Hyperthyroidism (overactive thyroid)

January is Thyroid Awareness Month and a good time to learn about this small, but mighty gland.  The thyroid is a small butterfly-shaped gland in the neck, just in front of the windpipe (trachea). It produces hormones that affect things such as your heart rate and body temperature. Hyperthyroidism (overactive thyroid—too much hormone being released) and hypothyroidism (underactive thyroid—too little hormone being released) can both cause unpleasant and potentially serious health issues.

In this week’s article, we will discuss hyperthyroidism (overactive thyroid).

There are several possible causes of hyperthyroidism. Graves’ disease, an autoimmune disorder in which your immune system attacks your thyroid and causes it to make too much hormone. Thyroid nodules (growths on the thyroid) can cause the thyroid to produce too much hormone. Thyroid nodules are more common in older adults. Thyroiditis (inflammation of the thyroid) can cause stored hormone to be released from the thyroid gland. Consumption of too much iodine, which can be found in some medicines, cough syrups, seaweed and seaweed-based supplements and too much thyroid medicine—the result of taking too much thyroid hormone medicine for hypothyroidism (underactive thyroid)—can both cause hyperthyroidism.

The National Library of Medicine reports that a person is at higher risk for hyperthyroidism if they:

  • Are a woman
  • Are older than age 60
  • Have been pregnant or had a baby within the past 6 months
  • Have had thyroid surgery or a thyroid problem, such as goiter
  • Have a family history of thyroid disease
  • Have pernicious anemia, in which the body cannot make enough healthy red blood cells because it does not have enough vitamin B12
  • Have type 1 diabetes or primary adrenal insufficiency, a hormonal disorder
  • Get too much iodine, from eating large amounts of foods containing iodine or using iodine-containing medicines or supplements

The symptoms of hyperthyroidism can vary from person to person and may include:

  • Nervousness or irritability
  • Fatigue
  • Muscle weakness
  • Trouble tolerating heat
  • Trouble sleeping
  • Tremor, usually in your hands
  • Rapid and irregular heartbeat
  • Frequent bowel movements or diarrhea
  • Weight loss
  • Mood swings
  • Thinning hair or hair loss
  • Goiter, an enlarged thyroid that may cause your neck to look swollen. Sometimes it can cause trouble with breathing or swallowing.

If hyperthyroidism is suspected, your doctor will likely discuss your medical history, perform a physical examination, and may perform blood and/or imaging tests.

The choice of treatment depends on factors such as the cause of hyperthyroidism, the patient’s age, overall health, and preferences. Your thyroidologist or endocrinologist (healthcare professionals specializing in diseases of the thryoid) will consider these factors when recommending a specific approach.

Untreated, an overactive thyroid can cause several complications including thyroid eye disease, pregnancy issues (pre-eclampsia, miscarriage, premature labor and birth, low birth weight), atrial fibrillation (an irregular heart rhythm), osteoporosis, or heart failure. Rarely, an undiagnosed or poorly controlled overactive thyroid can lead to a serious, life-threatening condition called a thyroid storm, which happens when your thyroid gland releases a large amount of thyroid hormone in a short amount of time. This sudden flare-up of symptoms can include rapid heartbeat, high temperature, high blood pressure, jaundice, agitation or confusion, and loss of consciousness. A thyroid storm is a medical emergency. If you think you or someone in your care is experiencing it, you should call 9-1-1 immediately.

If you are experiencing symptoms of hyperthyroidism, it’s important to contact your medical professional immediately. If hyperthyroidism is determined to be the problem, there are a variety of treatments. Your doctor will review your age, health, the underlying cause, and how severe the situation is when determining a treatment plan.