Hyperthyroidism: Symptoms, Causes, and Management

Hyperthyroidism, also known as overactive thyroid disease, is a medical condition in which the thyroid gland produces and releases excessive amounts of thyroid hormones. These hormones—thyroxine (T4) and triiodothyronine (T3)—are critical in regulating the body’s metabolism, energy production, and many essential physiological processes. When the levels of these hormones become abnormally high, the body’s metabolic rate increases significantly, potentially leading to a wide array of symptoms and health complications.

In this article, we will explore hyperthyroidism in depth, covering its symptoms, underlying causes, diagnostic procedures, treatment options, complications, and strategies for managing life with this condition.

Anatomy and Function of the Thyroid Gland

The thyroid gland is one of the most vital components of the endocrine system. Despite its small size, this butterfly-shaped organ exerts a profound influence on nearly every cell, tissue, and organ in the body through the hormones it produces. Understanding its anatomy and physiological role is key to grasping how disorders like hyperthyroidism develop and affect the body.

Location and Structure

The thyroid gland is located in the anterior (front) part of the neck, just below the larynx (voice box) and in front of the trachea (windpipe). Shaped like a butterfly, it has:

• Two lobes (right and left), one on each side of the trachea
• A central connecting portion called the isthmus
• In some people, a small third lobe known as the pyramidal lobe, which is a remnant of embryological development

 

The entire gland typically weighs about 15–25 grams in healthy adults but may become significantly enlarged in various thyroid disorders, such as goiter or Graves’ disease.

Histology of the Thyroid Gland

Under the microscope, the thyroid gland is made up of numerous small spherical structures called follicles. Each follicle contains:

• Follicular cells (thyrocytes): These line the follicles and are responsible for producing thyroid hormones—T3 and T4.
• Colloid: A protein-rich fluid in the center of the follicles that stores thyroglobulin, the precursor of thyroid hormones.
• Parafollicular cells (C cells): Located in the spaces between follicles, these produce the hormone calcitonin, which helps regulate calcium levels in the blood.

 

The Hypothalamic-Pituitary-Thyroid (HPT) Axis

The thyroid does not work in isolation; it is regulated through a complex feedback system involving the hypothalamus and pituitary gland—two structures located in the brain.

1. The hypothalamus releases thyrotropin-releasing hormone (TRH).
2. TRH stimulates the anterior pituitary to secrete thyroid-stimulating hormone (TSH).
3. TSH then travels through the bloodstream to the thyroid gland, prompting it to produce and release:
   

   • Thyroxine (T4) – the main hormone secreted by the thyroid (about 90%)

   • Triiodothyronine (T3) – the more biologically active hormone (about 10%)

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Most T4 is converted to T3 in peripheral tissues like the liver and kidneys. Once the body has enough circulating thyroid hormones, they send negative feedback to the hypothalamus and pituitary to decrease TRH and TSH production, maintaining hormonal balance.

Functions of Thyroid Hormones

Thyroid hormones are essential for life and play a critical role in regulating a wide variety of physiological functions:

1. Metabolic Regulation

• Increases basal metabolic rate (BMR)—the amount of energy the body uses at rest
• Enhances oxygen consumption and heat production, which explains why people with hyperthyroidism often feel warm or sweaty
• Stimulates lipid and carbohydrate metabolism

 

2. Cardiovascular Function

• Increases heart rate and force of contraction
• Promotes dilation of blood vessels to enhance blood flow
• Heightens sensitivity to catecholamines like adrenaline

 

3. Growth and Development

• Crucial for normal growth in children
• Essential for brain development during fetal life and early childhood (This is why newborns are screened for congenital hypothyroidism—absence of thyroid hormones during development can lead to intellectual disability)

 

4. Neurological Function

• Regulates mood, alertness, reflexes, and coordination
• Affects cognitive function, memory, and concentration

 

5. Reproductive System

• Helps maintain normal menstrual cycles
• Supports fertility in both men and women
• Imbalances can lead to menstrual irregularities, infertility, or complications during pregnancy

