Let’s Talk About Hyperthyroidism
We’ve got the doctor-approved info you need to know about hyperthyroidism causes, symptoms, treatments, and other ways to make life easier with this chronic condition.
Whether you’ve just been diagnosed or worry you could have hyperthyroidism, you’re probably nervous, confused, and maybe even a little scared. That’s normal, and everyone featured on HealthCentral with a chronic illness felt just like you do now. But we—and they—are here for you. On this page alone, you’ll discover the realities and challenges of the condition, but also the best treatments, helpful lifestyle changes, where to find your hyperthyroid community, and all the crucial information to help you not merely manage—but thrive. We’re sure you’ve got a lot of questions... and we’re here to answer them.
Our Pro Panel
We went to some of the nation’s top hyperthyroidism experts to bring you the most scientific and up-to-date information possible. Look who’s on your side:
Jennifer Mammen, M.D.
Assistant Professor of Medicine in the Division of Endocrinology, Diabetes, and Metabolism
Johns Hopkins University School of Medicine
Debbie Chen, M.D.
Clinical Lecturer in Endocrinology
Ann Arbor, MI
Ajaz A. Banka, M.D.
Endocrinologist and Thyroid Treatment Expert
Royal Oak, MI
There are a few potential causes of hyperthyroidism. The most common is an autoimmune condition called Graves’ disease in which your immune system accidentally attacks your thyroid, causing it to produce too much thyroid hormone. Other potential causes are nodules that grow on your thyroid and produce excess hormone or inflammation of the thyroid, called thyroiditis.
Some of the symptoms of hyperthyroidism you may experience include fast heartbeat, difficulty tolerating heat, weight loss, anxiety, irritability, hand tremors, trouble sleeping, muscle weakness, and more.
Treatment options for overactive thyroid include antithyroid medications, beta blockers, radioactive iodine therapy, and surgery to remove all or part of the thyroid. Work with your doctor to determine the best treatment for you.
Yes. If left untreated, hyperthyroidism increases your risk of major health problems and complications, ranging from heart problems (including heart failure) to osteoporosis. In rare cases, it can be life-threatening.
What Is Hyperthyroidism?
Hyperthyroidism is a chronic condition in which you have an overactive thyroid. But what exactly does that mean? First, let’s make sure we have a solid grasp on what the thyroid is and the role it plays in your body.
The thyroid is a butterfly-shaped gland on the lower part of the front of your neck. It’s an endocrine gland, which means it makes hormones. Thyroid hormones are super-important for your health because they help your body use energy properly. But if your thyroid is producing too much hormone—which is what happens in hyperthyroidism—the processes in your body go into overdrive, which can cause a range of symptoms.
Around 1.2% of Americans are living with hyperthyroidism. Some cases may be mild, while others are more severe. If left untreated, it can lead to other major health problems, such as heart failure, osteoporosis, and infertility. That’s why it’s so important to learn the signs and get diagnosed and treated as soon as possible
What Causes Hyperthyroidism?
There are a few potential reasons why someone might develop an overactive thyroid. Here are some of the more common possibilities.
Most people—more than 70%—develop hyperthyroidism as a result of an autoimmune disease called Graves’ disease. With this condition, your immune system starts attacking your thyroid by mistake, which leads it to grow and produce more thyroid hormone than it should. It’s not fully understood why some people develop Graves’ disease, but it does appear to run in families.
Overactive Thyroid Nodules
Sometimes you may develop hyperthyroidism if nodules begin to grow on your thyroid and produce too much thyroid hormone. This condition is also sometimes called multinodular goiter or toxic nodular goiter. These lumps tend to develop in older adults and are usually benign (not cancer).
Less commonly, you can develop temporary symptoms of hyperthyroidism if your thyroid becomes inflamed (a condition called thyroiditis, which usually lasts about three months). Inflammation can occur in the thyroid gland if there is a problem with your immune system—such as an autoimmune disease or a viral or bacterial infection that causes the gland to leak out any thyroid hormone it has stored.
