Learn more about the consequences of an overactive thyroid, along with various treatment options available for this condition.
Hyperthyroidism (overactive thyroid) occurs when your thyroid gland produces too much of the hormone thyroxine. Hyperthyroidism can accelerate your body's metabolism, causing unintentional weight loss and a rapid or irregular heartbeat.
Several treatments are available for hyperthyroidism. Doctors use anti-thyroid medications and radioactive iodine to slow the production of thyroid hormones. Sometimes, hyperthyroidism treatment involves surgery to remove all or part of your thyroid gland.
Although hyperthyroidism can be serious if you ignore it, most people respond well once hyperthyroidism is diagnosed and treated.
Hyperthyroidism can mimic other health problems, which can make it difficult for your doctor to diagnose. It can also cause a wide variety of signs and symptoms, including:
Older adults are more likely to have either no signs or symptoms or subtle ones, such as an increased heart rate, heat intolerance and a tendency to become tired during ordinary activities.
Sometimes an uncommon problem called Graves' ophthalmopathy may affect your eyes, especially if you smoke. This disorder makes your eyeballs protrude beyond their normal protective orbits when the tissues and muscles behind your eyes swell. Eye problems often improve without treatment.
Signs and symptoms of Graves' ophthalmopathy include:
If you experience unexplained weight loss, a rapid heartbeat, unusual sweating, swelling at the base of your neck or other signs and symptoms associated with hyperthyroidism, see your doctor. It's important to completely describe the changes you've observed, because many signs and symptoms of hyperthyroidism may be associated with a number of other conditions.
If you've been treated for hyperthyroidism or you currently are being treated, see your doctor regularly as advised so that he or she can monitor your condition.
Hyperthyroidism can be caused by a number of conditions, including Graves' disease, Plummer's disease and thyroiditis.
Your thyroid is a small, butterfly-shaped gland at the base of your neck, just below your Adam's apple. The thyroid gland has an enormous impact on your health. Every aspect of your metabolism is regulated by thyroid hormones.
Your thyroid gland produces two main hormones, thyroxine (T4) and triiodothyronine (T3), that influence every cell in your body. They maintain the rate at which your body uses fats and carbohydrates, help control your body temperature, influence your heart rate, and help regulate the production of protein. Your thyroid also produces a hormone that helps regulate the amount of calcium in your blood (calcitonin).
Normally, your thyroid releases the right amount of hormones, but sometimes it produces too much T4. This may occur for a number of reasons, including:
Risk factors for hyperthyroidism, include:
Hyperthyroidism can lead to a number of complications:
Hyperthyroidism is diagnosed using:
Blood tests. Blood tests that measure thyroxine and thyroid-stimulating hormone (TSH) can confirm the diagnosis. High levels of thyroxine and low or nonexistent amounts of TSH indicate an overactive thyroid. The amount of TSH is important because it's the hormone that signals your thyroid gland to produce more thyroxine.
These tests are particularly necessary for older adults, who may not have classic symptoms of hyperthyroidism.
Thyroid blood tests may give false results if you're taking biotin — a B vitamin supplement that may also be found in multivitamins. Let your doctor know if you are using biotin or a multivitamin with biotin. To ensure an accurate test, stop taking biotin at least 12 hours before blood is taken.
If blood tests indicate hyperthyroidism, your doctor may recommend one of the following tests to help determine why your thyroid is overactive:
Radioiodine uptake test. For this test, you take a small, oral dose of radioactive iodine (radioiodine) to see how much will collect in your thyroid gland. You'll be checked after four, six or 24 hours — and sometimes after all three time periods — to see how much iodine your thyroid has absorbed.
A high uptake of radioiodine indicates your thyroid gland is producing too much thyroxine. The most likely cause is either Graves' disease or hyperfunctioning thyroid nodules. If you have hyperthyroidism and your radioiodine uptake is low, this indicates that the thyroxine stored in the gland is leaking into the bloodstream, which may mean you have thyroiditis.