 

6. Musculoskeletal System

• Affects muscle tone and strength
• Influences bone turnover—an excess of thyroid hormones (as in hyperthyroidism) can lead to bone resorption and osteoporosis

 

Role of Calcitonin

Though not directly involved in metabolism like T3 and T4, calcitonin (produced by C cells of the thyroid) plays a role in calcium homeostasis. It:

• Lowers blood calcium levels by inhibiting osteoclast activity in bones
• Reduces calcium reabsorption in the kidneys

 

Calcitonin’s role in adults is relatively minor, and its absence usually does not cause major health problems. However, it is used as a tumor marker in medullary thyroid carcinoma.

Thyroid Hormone Storage and Release

What makes the thyroid gland unique among endocrine organs is its ability to store hormones in large quantities within the colloid of the follicles. This allows it to maintain steady hormone release even during brief interruptions in iodine supply or TSH signaling.

Hormone synthesis involves:

• Uptake of iodine from the blood (through sodium-iodide symporters)
• Oxidation of iodine and incorporation into tyrosine residues on thyroglobulin
• Coupling reactions to form T3 and T4

 

These steps are catalyzed by the enzyme thyroid peroxidase (TPO), which is a common target in autoimmune thyroid diseases.

Maintaining Hormonal Balance

The body requires a very delicate balance of thyroid hormone levels. Both insufficient and excessive levels can cause systemic dysfunction. This balance is maintained through the HPT axis and modulated by factors such as:

• Nutritional status (iodine, selenium)
• Stress and illness
• Medications (e.g., lithium, amiodarone)
• Autoimmune activity

 

What is Hyperthyroidism?

Hyperthyroidism is a condition in which the thyroid gland becomes overactive, producing and secreting excessive amounts of thyroid hormones—specifically thyroxine (T4) and triiodothyronine (T3). These hormones are responsible for controlling the body’s metabolism, which is the process by which cells convert food into energy. In people with hyperthyroidism, this metabolic engine is running in overdrive, causing the body to speed up all of its internal processes.

This overproduction disrupts the delicate hormonal balance required for healthy physiological function. As a result, nearly every system in the body is affected, often in dramatic ways—from the heart and digestive system to the muscles, skin, and nervous system.

Understanding the Term: Hyperthyroidism vs. Thyrotoxicosis

The terms hyperthyroidism and thyrotoxicosis are often used interchangeably, but technically, they are not the same:

• Hyperthyroidism refers specifically to conditions where the thyroid gland itself is producing too much hormone.
• Thyrotoxicosis is a broader term referring to any condition in which there is excess thyroid hormone in the bloodstream, regardless of its source. For example, taking too much thyroid hormone medication can cause thyrotoxicosis, but not hyperthyroidism.

 

In other words, all hyperthyroidism causes thyrotoxicosis, but not all thyrotoxicosis is due to hyperthyroidism.

How Common is Hyperthyroidism?

Hyperthyroidism is a relatively common endocrine disorder:

• Affects 1 in 100 people in the general population
• Up to 5 in 100 women over age 60
• 5 to 10 times more common in women than in men
• Can affect individuals of any age, but is most frequently diagnosed between ages 20 and 40

 

The higher prevalence in women may be due to the autoimmune nature of most thyroid disorders and the general predisposition of women to autoimmune diseases.

What Happens in the Body During Hyperthyroidism?

In hyperthyroidism, the body is flooded with an excess of thyroid hormones, which accelerates cellular activity in nearly every tissue. Some key systemic effects include:

1. Increased Basal Metabolic Rate

• Cells consume oxygen and nutrients at a much faster rate
• This results in unintentional weight loss despite normal or increased food intake

 

2. Overstimulation of the Cardiovascular System

• The heart works harder to meet increased metabolic demands
• Leads to rapid heart rate, palpitations, and in some cases, irregular rhythms like atrial fibrillation

 

3. Enhanced Sympathetic Nervous System Activity

• Patients may feel anxious, restless, jittery, or hyperactive
• Tremors, insomnia, and heightened reflexes are common