Thyroiditis may occur as a result of an infection, recent childbirth, or immune system problems.
Taking Too Much Thyroid Hormone Medication
People diagnosed with hypothyroidism are treated by taking replacement thyroid hormone medication to get back to healthy levels. But if they take too much, they can also develop symptoms of hyperthyroidism.
Getting Too Much Iodine
Iodine is a mineral found in foods that your thyroid needs to make hormones. That said, there’s such a thing as too much of this mineral, especially if you already have thyroid problems. Taking too much iodine can worsen hyperthyroidism.
There's a handful of drugs that could possibly lead to hyperthyroidism as well. Amiodarone, interferon-alpha, programmed death receptor-1 (PD-1) inhibitors (nivolumab and pembrolizumab), alemtuzumab, lithium, expectorants, and iodine-containing contrasts may all contribute to hyperthyroidism. Talk to your doctor if you are using any of these medications.
What Are the Risk Factors for Hyperthyroidism?
Some people are more likely to develop hyperthyroidism than others. Here are some of the risk factors.
Age. If you’re over age 60, you’re more likely to develop this condition.
History of a thyroid problem. If you’ve had a thyroid problem before, including thyroid surgery or a goiter, your chances of developing hyperthyroidism are increased.
Family history. If you have a family member with hyperthyroidism, you’re also at higher risk.
Other health conditions. Having certain other medical conditions, including pernicious anemia, type 1 diabetes, or primary adrenal insufficiency, can make you more likely to get hyperthyroidism.
Recent pregnancy. Women who have been pregnant in the last six months are at greater risk of hyperthyroidism.
Sex. Hyperthyroidism affects women five to 10 times more frequently than men.
With too much thyroid hormone circulating in your body, everything is sped up. It’s kind of like your body is a car careening down a steep hill, but you can’t take your foot off the gas. And with your organs and body functions kicked into overdrive, a range of symptoms can occur. These include:
Difficulty tolerating heat
Eyes that look enlarged or bulging, sometimes with double vision
Goiter, which is swelling of the neck due to an enlarged thyroid gland, which may lead to problems with breathing and swallowing
Increased miscarriage risk in pregnant women
Increased or irregular heart rate
Lighter or more infrequent menstrual periods than normal
Loose or frequent bowel movements
Thinning skin and hair
Symptoms may come on gradually over time, but in others—especially younger folks—onset may be more sudden.
When to Call Your Doctor or Endocrinologist
While having any one of the above symptoms doesn’t guarantee a diagnosis of hyperthyroidism, they are cause for concern—particularly the more of them you have—and warrant a trip to your primary healthcare provider. They may refer you to an endocrinologist, which is a doctor who specializes in hormonal disorders.
At your appointment, your doctor can examine you and run tests to determine whether you have hyperthyroidism. The sooner you get diagnosed, the sooner you can get on the road to treatment and feeling better—not to mention, you’ll lower your risk of severe complications.
How Do Doctors Diagnose Hyperthyroidism?
The process of diagnosing hyperthyroidism involves several steps. First, your doctor will likely ask you questions about your symptoms, past health history, family health history, and more. They also likely will perform a physical exam, checking for things like increased heart rate, hand tremors, abnormally fast reflexes, eye problems, and an enlarged thyroid gland.
Next, your doctor will order one or more thyroid-related tests to measure levels of different hormones and get a better picture of what’s going on in your body. Let’s take a closer look at some of these tests.
Thyroid Blood Tests
There are various blood tests your doctor may order to determine whether you have thyroid disease. Important note: Some drugs can interfere with how accurate these test results are, such medications containing estrogen (like some birth control pills) and biotin supplements. Make sure you tell your doctor about any medications or supplements you are taking prior to testing. These are some of the potential blood tests used to diagnose hyperthyroidism:
Thyroid Stimulating Hormone (TSH) Test
The most common and (most sensitive) test doctors order to test for thyroid problems is called a thyroid stimulating hormone (TSH) test. The pituitary gland in your brain produces TSH to send a message to your thyroid about how much thyroid hormone (called T3 and T4) it should make. By testing to see how much TSH is in your blood, your doctor can determine whether you may have hyperthyroidism or another problem.
