Hyperthyroidism, also called overactive thyroid, is when the thyroid gland produces too much thyroid hormone. It is the opposite of hypothyroidism, aka underactive thyroid, where the gland does not have enough thyroid hormone to meet your daily needs.
These two words are easily confused, so here's a tip that may help you. First, think of the word "hyper," which is short for hyperactive, meaning extremely active. So,hyperactivemeans an overactive thyroid gland.
The thyroid is a small butterfly-shaped gland located in your neck just beneath the larynx (Adam's apple). It produces and releases thyroid hormones that regulate numerous essential bodily functions, including metabolism, heartbeat, respiration, digestion, and mood. These hormones affect nearly every organ in the body.
So, when your thyroid hormone levels are too high, as with hyperthyroidism, many of your bodily functions speed up, causing numerous unpleasant and even dangerous symptoms.
Prevalence of Hyperthyroidism
According to the National Institutes of Health (NIH), 1 out of 100 Americans age 12 and older have hyperthyroidism.
Symptoms of Hyperthyroidism
Hyperthyroidism symptoms are varied and may include:
Unintentional weight loss
Irregular or rapid heartbeat
Enlarged thyroid gland (goiter)
Brittle hair or hair loss
Irregular menstrual periods
Elevated blood pressure levels
Increased metabolic rate
Frequent bowel movements
Tremor, usually in the hands
What Causes Hyperthyroidism?
Hyperthyroidism has several causes, including:
Graves disease is an autoimmune disorder where the immune system attacks the thyroid gland causing it to overproduce hormones.
It is the most common cause of hyperthyroidism, accounting for 60% to 80% of all cases. (2) Graves disease affects about 1 in 100 Americans. (3)
Thyroiditis occurs when the thyroid gland becomes inflamed, causing damage to the thyroid cells, and thyroid hormone leaks out of the gland resulting in an overabundance of circulating thyroid hormone.
Several types of thyroiditis exist, including Hashimoto’s thyroiditis, a condition in which antibodies attack the thyroid gland.
Thyroid nodules are abnormal growths of thyroid cells that form lumps on the thyroid gland. They can be solid, fluid-filled, or mixtures of both. They are usually non-cancerous and have no symptoms.
However, they can become overactive at times, triggering a release of too much thyroid hormone.
According to Johns Hopkins, thyroid nodules are so common that about half of Americans will have one by 60. (4)
Too Much Iodine
Iodine is a trace mineral found naturally in some foods and commonly added to table salt.
The thyroid gland uses iodine to make thyroid hormones, so this mineral is crucial for proper thyroid function.
Too much iodine consumption causes the thyroid to make excess thyroid hormone leading to an overactive thyroid.
Taking Thyroid Replacement Medication
The standard treatment for underactive thyroid disease (hypothyroidism) is synthetic hormone replacement therapy. But if those with hypothyroidism take too much of this medication, they can develop hyperthyroidism (overactive thyroid).
So, thyroid replacement therapy must be monitored closely to prevent these issues.
Hyperthyroidism Risk Factors
Those at greater risk of developing hyperthyroid include:
Gender.According to the National Institutes of Health, women are two to ten times more likely than men to develop hyperthyroidism. (5) Experts aren't sure why women are more susceptible to hyperthyroidism and thyroid disease, but many believe hormonal fluctuations, hormone imbalances, or autoimmune susceptibility play a role.
Family History. Having a family history of thyroid disease increases your risk of developing hyperthyroidism.
Age. Though hyperthyroidism can occur at any age, it is more common in those 60 and older. The exception is Graves disease, a form of hyperthyroidism, which typically occurs in those 40 to 60.
Pregnancy. Postpartum thyroiditis (hyperthyroidism occurring within a year following childbirth) affects an estimated 5% percent of women. Why? According to the Cleveland Clinic, "Postpartum thyroid is caused by antithyroid antibodies attacking the thyroid," causing the thyroid gland to become inflamed. (6)
Thyroid Surgery. Having thyroid surgery can disrupt thyroid hormone production and cause the gland to produce too much thyroid hormone.
History of Autoimmune Disorders. An autoimmune disorder increases your risk of developing thyroid disease, including hyperthyroidism.
How is Hyperthyroidism Diagnosed?
The doctor will first take a medical history and perform a physical exam to diagnose hyperthyroidism.
