What is an overactive thyroid (hyperthyroidism)?
From symptoms to complications, find out all you need to know about an overactive thyroid.
Have you been diagnosed with an overactive thyroid? Or do you just want to know more about this condition? You’ve come to the right place.
In this blog, we discuss:
- What is hyperthyroidism?
- What causes an overactive thyroid?
- What are the symptoms of an overactive thyroid?
- How is hyperthyroidism diagnosed?
- How is hyperthyroidism treated?
- What are the health risks associated with hyperthyroidism?
What is hyperthyroidism?
Hyperthyroidism (also known as an overactive thyroid), is where the thyroid produces too much of the thyroid hormones [1].
Thyroid hormones, T4 and T3, all play a part in several bodily functions, from metabolism to heat regulation. So, if the body starts to produce more of these hormones, you may start to experience symptoms.
What causes an overactive thyroid?
An overactive thyroid can occur in both men and women at any age. But, it is more common in women between 20 and 40 years old.
Causes of hyperthyroidism include:
- Graves’ disease – a condition where the immune system attacks and damages the thyroid.
- Thyroiditis – inflammation of the thyroid gland.
- Incorrect dose of medication – overmedicating with thyroid hormone replacement, it can cause hyperthyroidism.
- Lumps on the thyroid – extra tissue called nodules that grow on the thyroid can lead to an overproduction of thyroid hormones.
What are the symptoms of an overactive thyroid?
In some cases, the symptoms of hyperthyroidism are subtle and go unnoticed, but in others, they come on very quickly and severely.
Common symptoms of an overactive thyroid include:
- Anxiety and irritability
- Mood swings
- Tiredness
- Heat sensitivity and sweating
- Swelling in your neck (goitre)
- Heart palpitations and arrhythmia
- Weight loss
- Increased appetite
- Nausea and loose bowels
How is hyperthyroidism diagnosed?
A diagnosis of hyperthyroidism is based on your symptoms and blood test results. Your doctor may also request an ultrasound scan of the thyroid gland to help work out the underlying cause.
A blood test to measure thyroid hormones, is a very accurate method of diagnosing an overactive thyroid. In most people with the condition, this will show low levels of thyroid-stimulating hormone (TSH) and high levels of thyroxine (T4).
With diagnosed hyperthyroidism, another blood test may be used to measure TSH receptor antibodies to see if it is likely caused by Graves’ disease [2].
Being diagnosed with hyperthyroidism can seem overwhelming, but managing a thyroid condition is possible. Check out our five ways to manage your thyroid condition for some tips.
How is hyperthyroidism treated?
An overactive thyroid is treatable. The doctor’s approach will depend on the cause and severity of hyperthyroidism.
Treatments for hyperthyroidism include:
- Beta-blockers – this medication can, in some more severe cases (and alongside antithyroid medication), help to relieve some of the symptoms.
- Medication – antithyroid medicines are usually one of the first-line treatments for hyperthyroidism. They are used to stop the thyroid from producing high levels of hormones. The tablets should be taken daily and only stopped if advised to do so by a doctor.
- Radioiodine – radiotherapy is used to destroy cells in the thyroid, which reduces its ability to produce thyroid hormones. Radioiodine is very effective, safe and has minimal side effects.
- Surgery – the thyroid gland can be partially or entirely removed during an operation. This option is usually considered if the medication does not work or if the thyroid gland is swollen and causing symptoms of compression. Removing all or part of the thyroid may also be the preferred option if there is a possibility or suspicion of thyroid cancer. Levothyroxine will need to be taken after surgery [3].
- A balanced diet – along with a few specific foods, a balanced diet can support thyroid health, but is not a standalone treatment. Hyperthyroidism can cause bones to weaken, so getting enough calcium is important. Calcium is found in foods such as cheese, yoghurt, spinach, soybeans, and nuts (especially almonds). Taking vitamin D and calcium supplements during treatment can strengthen bones [4].
Have a look at our blog: what foods are good for thyroid health? for more information.