The normal range for TSH is 0.40-4.50, and an abnormally low level may indicate that your pituitary gland has stopped producing enough TSH. In turn, your thyroid may be making too much thyroid hormone, indicating hyperthyroidism.
Your doctor may also order a test to measure your levels of the thyroid hormone T4, aka thyroxine. Your thyroid makes two hormones: T4 and T3 (triiodothyronine). About 90% is T4. If your T4 levels are abnormally high, you may have hyperthyroidism.
There are two types of T4 tests: total T4 and free T4. A total T4 test looks at the amount of both “bound” and “free” T4 in your blood. “Bound” T4 refers to the hormone that is kept in storage until your body needs it, while “free” T4 is able to enter the body’s tissues for use. Usually, doctors prefer to test free T4 since it is more accurate in assessing how well your thyroid is working. The normal total T4 range for an adult is 5.0-11.0 ug/dL, and the normal free T4 range is 0.9-1.7 ng/dL.
In some cases, you can have a normal T4 level and still have hyperthyroidism. If your doctor suspects this is the case, they may also order a test to measure your T3 levels. If your T3 is high, that can also be a sign of hyperthyroidism since T3 is responsible for most of the thyroid hormone actions in your body.
Thyroid Antibody Test
After your doctor determines that the above test results point to hyperthyroidism, they may want to order a thyroid antibody test to determine whether you have an autoimmune form of Graves’ disease. If you test positive for anti-thyroid peroxidase antibodies or TSH receptor antibodies, it means your body has mistakenly produced proteins to attack your thyroid cells, and it can be a sign of Graves’ disease.
In addition to blood tests, your doctor also may use imaging tests to investigate the root cause of any thyroid issues.
Ultrasound. An ultrasound may be used to take pictures of your thyroid. This can often detect nodules and determine whether they are potentially cancerous.
Thyroid scan. In a thyroid scan, you first take a pill that contains a small amount of radioactive iodine. Overactive thyroid nodules will absorb more iodine, which can be seen on a scan that is done several hours later. This test can help determine whether you have Graves’ disease and detect and examine suspicious nodules on your thyroid gland.
Radioactive iodine uptake test. For this test, your doctor will give you a small amount of radioactive iodine in a pill or liquid to swallow. Then, they will use a device on your neck to measure how much of the iodine your thyroid takes up. If the amount is high, it may be a sign of Graves’ disease or thyroid nodules.
Because hyperthyroidism means your body has too much thyroid hormone, the goal of hyperthyroidism treatment is to reduce those hormone levels so your body can function normally. There are several different treatment options available. You and your healthcare team will work together to determine the best option for you based on personal health factors and preferences.
Medications for Hyperthyroidism
There are two main types of medications your doctor may prescribe to help bring your thyroid hormones back to a healthy level. These medications include:
These drugs work by blocking your thyroid from producing thyroid hormone without causing permanent thyroid damage. Most people take these oral medications for one to two years. That said, it may not result in permanent remission, in which case may need to take it for a longer period of time. The most common antithyroid drug is methimazole (Tapazole).
In some cases, another option called propylthiouracil (PTU) may be prescribed, but it’s not preferred because it has a potential (although very rare) side effect of severe liver damage. You may also need to take antithyroid drugs in preparation for other treatments, like surgery. Note: These drugs aren’t used as a treatment for hyperthyroidism that is the result of thyroiditis.
Beta Blocker Drugs
Beta blocker medications work to reduce hyperthyroid symptoms, including rapid heartbeat, nervousness, and hand tremors. Your doctor may prescribe this medication to help you manage your symptoms and start to feel better while waiting for other treatments to begin working. Generally, these drugs are oral pills taken for a short period until symptoms are under control.