 

4. Thermoregulatory Changes

• Increased heat production causes patients to feel warm or overheated
• Excessive sweating and heat intolerance are hallmark symptoms

 

5. Gastrointestinal Hyperactivity

• Faster digestive motility can lead to frequent bowel movements or diarrhea

 

6. Altered Hormone Interaction

• Hyperthyroidism disrupts normal interactions with reproductive and adrenal hormones
• Results in menstrual irregularities, fertility issues, and libido changes

 

Types of Hyperthyroidism (Based on Hormone Production and Origin)

Hyperthyroidism isn’t a one-size-fits-all diagnosis. It can manifest in several different forms, depending on the underlying cause.

Primary Hyperthyroidism

• The problem lies within the thyroid gland itself
• Common causes: Graves’ disease, toxic multinodular goiter, toxic adenoma

 

Secondary Hyperthyroidism

• Caused by excessive TSH production from the pituitary gland
• Usually due to TSH-secreting pituitary tumors (rare)

 

Exogenous Thyrotoxicosis

Not true hyperthyroidism, but caused by:

• Overuse of thyroid hormone medication
• Dietary or supplement-related iodine excess
• Accidental or intentional ingestion of thyroid hormone

 

Hyperthyroidism vs. Hypothyroidism: Opposite Sides of the Same Coin

It helps to understand hyperthyroidism by contrasting it with its counterpart: hypothyroidism, or underactive thyroid.

This comparison highlights just how dramatically the balance of thyroid hormones can impact the body’s function and overall health.

Why is Hyperthyroidism a Big Deal?

Unchecked, hyperthyroidism can lead to severe complications, including:

• Heart rhythm abnormalities (especially in older adults)
• Thyroid storm, a rare but life-threatening medical emergency
• Osteoporosis due to accelerated bone turnover
• Vision problems in Graves’ disease
• Reduced quality of life due to anxiety, fatigue, insomnia, and weight changes

 

Because of these risks, early recognition, accurate diagnosis, and appropriate treatment are critical for managing hyperthyroidism effectively and avoiding long-term consequences.

 

Causes of Hyperthyroidism

Hyperthyroidism is not a single disease but rather a clinical syndrome that can result from a variety of underlying causes. Each cause has its own distinct pathophysiology, progression, and treatment considerations. Understanding these different causes is essential not only for accurate diagnosis but also for effective, individualized treatment planning.

Below is a detailed overview of the major causes of hyperthyroidism:

1. Graves’ Disease (Autoimmune Hyperthyroidism)
2. Toxic Nodular Goiter (Multinodular or Solitary Toxic Adenoma)
3. Thyroiditis (Inflammation of the Thyroid Gland)
4. Excessive Iodine Intake
5. Functional Thyroid Cancer (Rare)
6. TSH-Secreting Pituitary Adenomas (Secondary Hyperthyroidism)
7. Overuse of Thyroid Hormone Supplements
8. Struma Ovarii (Ectopic Thyroid Tissue)

 

Graves’ Disease (Autoimmune Hyperthyroidism)

Graves’ disease is the most common cause of hyperthyroidism, accounting for approximately 60–80% of all cases. It is an autoimmune disorder in which the body’s immune system mistakenly attacks the thyroid gland, causing it to become overactive.

How It Works:

• The immune system produces thyroid-stimulating immunoglobulins (TSIs).
• These antibodies mimic thyroid-stimulating hormone (TSH).
• As a result, the thyroid is continuously stimulated to produce T3 and T4, even when TSH levels are low.

 

Unique Features of Graves’ Disease:

• Goiter: Painless, diffuse enlargement of the thyroid gland.
• Graves’ Ophthalmopathy (also known as thyroid eye disease): Inflammation and swelling behind the eyes causing bulging eyes (exophthalmos), double vision, or eye irritation.
• Graves’ Dermopathy: Rare thickening of the skin, especially on the shins (called pretibial myxedema).
• Can occur in conjunction with other autoimmune diseases, such as type 1 diabetes, celiac disease, or rheumatoid arthritis.