What are the health risks associated with hyperthyroidism?
An overactive thyroid can cause complications if it is not treated appropriately or early enough.
Complications of hyperthyroidism include:
- Thyroid eye disease – the immune system can attack the tissues around the eyes and cause irritation, double vision, and bulging eyes.
- Heart problems – the heart can develop an irregular rhythm and may struggle to pump efficiently if hyperthyroidism is not treated.
- Mental health problems – hyperthyroidism can cause anxiety and hyperactivity.
- Weight loss and loss of bone – the increase in metabolic rate increases the body's energy requirements, which uses energy stored in body fat. The calcium stored in bones can also decrease, resulting in osteoporosis.
- Pregnancy complications – untreated hyperthyroidism can increase the risk of preeclampsia, premature birth, and miscarriage.
- A thyroid storm – the term given to a sudden and life-threatening flare-up of symptoms and usually occurs when hyperthyroidism is undertreated [5].
If you are planning a pregnancy and have an overactive thyroid, it is important to check that your hormone levels are normal. As soon as you are pregnant, you should have a thyroid function test. Your doctor will likely adjust your medication and recommend more frequent blood tests.
Next steps if you have an overactive thyroid
If you have any concerns or are experiencing any symptoms related to an overactive thyroid, visit your doctor. Need help choosing a test? Look at our range of Thyroid Blood Tests or read our Thyroid Blood Test Buying Guide.
If you think that you may have hyperthyroidism, it is important to see your doctor as the condition can deteriorate rapidly.
References
- nhs.uk. 2022. Overactive thyroid (hyperthyroidism). [online] Available at: <https://www.nhs.uk/conditions/overactive-thyroid-hyperthyroidism/> [Accessed 4 March 2022].
- British Thyroid Foundation. 2022. Hyperthyroidism. [online] Available at: <https://www.btf-thyroid.org/hyperthyroidism-leaflet> [Accessed 4 March 2022].
- Healthline. 2022. Hyperthyroidism: Causes, Symptoms, Treatment, Diagnosis & More. [online] Available at: <https://www.healthline.com/health/hyperthyroidism> [Accessed 4 March 2022].
FAQs
Graves' disease often runs in families – having a close family member with the condition increases an individual's risk of developing an overactive thyroid. Like many autoimmune diseases, women are at a greater risk of developing Graves' disease than men.
Other causes of hyperthyroidism include:
- Thyroiditis - the inflammation of the thyroid gland. Caused by either a problem with the immune system or a viral infection, inflammation causes thyroid hormones that are stored in the gland to leak into the bloodstream.
- Certain medications - including amiodarone, lithium, interferon-alpha and interleukin-2 can affect the production of thyroid hormones.
- A toxic nodular goitre (TNG) - an enlarged thyroid with independently functioning thyroid nodules, capable of increasing the levels of thyroid hormones produced. TNG is often caused by low iodine levels in the body.
- Low iodine levels - encourage the thyroid to grow, absorb as much iodine as possible and create excess levels of thyroid hormones. Excessively high levels of iodine can also result in hyperthyroidism.
There are many ways to treat an overactive thyroid:
- Medications - thioamides, a group of drugs used to treat hyperthyroidism, work by reducing the levels of thyroid hormones produced. Methimazole and propylthiouracil belong to this drug class are the most used.
- Radioiodine treatment - radioactive iodine is taken in by the thyroid and destroys the thyroid cells, ultimately reducing the level of hormones produced and decreases the size of the enlarged gland.
- Surgery - either removing a small section of the thyroid or the whole gland. After surgery, synthetic thyroid hormones may be needed to prevent hypothyroidism from developing. If the entire thyroid is removed, then lifelong thyroid hormone replacement therapy is needed to maintain hormone levels in the body.
There are rare forms of hyperthyroidism where the pituitary gland malfunctions and produces too much TSH. Although the thyroid gland is healthy, it is overstimulated by TSH and produces too much T3 and T4. In this case TSH, FT4 and FT3 results are all elevated.
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