Radioiodine Therapy for Hyperthyroidism
Another common treatment for this condition is radioiodine therapy. With this treatment, you will take a capsule or liquid containing radioactive iodine. This substance will destroy the thyroid gland cells that produce thyroid hormone, thereby reducing the amount of that hormone in your body.
This treatment is effective and doesn’t harm other tissues in your body. Here’s the catch: Almost everyone who undergoes this therapy later develops the opposite problem and becomes hypothyroid, meaning their body doesn’t have enough thyroid hormone. But often, this risk is worthwhile, as hypothyroidism is easier to treat and manage in the long term with the use of a daily pill.
Less commonly, your doctor may suggest surgery to remove part or all of your thyroid gland to treat your hyperthyroidism. Removal of part of the thyroid may result in normal levels, or you may develop hypothyroidism and need to take medication. When the full thyroid is removed, you will definitely become hypothyroid and need to take thyroid hormone replacement medications for the rest of your life.
Surgery may be a good option for pregnant women who can’t take other treatments, or in people with large goiters that are impeding breathing or swallowing. That said, as with any surgery, there are potential complications that may occur in rare cases, such as damage to nearby glands and nerves that control the vocal cords.
Alternative Therapies for Hyperthyroidism
Medical treatments are the most important ways to manage hyperthyroidism—unfortunately, there’s no natural remedy that can cure it. But you may be wondering if there are other steps you can take to stay healthy and reduce your symptoms. The answer is a resounding yes! Here’s what you need to know.
While there’s no “hyperthyroidism diet,” eating balanced meals can help keep you healthy overall. That means getting a variety of fruits and veggies, whole grains, and lean proteins in your diet. And if you have Graves’ disease, you may need to avoid eating foods high in iodine, such as certain types of seaweed. This is because your autoimmune condition makes you more sensitive to potentially harmful effectives of this mineral. Talk with your doctor about the types of foods, supplements, and medications you may need to limit or avoid.
Getting enough physical activity is critical for overall health. Plus, it can help manage symptoms of anxiety that hyperthyroidism can often cause and help keep you at a healthy weight. But remember: Hyperthyroidism means your body is in overdrive, so until your thyroid hormone levels are back in normal range, you may need to avoid high-intensity exercises. That’s because intense exercise may worsen problems like fast heart rate and difficulty tolerating heat that can be potentially dangerous. Talk to your doctor about what a healthy level of exercise is for you.
Does Hyperthyroidism Have Serious Complications?
In some cases, hyperthyroidism can lead to other health problems, particularly if left untreated. That’s why it’s important to get a diagnosis as early as possible and work with your healthcare team to get your thyroid levels under control. Potential complications include:
An excess of thyroid hormone can speed up the systems in your body, including your cardiovascular system. This can lead to a heartbeat that is irregular and has to work harder and faster to do its job. Left untreated, this can then raise your risk of heart problems (including heart failure), blood clots, and stroke.
Thyroid hormone also plays a role in the cycle of bone formation and resorption in the body. Having too much thyroid hormone, as in hyperthyroidism, can increase the rate at which bone cells turn over and throw this process out of balance. This can lead to bone thinning and osteoporosis, which raises your risk of fractures.
Thyroid Eye Disease (Graves’ Ophthalmopathy)
This complication affects about 30% of people diagnosed with the Graves’ disease. In thyroid eye disease, the immune system attacks the tissues around your eyes. This can cause eye pain, double vision, sensitivity to light, and even vision loss.
Fertility and Pregnancy Problems
Because hyperthyroidism can disrupt your menstrual cycle, you may have trouble getting pregnant. Complications in pregnancy, such as premature birth, low birth weight, high blood pressure (preeclampsia), and miscarriage, are also more likely than average in people who are hyperthyroid.
Thyroid storm is the name of a very rare condition that can be life-threatening. It can occur when hyperthyroidism is untreated and your body undergoes another major stress, such as heart attack, infection, or trauma. Another rare cause of thyroid storm is radioactive iodine therapy, which may be used as a treatment for Graves’ disease.
