conservative methods. Expert-class equipment allows you to accurately diagnose hyperfunction of the thyroid gland, determine the exact causes of its occurrence, and differentiate it from other pathologies.

Hyperthyroidism is a disease of the thyroid gland in which the organ produces excessive amounts of thyroid hormones (T3 and T4). Due to a glut of them, all the internal processes of the body are accelerated, a person is faced with tachycardia, sudden weight loss, tremor, and increased excitability. If you notice these symptoms in yourself, you should immediately consult a doctor.

Diagnosis of hyperthyroidism includes a hormonal blood test and a number of instrumental studies. It is important to quickly determine the cause of such a deviation in order to restore normal body functions. Statistics show that the disease most often occurs in people 20-45 years old.

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Zavarzina
Natalya Pavlovna

Gastroenterologist-nutritionist

Work experience: 14 years

Cost of admission: from 6500 ₽

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Drunk
Olga Pavlovna

Endocrinologist, dietitian, Ph. D.

Work experience: 11 years

Cost of admission: from 9000 ₽

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Benefits of Hadassah

Advanced diagnostic methods

The hospital uses the most effective diagnostic methods to identify thyroid pathology and its causes. Hormonal blood test for TSH, T3, T4, ultrasound of the gland and internal organs, fine needle biopsy followed by histology, CT, MRI, ECG allow you to identify the disease and track the dynamics of treatment.

Own laboratory

The hospital has its own laboratory with modern equipment and qualified laboratory assistants. We do all kinds of research, which significantly increases the success in the treatment of any pathology.

Internationally qualified doctors

The clinic employs specialists with international experience, doctors improve their skills in the largest European and Israeli clinics. Doctors-experts from Israel and European countries participate in the treatment. Endocrinologists have extensive practical experience, knowledge of modern methods of treating hyperthyroidism.

Individual plan

Diagnosis and treatment programs are always personalized. We do not use universal programs for all patients, each patient receives a program with carefully selected diagnostic and therapeutic methods. The treatment takes into account the features of the course of the disease, individual indicators of the state.

Multidisciplinary approach

We are not focused on treating only one disease. The doctors of the clinic use a multidisciplinary approach of several highly specialized doctors to each patient, so our treatment shows good results.

Medical consultations

Treatment of a patient is not based on the opinion of one doctor. We gather consultations of several specialized specialists in order to make important decisions on treatment correction, evaluate the results of diagnostics and the dynamics of the treatment process. Foreign doctors from Israel and European countries also participate in the consultations.

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What is hyperthyroidism

The thyroid gland is butterfly-shaped and located in the lower part of the neck on the front side, above the fossa between the collarbones. The body produces specific hormones: thyroxine (T4), triiodothyronine (T3) and calcitonin. The hormones produced by the gland are necessary for the normal formation, development, and functioning of the human body. They regulate metabolic processes, hormonal balance, the work of all organs and systems, monitor the heartbeat, respiration, the activity of the genital organs, and the gastrointestinal tract.

The regulators of the thyroid gland are the hypothalamus and pituitary gland located in the brain.

When the gland, for some reason, begins to produce hormones excessively, all processes controlled by it receive an additional acceleration.

Accordingly, there is a general dysfunction of all organs and systems of the body – this is thyrotoxicosis, leading to serious consequences. Complications can be severe pathologies of the cardiovascular system, kidneys, nervous and endocrine systems.

With hyperfunction of the thyroid gland, there is a danger of developing a life-threatening condition – a thyrotoxic crisis. A person loses consciousness, tachycardia occurs, he sweats profusely.

Attention! Only urgent medical care in such situations will help overcome the dangerous consequences, therefore, with these symptoms, you should consult a doctor as soon as possible!

The reverse state of the reduced hormonal activity of the gland is hypothyroidism.

Causes of hyperthyroidism

In most cases, hyperthyroidism occurs against the background of pathological processes in the thyroid gland. Women face this problem 10 times more often than men. This is due to constant hormonal fluctuations in their body: menstruation, pregnancy, menopause.

Common causes of hyperthyroidism include:

• Diffuse toxic or nodular goiter (Graves’, Perry’s, Flayani’s, Plummer’s, Basedow’s disease).
• Autoimmune diseases.
• Genetic predisposition.
• Pathology of the pituitary gland.
• Consequences of infectious processes.
• Prolonged exposure to stress.
• Toxic thyroid adenoma.
• Adenoma of ovarian stroma in men.
• Overdose of thyroid drugs.
• Prolonged sun exposure.
• Thyroiditis.