Several treatments for hyperthyroidism exist. The best approach for you depends on your age, physical condition, the underlying cause of the hyperthyroidism, personal preference and the severity of your disorder. Possible treatments include:
Radioactive iodine. Taken by mouth, radioactive iodine is absorbed by your thyroid gland, where it causes the gland to shrink. Symptoms usually subside within several months. Excess radioactive iodine disappears from the body in weeks to months.
This treatment may cause thyroid activity to slow enough to be considered underactive (hypothyroidism), and you may eventually need to take medication every day to replace thyroxine.
Anti-thyroid medications. These medications gradually reduce symptoms of hyperthyroidism by preventing your thyroid gland from producing excess amounts of hormones. They include methimazole (Tapazole) and propylithiouracil. Symptoms usually begin to improve within several weeks to months, but treatment with anti-thyroid medications typically continues at least a year and often longer.
For some people, this clears up the problem permanently, but other people may experience a relapse. Both drugs can cause serious liver damage, sometimes leading to death. Because propylthiouracil has caused far more cases of liver damage, it generally should be used only when you can't tolerate methimazole.
A small number of people who are allergic to these drugs may develop skin rashes, hives, fever or joint pain. They also can make you more susceptible to infection.
Surgery (thyroidectomy). If you're pregnant or you otherwise can't tolerate anti-thyroid drugs and don't want to or can't have radioactive iodine therapy, you may be a candidate for thyroid surgery, although this is an option in only a few cases.
In a thyroidectomy, your doctor removes most of your thyroid gland. Risks of this surgery include damage to your vocal cords and parathyroid glands — four tiny glands situated on the back of your thyroid gland that help control the level of calcium in your blood.
In addition, you'll need lifelong treatment with levothyroxine (Levoxyl, Synthroid, others) to supply your body with normal amounts of thyroid hormone. If your parathyroid glands also are removed, you'll need medication to keep your blood-calcium levels normal.
If Graves' disease affects your eyes (Graves' ophthalmopathy), you can manage mild signs and symptoms by using artificial tears and lubricating gels and by avoiding wind and bright lights. If your symptoms are more severe, your doctor may recommend treatment with corticosteroids, such as prednisone, to reduce swelling behind your eyeballs.
Two drugs — rituximab (Rituxan) and teprotumumab — are being used to treat Graves' ophthalmopathy, even though there isn't a lot of definitive evidence yet to prove that they're effective. Teprotumumab received fast-track approval from the Food and Drug Administration based on one small study. More study of both drugs as a treatment for Graves' ophthalmopathy is needed.
In some cases, a surgical procedure may be an option:
Once you begin treatment, symptoms of hyperthyroidism should subside and you should start feeling much better. However, your doctor may recommend that you watch out for iodine in your diet because it can cause hyperthyroidism or make it worse.
Kelp, dulse and others types of seaweed contain a lot of iodine. Cough syrup and multivitamins also may contain iodine.
If you have Graves' ophthalmopathy or dermopathy, the following suggestions may help your eyes or skin:
If you've been diagnosed with hyperthyroidism, the most important thing is to receive the necessary medical care. After you and your doctor have decided on a course of action, there are some things you can do that will help you cope with the condition and support your body during its healing process.
You'll likely start by seeing your primary care doctor. However, in some cases, you may be referred immediately to a doctor who specializes in the body's hormone-secreting glands (endocrinologist). If you have eye involvement, you may also be referred to an eye doctor (ophthalmologist).
It's good to prepare for your appointment. Here's some information to help you get ready for your appointment, and to know what to expect from your doctor.
Preparing a list of questions will help you make the most of your time with your doctor. For hyperthyroidism, some basic questions to ask your doctor include:
Don't hesitate to ask any other relevant questions you have.
Your doctor is likely to ask you a number of questions, including:
December 22nd, 2020