Because many of the symptoms of hyperthyroidism are similar to those of other diseases, the doctor will also run several tests to verify the diagnosis.
Here are a few tests typically used to diagnose hyperthyroidism.
Thyroid Blood Tests
The doctor will order a series of blood tests for the thyroid, including:
TSH. Measures thyroid activity by measuring thyroid-stimulating hormone. TSH is a hormone produced by the pituitary gland to send messages to the thyroid gland to produce more thyroid hormones.
T3 and T4. Measures the levels of these thyroid hormones.
TSI. Measures thyroid-stimulating immunoglobulin. Due to Graves ' disease, TSI levels are incredibly high in those with hyperthyroidism. (7)
Antithyroid antibody test. Measures antibodies in the blood to test for thyroid autoimmune diseases such as Graves' disease (the most common cause of hyperthyroidism) or Hashimoto's thyroiditis (the most common cause of hypothyroidism).
Radioiodine Uptake Test
The radioiodine uptake test helps determine thyroid function.
The patient swallows a small amount of radioactive iodine for the radioiodine uptake test. Then, using a special probe, the technician measures how much radioactive iodine your thyroid absorbs from your blood.
Since the thyroid absorbs (takes up) iodine from the blood, this is an excellent measure of thyroid function. For instance, if the test reveals that the thyroid gland is taking up too much iodine, this indicates an overproduction of thyroid hormones and potential hyperthyroidism.
In a thyroid scan, a small camera takes several images of the thyroid gland. It is performed in concert with the radioiodine uptake test, as the radioactive material highlights certain parts of the thyroid, allowing the doctor to see inflammation, goiter, lumps, or other abnormalities of this gland.
Using high-frequency sound waves, ultrasound produces images of the thyroid for the same purpose as a thyroid scan.
However, thyroid ultrasound is a quicker non-invasive method than a thyroid scan.
Complications of Hyperthyroidism
The complications of untreated hyperthyroidism vary depending upon the cause, age, sex, and comorbidities and can range from minor to severe.
Here are some of them.
Hyperthyroidism speeds up every system in your body, including the heart. This makes the heart beat faster and work harder, which can lead to the following conditions:
High Blood Pressure
The rapid heartbeat caused by untreated hyperthyroidism increases the force of blood against the artery walls leading to high blood pressure.
High blood pressure or hypertension is a significant risk factor for heart disease.
Irregular Heartbeat (Atrial Fibrillation) or Fast Heartbeat (Sinus Tachycardia)
Atrial fibrillation, a heart that beats erratically, can cause the lower part of the heart to quiver rather than pump blood through the veins. Consequently, an irregular heartbeat could lead to cardiac arrest, where the heart suddenly stops beating. It can also lead to stroke, where the blood supply to the brain is reduced or blocked.
Sinus tachycardia is an abnormally fast heartbeat that exceeds 100 beats per minute when at rest. This condition can be harmful to health if it persists for several years.
For example, in a study published in the European Heart Journal, researchers found that a "resting heart rate of over 84 beats per minute that either developed or persisted over 5 years increased the risk of cardiovascular death by 55%, and raised the risk of death from any cause by 79%." (9)
Several years of atrial fibrillation or sinus tachycardia taxes the heart so severely that heart failure can occur.
When you have heart failure, the heart cannot pump enough blood to meet the body's needs.
Eye Problems (Graves' Ophthalmopathy)
One in three people with an overactive thyroid caused by Graves' disease will develop eye problems known as Graves' ophthalmopathy.
The symptoms of this eye condition include:
Eye-sensitivity to light
Frequent dry eyes
With adequate hyperthyroidism treatment, these symptoms often recede. However, there is a risk of vision loss with this disease, which is even greater if your hyperthyroidism goes untreated.
Osteoporosis is a condition in which the bones become thin and brittle, increasing the risk of bone fractures even with little pressure. For example, a sneeze might fracture a bone if you have osteoporosis.
What do brittle bones have to do with hyperthyroidism?
According to the National Library of Medicine:
"Thyroid hormones are essential for normal skeletal development and normal bone metabolism in adults but can have detrimental effects on bone structures in states of thyroid dysfunction. Untreated severe hyperthyroidism influences the degree of bone mass and increases the probability of high bone turnover osteoporosis." (10)
Hyperthyroidism also affects the brain, and there is scientific evidence that hyperthyroidism and hypothyroidism may cause cognitive issues that may resemble dementia.