 

Genetic Component:

• Tends to run in families, indicating a genetic predisposition.
• More common in women and often triggered by stress, pregnancy, infection, or smoking.

 

Toxic Nodular Goiter (Multinodular or Solitary Toxic Adenoma)

This form of hyperthyroidism occurs when nodules in the thyroid become autonomously active, meaning they produce thyroid hormones without needing stimulation from TSH.

Types:

• Toxic Multinodular Goiter (Plummer’s Disease): Multiple autonomously functioning nodules.
• Toxic Adenoma: A single “hot” nodule (benign tumor) that produces thyroid hormone independently.

 

How It Happens:

• Over time, these nodules grow and develop mutations that make them TSH-independent.
• This is more common in older adults, especially in areas with long-standing iodine deficiency.

 

Diagnosis:

• Often identified through a thyroid scan using radioactive iodine or technetium, which shows increased uptake in nodules.
• TSH is suppressed, but one or more nodules continue to produce T3 and T4.

 

Thyroiditis (Inflammation of the Thyroid Gland)

Thyroiditis refers to inflammation of the thyroid gland, which can cause the release of pre-formed thyroid hormone into the bloodstream, leading to temporary hyperthyroidism. However, in most cases, this is not due to increased production but leakage from damaged thyroid cells.

Types of Thyroiditis:

a. Subacute (De Quervain’s) Thyroiditis

• Typically follows a viral infection.
• Painful, tender thyroid gland.
• Associated with fever, malaise, and neck pain that may radiate to the jaw or ears.
• Hyperthyroidism is usually transient and may be followed by hypothyroidism before recovery.

 

b. Painless (Silent) Thyroiditis

• Often autoimmune in nature.
• Common in postpartum women (postpartum thyroiditis).
• No pain or tenderness.
• Usually self-limiting over a few months.

 

c. Drug-Induced Thyroiditis

Certain drugs can cause inflammation or damage to the thyroid, including:

• Amiodarone (a heart medication high in iodine)
• Interferon-alpha
• Lithium

 

May cause biphasic thyroid dysfunction: hyperthyroidism followed by hypothyroidism.

Excessive Iodine Intake

Iodine is essential for the synthesis of thyroid hormones, but too much of it can trigger hyperthyroidism in susceptible individuals—a condition known as the Jod-Basedow phenomenon.

Common sources of excess iodine:

• Dietary supplements
• Iodine-containing contrast dyes used in imaging studies (e.g., CT scans)
• Medications like amiodarone

 

This cause is more common in:

• People with underlying nodular thyroid disease
• Elderly individuals
• Populations with low baseline iodine intake suddenly exposed to high levels

 

Functional Thyroid Cancer (Rare)

In rare cases, certain forms of thyroid cancer—specifically follicular thyroid carcinoma—can become “hot” or functioning tumors, meaning they actively produce thyroid hormones.

This is extremely uncommon but should be considered in:

• A solitary thyroid nodule with increased uptake on a scan
• Evidence of malignancy or rapidly growing mass
• Poor response to conventional treatments

 

TSH-Secreting Pituitary Adenomas (Secondary Hyperthyroidism)

A very rare cause of hyperthyroidism, this occurs when a tumor in the pituitary gland secretes excess thyroid-stimulating hormone (TSH), despite high levels of thyroid hormones.

Key Features:

• Both TSH and free T3/T4 are elevated (unlike typical hyperthyroidism, where TSH is suppressed)
• May be accompanied by headaches, visual disturbances, or other signs of a pituitary mass
• Diagnosed through MRI of the brain and endocrinology workup

 

Overuse of Thyroid Hormone Supplements

Taking excessive amounts of levothyroxine or other thyroid hormone medications—either intentionally (e.g., for weight loss) or accidentally—can lead to hyperthyroid symptoms and lab abnormalities.