Causes:

• Long-term treatment with iodine-based drugs (iatrogenic causes).
• Exposure to radioactive iodine.
• Ovarian teratoma.
• Pregnancy with abnormal hCG levels.
• Thyroid cancer, gland metastases, pituitary cancer.

Risk groups for the development of thyrotoxicosis:

• Pregnant women.
• Persons with a burdened family history.
• People who have had or are having long-term exposure to radiation.
• Population of endemic areas for iodine deficiency in water.
• Despite the large list of factors that can form hyperfunction of the gland, doctors in the vast majority of cases are faced with the consequences of Plummer’s goiter and Graves’ disease.

Types, severity

Precise determination of the type, stage of the disease is very helpful in treatment, as it allows you to choose an adequate program, eliminating the typical risks of a pathological condition.

According to the generally accepted medical classification, there are three forms of hyperthyroidism:

• Subclinical. The patient is asymptomatic. The production of hormones T3, T4 in subclinical thyrotoxicosis is still unchanged, but the level of thyroid-stimulating hormone of the pituitary gland, which controls the functioning of the gland, is lowered.
• Manifest. With a strong decrease in the level of TSH, the concentration of T4 increases. With this form, obvious symptoms of pathology begin.
• Complicated. Complications are actively developing. Tachycardia, instability of the psycho-emotional background, neurological status, heart or multiple organ failure appear.

Depending on endogenous or exogenous causes of development, the disease can be:

• Primary, caused by pathologies of the gland itself.
• Secondary. The reasons are in the pathological work of the pituitary gland, which controls the gland.
• Tertiary. Provokes pathology improperly working hypothalamus.

The severity of the disease is determined by the symptomatic manifestation and the presence of complications:

• Mild. Satisfactory condition, weight loss not more than 15%, heart rate up to 80-100 beats/min.
• Medium. Weight is reduced by 15-35%, heart rate is fixed up to 120 beats / min. There are negative symptoms of pathology.
• Heavy. Loss of body weight more than 35%. Adrenal insufficiency, multiple organ failure, disorders of the gastrointestinal tract, and the cardiovascular system are manifested. The risk of thyrotoxic crisis, coma increases.

Timely correction of the condition helps to prevent all the risks associated with hyperthyroidism.

Attention! Seeing a doctor is a logical, life-saving solution for overactive thyroid symptoms.
Do not self-medicate!

Symptoms of thyrotoxicosis

It is difficult to identify hyperthyroidism in the initial stages, since the symptoms of thyrotoxicosis are confused with other somatic abnormalities.

As metabolic processes are disturbed, the following signs increase in a person:

• Excessive sweating, increased sensitivity to heat.
• Irritability, aggressiveness, nervousness.
• Hand tremor.
• Palpitations and shortness of breath.
• Rapid weight loss.
• Lachrymation.
• Retraction of the eyes, their swelling, soreness.
• Menstrual disorders.
• Digestive disorders.
• Deterioration of hair and nails.
• Exacerbation of skin diseases – urticaria, hyperpigmentation.
• Subfebrile body temperature for a long period of time.
• A marked enlargement of the gland, which can be seen as a rounded mass on the neck above the collarbones.
• Without treatment, the symptoms of hyperthyroidism in women can be expressed in difficulty conceiving, dangerous dysfunctional uterine bleeding. Against the background of the disease, menstrual irregularities, amenorrhea, polycystic ovaries, endometriosis can be observed.
• Chronic fatigue, muscle weakness.
• Insomnia, night sweats, fever.
• The skin on the ankles is thickened and pigmented, itching, small rashes occur.

Symptoms of hyperthyroidism in men – problems with potency, male infertility, erectile dysfunction.

Symptoms of hyperthyroidism are often disguised as diseases of the digestive, nervous, cardiovascular systems, therefore, in each clinical case, careful diagnosis is necessary to make the correct diagnosis.

Symptoms of thyrotoxicosis in menopausal women may be absent or may be blurred.

Symptoms of thyrotoxicosis in men are more often expressed in cardiac arrhythmias, irritability, attacks of aggressive behavior.

Methods for diagnosing thyrotoxicosis

Diagnosis of thyrotoxicosis begins with a consultation with an endocrinologist. The specialist will collect a detailed history, determine the dynamics of the disease and hereditary predisposition. Further diagnostics includes the following measures:

Palpation of the thyroid gland

determination of its size, mobility, pain

Hormonal blood test

TSH, T3, T4

Ultrasound of the thyroid gland

shows the size, shape, structure of the thyroid gland, the presence of pathological changes

Fine-needle biopsy

allows you to assess the nature of neoplasms (benign or malignant)

CT or MRI

to identify tumors

ECG

for assessing the state of the cardiovascular systems

Additional diagnostic methods:

General clinical blood test

if a high ESR level is registered, there may be an inflammatory focus in the tissues of the gland

Biochemical blood test

High calcium concentration and low levels of protein, cholesterol, and glucose can lead to suspicion of thyroid pathology.