Watch for severe symptoms such as loss of consciousness, pounding heart, agitation, confusion, bulging eyes, rising temperature, diarrhea, and sweating and shaking, and seek emergency treatment right away. It’s true—some of these symptoms are similar to anxiety or a panic attack, so when in doubt, see a doctor!
Living With Hyperthyroidism
Hyperthyroidism can leave you feeling irritated, anxious, sweaty, and downright uncomfortable—not to mention the slew of other health problems it can cause, some of which can be life-threatening. Plus, treating hyperthyroidism can be tricky—in some cases, it can take a few years to find a treatment that works for you in the long term.
In part, that’s because hyperthyroidism may return after treatment in some cases, such as with radioiodine therapy. The ongoing adjustment of doses, waiting periods, and recovery from more intense treatments like surgery can be daunting and frustrating. Add to that the fact that hyperthyroidism is often considered an “invisible illness” that friends and family may not understand, and this chronic illness can leave you feeling isolated and alone.
Over time, though, you will find a treatment plan that works for you and your body. Arming yourself with knowledge about the best ways to manage your condition can help you move forward with confidence in your health.
Hyperthyroidism and Mental Health
Like many chronic illnesses, hyperthyroidism can unfortunately have a significant effect on your mental health. For example, you may experience mood changes including increased anxiety and irritability as a result of excess thyroid hormone in the body. Further, living with a chronic condition raises your risk of depression, too, thanks to the stress of managing a long-term disease.
That said, taking care of your emotional health is crucial when living with hyperthyroidism. Here are some steps you can take:
Get treatment. Starting treatment for your overactive thyroid will in turn help reduce any thyroid-related symptoms that impact your mood, such as irritability, nervousness, anxiety, and restlessness.
Find your community. Find others who just get it. Seek out other thyroid warriors via social media, nonprofit organizations, or support groups to help you feel less alone and share resources. (More on this below!)
Focus on stress relief. It’s no secret that stress is bad for you. And when your thyroid is in overdrive, more stress on your mind and body is the last thing you need. That’s why taking time to prioritize self-care is so important. Try relaxation breathing techniques, take up meditation or yoga, and practice proper sleep hygiene. And don’t forget to make time to do activities you enjoy, whether that’s spending time with family in the great outdoors or curling up with a good book.
Talk to a therapist. Speaking with a mental-health professional, like a therapist, about your experience with hyperthyroidism can help you feel less alone. Plus, a therapist can teach you skills to help you cope with the stress of chronic life. Don’t be afraid to reach out for help.
Hyperthyroidism and Your Sex Life
A recent study in Clinical Thyroidology for the Public found that 40% of patients with thyroid disorders reported that it negatively impacted their sex life. In men, hyperthyroidism may increase the risk of erectile dysfunction or other problems like premature ejaculation. In women, hyperthyroidism may result in sexual pain, decreased sexual desire, and problems with vaginal lubrication and orgasm.
Finding a hyperthyroidism treatment that works for you can help improve these sexual problems. Working with a sex therapist who specializes in these issues can also be helpful. Don’t be afraid to talk to your doctor if you have concerns about how your thyroid health is impacting your sex life.
Hyperthyroidism During Pregnancy
Not only can hyperthyroidism make it difficult to get pregnant, but in cases of severe hyperthyroidism, it can also increase your risk of complications during pregnancy. These include:
Preeclampsia (high blood pressure in pregnancy)
Low birth weight
Thyroid storm, which is when your hyperthyroid symptoms suddenly worsen to a life-threatening degree
Congestive heart failure
Hyperemesis gravidarum, which is severe nausea and vomiting in pregnancy (rarely)
Hyperthyroidism in your baby, which can lead to heart problems, poor weight gain, irritability, and other issues (rarely)
That’s why it’s important to get your thyroid hormone levels down to a healthy level prior to pregnancy if at all possible. While mild cases of hyperthyroidism in pregnancy may not cause any issues or require treatment, more severe cases may require you to take antithyroid drugs. Your doctor will want to monitor you and your baby closely throughout pregnancy while you are on these drugs, and they may even refer you to a reproductive endocrinologist who specializes in treatment of thyroid disease during pregnancy.