This is known as exogenous thyrotoxicosis and is particularly common in:

• People self-medicating with unregulated “natural” thyroid products
• Patients with poorly monitored hypothyroidism
• Athletes or bodybuilders using thyroid hormones as a performance enhancer

 

Struma Ovarii (Ectopic Thyroid Tissue)

An extremely rare condition in which a teratoma (tumor) containing thyroid tissue develops in the ovary and begins secreting thyroid hormones.

• Typically part of an ovarian dermoid cyst
• Presents with signs of hyperthyroidism but a normal or small thyroid gland
• Diagnosed through imaging and sometimes surgical removal

 

Summary Table of Causes

 

Signs and Symptoms of Hyperthyroidism

Hyperthyroidism can be a system-wide disruptor, affecting nearly every organ in the body due to the central role thyroid hormones play in regulating metabolism, cardiovascular function, mood, energy levels, and more. Because of this, symptoms can be wide-ranging and sometimes mistaken for other conditions, especially anxiety disorders, menopause, or cardiac issues.

Symptoms may develop gradually or suddenly, and their severity depends on the underlying cause, the patient’s age, and the duration of the hormone imbalance.

General Metabolic Symptoms

Thyroid hormones significantly influence the body’s basal metabolic rate (BMR). When these hormones are elevated, the body’s energy demands increase, leading to a range of metabolic symptoms:

• Unintentional weight loss – despite eating the same or even more food
• Increased appetite (hyperphagia) – patients often feel constantly hungry
• Fatigue – paradoxically, even though metabolism is accelerated, the body becomes exhausted
• Heat intolerance – patients often feel overheated, even in cool environments
• Excessive sweating (hyperhidrosis) – common, even with minimal exertion
• Low-grade fever – some individuals may have a slightly elevated body temperature

 

These symptoms reflect the body running in overdrive, burning calories faster than they can be replenished.

Cardiovascular Symptoms

The cardiovascular system is particularly sensitive to excess thyroid hormone, which can increase the heart’s workload and affect its rhythm and function.

• Palpitations – awareness of a fast or pounding heartbeat
• Tachycardia – resting heart rate often exceeds 100 beats per minute
• Arrhythmias – irregular heartbeat; atrial fibrillation is common, especially in older adults
• Elevated blood pressure (systolic hypertension) – due to increased cardiac output
• Shortness of breath – especially on exertion
• Chest discomfort or angina – due to increased myocardial oxygen demand

 

In older adults, cardiovascular symptoms may be the only sign of hyperthyroidism, making diagnosis tricky. Atrial fibrillation in the elderly should always trigger a thyroid function test.

Neurological and Psychological Symptoms

Thyroid hormones influence brain function, mood regulation, and neuromuscular control. An excess can heighten activity in the sympathetic nervous system, causing:

• Anxiety or nervousness
• Restlessness or hyperactivity
• Insomnia
• Irritability or mood swings
• Difficulty concentrating (“brain fog”)
• Tremors, especially in the hands and fingers (fine or coarse)
• Increased deep tendon reflexes (hyperreflexia)
• Muscle weakness, particularly in the upper arms and thighs (proximal muscle weakness)
• Emotional lability – rapid shifts in mood

 

These symptoms are often mistaken for psychological conditions like generalized anxiety disorder or panic disorder, delaying appropriate diagnosis and treatment.

Thermoregulation and Skin Manifestations

Due to the hypermetabolic state, the skin and hair are often affected in visible and sometimes distressing ways:

• Warm, moist skin – due to vasodilation and excessive sweating
• Flushed face or red palms
• Fine, soft, or thinning hair – sometimes leading to visible hair loss
• Increased hair shedding
• Fragile nails – may break or peel easily
• Pruritus (itchiness) – not uncommon
• Pretibial myxedema – localized, thickened, orange-peel skin over the shins, specific to Graves’ disease

 

Ophthalmic (Eye) Symptoms

In Graves’ disease, the autoimmune component targets not only the thyroid but also tissues around the eyes, resulting in Graves’ ophthalmopathy, which can range from mild irritation to severe vision problems.