Indeed, some people with Graves' disease, the most common cause of hyperthyroidism, exhibit some degree of cognitive dysfunction. For example, they often experience memory lapses, poor concentration, and sluggish reaction times. (11, 12)
One study suggests that hyperthyroidism is a potential risk factor for cognitive impairment in older people. (13)
Several treatments for hyperthyroidism exist. Your healthcare provider will discuss the various treatment options with you and decide which ones will likely be the most effective for your overactive thyroid condition.
Here are just a few hyperthyroidism treatments.
Radioactive iodine is taken orally and absorbed by the thyroid gland, damaging the cells and causing the thyroid to shrink. This method helps relieve hyperthyroidism symptoms in a few months.
Unfortunately, there is one problem with this treatment. Radioactive iodine may excessively slow thyroid activity to such an extent that you develop hypothyroidism or underactive thyroid. If this happens, you may need to undergo thyroid hormone replacement therapy, taking a synthetic thyroid hormone daily for the rest of your life.
Anti-thyroid medications prohibit the thyroid gland from producing too much thyroid hormone.
With anti-thyroid medications, hyperthyroidism symptoms gradually disappear within a few weeks or months. Treatment is usually administered for at least a year, even after symptoms have subsided. (8)
Anti-thyroid medication can cause severe liver damage and even death. So, you must call your doctor immediately if you develop persistent lethargy, yellowing the whites of the eyes and skin (jaundice), fluid retention in various body parts (edema), and other liver-dysfunction symptoms.
Typically used to treat high blood pressure, beta-blockers are medications that block the action of specific substances on nerve cells.
Though they don't alter or stop thyroid hormone production, they can reduce unpleasant hyperthyroidism symptoms -- i.e., tremors, rapid heartbeat, heart palpitations, and anxiety -- until other treatments start working.
Beta-blockers aren't used alone but are typically paired with another treatment option that modifies thyroid hormone production.
Surgical removal of the entire thyroid or part of it is not as frequently used as the other treatment options. Instead, it is generally prescribed when the other treatments don't work or you cannot tolerate or refuse the most effective methods.
Whether you have all or part of the thyroid gland removed, the risks are the same. The primary risk is damage to your vocal cords and parathyroid glands that help regulate calcium levels in your blood.
After the thyroidectomy, you will need to take daily thyroid hormone replacement medication for the rest of your life. You will also need to take drugs to maintain healthy blood-calcium levels if your parathyroid glands are damaged or removed.
Natural Hyperthyroidism Treatments
If you have hyperthyroidism, you and your doctor will create a treatment plan that you should follow. However, a few natural treatment options can be a valuable adjunct to medical treatment.
Here are a few of these natural treatments.
Watch Your Iodine Intake
Consuming too much iodine can dramatically increase thyroid hormone production.
The recommended daily iodine intake is 150 micrograms (mcg) per day for most healthy adults. But the maximum intake may be lower if you have hyperthyroidism.
Speak with your doctor to determine the correct intake of iodine for you.
Foods with high amounts of iodine include:
Eat More Lean Beef
Beef and other animal products are rich sources of L-Carnitine, a natural compound that act like a B-vitamin and amino acids.
L-carnitine blocks thyroid hormones from entering specific hormones. Perhaps that's why research suggests it may help ease common hyperthyroidism symptoms like fatigue, tremors, and heart palpitations. (15)
Increase Intake of Foods Containing Selenium
Selenium is a mineral that plays a crucial role in metabolism, possibly due to its effect on the thyroid gland.
One study showed that those newly diagnosed with Graves disease, the most common cause of hyperthyroidism, were more likely to have low selenium levels. In contrast, those with higher levels experienced a reduced relapse rate of Graves disease. (16)
In addition, several studies suggest that taking selenium supplements in combination with standard medical treatments for hyperthyroidism improved the results. (17, 18, 19)
The current daily value (DV) for selenium is micrograms.
You can get selenium through dietary supplements or by increasing your intake of selenium-containing foods.
Foods containing selenium include:
Whole wheat pasta
If you have hyperthyroidism, speak with your doctor before increasing your selenium intake.
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