Examination with radioisotope iodine

pictures with the level of iodine concentration in the gland will show the nature of hormone production, the presence of pathological foci.

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Other tests may be ordered to help differentiate overactive thyroid from other disorders.

The final conclusion of the doctor is formed after the analysis of all the results of laboratory and hardware diagnostics.

Treatment methods for hyperthyroidism

The treatment regimen for hyperthyroidism depends on the degree of damage, the cause of the disease, and the patient’s condition.

Treatment usually includes:

• Radioiodine intake. Due to this, the thyroid gland decreases in size, the production of hormones is suppressed. Gradually, the signs of hyperthyroidism subside.
• It is necessary to take radioactive iodine for several months and under the constant supervision of a doctor;
• Taking antithyroid drugs. They suppress the production of hormones, due to which the manifestations of hyperthyroidism quickly decrease.
• Symptomatic treatment of thyrotoxicosis. If there are problems with the cardiovascular system against the background of hyperthyroidism, drugs are prescribed to maintain it. Other tricks also apply:

1. B-blockers are prescribed to equalize the heart rhythm.
2. In case of complications in the eyes, eye drops are used to eliminate dryness and burning of the mucous membranes.
3. In advanced conditions and the “angry look” syndrome, due to an increase in the extraorbital tissue, injections of prednisolone are sometimes performed in this area.

Surgical treatment

With a significant increase in the thyroid gland or the presence of multiple neoplasms, organ resection is indicated. Removal is also performed for cancer.

After the intervention, the patient must take hormones for the rest of his life.

Prevention of hyperthyroidism

People who have a predisposition to thyroid pathologies should regularly undergo an examination by an endocrinologist and take a blood test for hormones.
The following recommendations will help minimize the likelihood of developing hyperthyroidism:

• Eat a healthy and balanced diet;
• drink vitamin complexes regularly;
• give up bad habits;
• minimize the amount of stress in life;
• watch your body weight;
• refuse self-medication with medicines;
• support gastrointestinal health.

To prevent the disease, the diet should include more often foods and dishes rich in vitamins (especially groups A, B, C), copper, selenium.

Foods that the thyroid gland “likes” the most:

• Apples.
• Persimmon.
• Seaweed.
• Onion.
• Fish and seafood.
• Blueberry.
• Germinated seeds of cereals and legumes, microgreens.
• Nuts.
• Vegetable and butter.

Those with chronic diseases and a predisposition to the development of hyperthyroidism and other pathologies of the thyroid gland should be examined by a doctor 1-2 times a year.

Complications of hyperfunction of the thyroid gland

With timely relief of the pathological condition, complications can be avoided.

However, without treatment or with incorrect actions, conditions dangerous to health and life develop:

• Arrhythmia, heart or multiple organ failure.
• Osteoporosis, brittleness of bone tissue resulting in pathological fractures.
• Ophthalmopathy, or “angry look” (Graves’ syndrome).
• Dermopathy on the ankles, shins, feet (Graves’ syndrome).
• A life-threatening condition in which the lack of medical care leads to death – thyrotoxic crisis.

Thyrotoxicosis complicates the patient’s situation, gives unpleasant symptoms, worsens the quality of life. All this can be solved by a timely appeal to an experienced endocrinologist.

Treatment of hyperthyroidism in the Hadassah Medical Moscow clinic

Knowing what hyperthyroidism is and how it manifests itself, you can notice dangerous signs of the disease in yourself or loved ones in time and seek help in our clinic in time.

Hyperthyroidism is a condition that requires mandatory and immediate treatment.

If you notice signs of illness or just want to check your thyroid gland, contact the Hadassah clinic in Moscow. Specialists will conduct a comprehensive diagnosis and, if necessary, prescribe adequate treatment.

Examination in the clinic is carried out using high-precision expert-class hardware diagnostic equipment, and analyzes are performed in a modern advanced laboratory.

The doctors of the clinic have extensive practical experience in the application of modern therapeutic methods. Our hospital develops and uses unique developments to help with thyroid diseases, including hyperthyroidism.

In treatment programs we use the best therapeutic regimens with proven effectiveness in foreign clinics.

#DrunkOP

Drunk
Olga Pavlovna

Endocrinologist, dietitian, Ph.D.

Work experience: 11 years

Published: 06/22/2023

The information provided on the site is for reference only and cannot serve as a basis for making a diagnosis or prescribing treatment. Internal consultation of the expert is necessary.

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