• Exophthalmos (proptosis) – bulging of the eyes due to inflammation and tissue swelling behind the eye
• Lid lag – upper eyelid appears stuck above the iris when looking down
• Eye dryness or grittiness
• Redness and inflammation
• Photophobia (sensitivity to light)
• Double vision (diplopia) – due to weakness of eye muscles
• Decreased visual acuity – in severe cases

 

Up to 25–50% of Graves’ patients develop some form of eye involvement, and smoking significantly worsens eye symptoms.

Gastrointestinal Symptoms

Accelerated metabolism leads to increased gastrointestinal motility, which can cause:

• Frequent bowel movements
• Loose stools or mild diarrhea
• Abdominal discomfort or cramps
• Occasionally mild liver dysfunction – reflected in abnormal liver enzyme tests

 

Note: Severe diarrhea or malabsorption is rare but can occur in more advanced or untreated cases.

Reproductive and Hormonal Symptoms

Thyroid hormones play a critical role in reproductive function, and excess hormones disrupt normal hormonal rhythms.

In women:

• Oligomenorrhea (infrequent periods)
• Amenorrhea (absence of menstruation)
• Shorter, lighter periods
• Infertility
• Increased risk of miscarriage and preterm delivery (in pregnancy)

 

In men:

• Reduced libido
• Erectile dysfunction
• Gynecomastia (breast enlargement) – rare but possible due to hormone imbalance
• Low sperm count – in prolonged or untreated cases

 

Musculoskeletal Symptoms

Thyroid hormones influence bone turnover and muscle metabolism. Excess can lead to:

• Muscle weakness – often without pain
• Wasting of muscle mass – especially in proximal limbs
• Osteopenia or osteoporosis – increased bone resorption leads to bone thinning
• Increased risk of fractures – especially in older adults or postmenopausal women

 

Bone health should be monitored in patients with chronic or severe hyperthyroidism.

Immunologic and Hematologic Symptoms

In autoimmune hyperthyroidism (Graves’ disease), other immune responses may be activated:

• Mild anemia
• Neutropenia or lymphocytosis – sometimes seen in lab results
• Co-occurring autoimmune diseases – such as vitiligo, type 1 diabetes, or celiac disease

 

Hyperthyroidism in Children and Adolescents

Though less common, hyperthyroidism in younger populations presents with unique challenges:

• Rapid growth and advanced bone age
• Behavioral problems
• Poor academic performance
• Increased appetite with weight loss
• Restlessness, hyperactivity, or attention deficits

 

Diagnosis is often delayed because symptoms are misattributed to typical teenage behavior or ADHD.

Atypical Presentation in Older Adults (“Apathetic Hyperthyroidism”)

In elderly patients, symptoms may be subtle or atypical, sometimes referred to as apathetic hyperthyroidism. Instead of classic signs, they may present with:

• Fatigue or lethargy
• Weight loss without increased appetite
• Depression or withdrawal
• Atrial fibrillation or heart failure
• Cognitive decline or confusion

 

This can be easily misdiagnosed as dementia, depression, or frailty, making thyroid function testing essential in unexplained geriatric symptoms.

Summary Table of Key Symptoms by System

 

Complications of Untreated Hyperthyroidism

If left undiagnosed or inadequately treated, hyperthyroidism can have serious, widespread, and sometimes life-threatening consequences. Thyroid hormones influence nearly every system in the body, and their prolonged excess can result in long-term damage. While some complications are mild or reversible, others may become permanent or fatal without timely intervention.

Early recognition and appropriate treatment are critical to preventing these complications, especially in high-risk populations like the elderly, pregnant women, and individuals with pre-existing heart disease.

1. Thyroid Storm (Thyrotoxic Crisis)

Thyroid storm is the most dangerous acute complication of hyperthyroidism—a rare but life-threatening medical emergency.

What is it?

It’s an extreme and sudden intensification of hyperthyroid symptoms, usually triggered by stress, illness, surgery, or trauma in someone with untreated or poorly controlled hyperthyroidism.