About one in 20 women develop a condition called postpartum thyroiditis during the first year after they give birth. This is when your thyroid becomes inflamed, which may lead to thyroid hormone leaking from your gland. This can lead to hyperthyroidism that can last for about three months, and thankfully, it rarely requires any treatment. Sometimes, your doctor may prescribe a beta blocker to help manage your symptoms. After this temporary period of hyperthyroidism, you may develop hypothyroidism due to the damage done to your thyroid gland. This usually goes away after about a year—but in some women it doesn’t and will require treatment. The risk of postpartum thyroiditis is greater if you have type 1 diabetes.
Because some of the symptoms of postpartum thyroiditis may be mistaken for postpartum depression, it’s extra important to talk to your doctor to rule out a thyroid problem.
Where Can I Find Hyperthyroidism Communities?
Hyperthyroidism affects a little more than one in every 100 people in the United States, and it can often feel like you’re all alone in navigating symptom management and treatment decisions. Enter the power of the Internet age: People who truly understand what you’re going through are just a few clicks or taps away. Here are some ways to form connections and find helpful resources to help navigate life with hyperthyroidism.
Top Hyperthyroidism Instagrammers
Whitney Crouch, @whitneyc.the.rd
Follow because: Want a registered dietitian’s take on living well with thyroid disease? Whitney describes herself as a “no BS dietitian” and aims to share empowering information about thyroid issues on her feed.
Izabella Wentz, @izabellawentzpharmd
Follow because: Izabella is a pharmacist who specializes in thyroid disease. Izabella shares easy-to-understand information about thyroid disease causes, testing, and medications—plus, she’s a New York Times bestselling author!
Christy Wohlert, @christy_comesclean
Follow because: Christy shares her firsthand experience of living with Graves’ disease and thyroid eye disease. Follow for real-talk reflections, clean beauty tips, healthy eating inspo, and more about living life as a mom with thyroid disease.
Rachel Hill, @theinvisiblehypothyroidism
Follow because: Rachel lives with thyroid disease and is an award-winning thyroid patient advocate. Follow her for inspirational quotes, education about living with thyroid disease, and resources on pregnancy, advocacy, and beyond.
Top Hyperthyroidism-Related Podcasts
Doctor Thyroid. Philip James was diagnosed with thyroid cancer in August 2013 and had his thyroid surgically removed. The experience led to him launching his podcast Doctor Thyroid, in which he invites top doctors to share information for patients to help you understand your thyroid health and make the best decisions for your care.
Thyroid Refresh TV. Started by thyroid patients Ginny and Danna, Thyroid Refresh TV is a podcast aimed to keep you informed about the best ways to manage your thyroid condition, including guest episodes featuring experts and covering topics from diet to mindfulness.
Let’s Talk Thyroid. This podcast aims to inject positivity into your life with thyroid disease. Host Annabel Bateman, who has Hashimoto’s, and her guests share practical tips on nutrition, stress reduction, advocacy, women’s health, and more.
Top Hyperthyroidism Support Groups and Non-Profits
American Thyroid Association. This professional organization provides accurate information for people living with thyroid disease, along with resources to help you find a thyroid specialist in your area.
Graves’ Disease and Thyroid Foundation. This nonprofit organization aims to provide evidence-based information for people living with Graves’ disease—and the people that love them. Resources include patient education, support groups around the country, and more.
Graves’ Disease Support Group. This Facebook group is a space created for people living with Graves’ disease—affectionately called Gravestars—to get support, share stories, and learn more from other people living with this autoimmune condition.
Thyroid Change. This thyroid-disease organization, launched by a thyroid patient advocate named Denise Roguz, offers patient education as well as resources to help you find community.
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