Common Triggers:

• Infections (e.g., pneumonia)
• Surgery (especially thyroid surgery)
• Trauma or childbirth
• Discontinuation of antithyroid medications
• Use of iodine contrast (CT scans)

 

Symptoms:

• High fever (often above 104°F / 40°C)
• Severe tachycardia or arrhythmias
• Agitation, delirium, or psychosis
• Profuse sweating
• Nausea, vomiting, diarrhea
• Heart failure or shock
• Coma

 

Mortality rate can exceed 20–30% if not treated promptly with aggressive medical therapy, including beta-blockers, antithyroid drugs, IV corticosteroids, cooling measures, and supportive care in an ICU setting.

2. Cardiovascular Complications

The heart is one of the organs most affected by prolonged hyperthyroidism. The constant stimulation from elevated thyroid hormones puts immense strain on the cardiovascular system, potentially leading to both structural and functional problems.

Common Cardiovascular Complications:

a. Atrial Fibrillation (AFib)

• The most common arrhythmia associated with hyperthyroidism
• Seen in up to 15–25% of older adults with the condition
• Can lead to stroke or heart failure
• Often persists even after thyroid function normalizes

 

b. Supraventricular Tachycardia (SVT) or Sinus Tachycardia

• Chronic high heart rate increases cardiac workload and oxygen demand

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c. Congestive Heart Failure (CHF)

• Especially in elderly patients or those with preexisting heart disease
• Characterized by fatigue, dyspnea, edema, and pulmonary congestion

 

d. High-output Heart Failure

• Unique to hyperthyroidism: the heart pumps excessive volume but still can’t meet the body’s demand

 

e. Hypertension

• Primarily systolic hypertension due to increased stroke volume

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3. Neuropsychiatric Complications

Untreated hyperthyroidism can have significant effects on mental health and cognitive function. These effects can mimic primary psychiatric disorders and are often misdiagnosed.

Mental and Cognitive Issues:

• Persistent anxiety or panic attacks
• Irritability or emotional instability
• Restlessness or insomnia
• Mania-like symptoms or agitation
• Psychosis (rare, but can occur during thyroid storm)
• Depression (especially in elderly patients)
• “Brain fog” or poor concentration
• Memory loss or cognitive decline – can mimic early dementia

 

In older adults, this presentation is often referred to as “apathetic hyperthyroidism”, where classic hyperactive symptoms are absent, but confusion, lethargy, or withdrawal dominate.

4. Osteoporosis and Bone Loss

Thyroid hormones play a vital role in bone metabolism. In hyperthyroidism, the bone remodeling cycle speeds up, favoring resorption over formation.

Consequences:

• Accelerated bone loss (osteopenia, osteoporosis)
• Increased risk of fractures – particularly of the hip, spine, and wrist
• Hypercalcemia – as bone releases calcium into the bloodstream

 

Even in younger individuals, prolonged untreated hyperthyroidism can reduce bone mineral density (BMD), with effects that may not be fully reversible even after treatment.

5. Weight and Nutritional Imbalance

Although many people associate weight loss with hyperthyroidism, prolonged untreated disease can cause malnutrition and significant health consequences.

• Muscle wasting and weakness – particularly in proximal muscles (e.g., thighs, shoulders)
• Vitamin and mineral deficiencies – due to increased metabolism and poor absorption
• Hypokalemia (low potassium) – in severe cases or thyroid storm

 

6. Eye Complications (Thyroid Eye Disease)

Specific to Graves’ disease, thyroid eye disease can become a long-term, disfiguring, and sight-threatening complication if not managed properly.

Progression:

• Starts as mild irritation or dryness
• Can advance to exophthalmos (bulging eyes), pain, and double vision
• In severe cases, leads to:
  

  • Optic nerve compression

  • Corneal ulceration

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  • Vision loss

Even when hyperthyroidism is treated, eye symptoms may persist or worsen, highlighting the need for early ophthalmology referral and sometimes steroid, radiation, or surgical intervention.

7. Reproductive and Pregnancy Complications

Hyperthyroidism can have serious reproductive consequences in both men and women and poses significant risks during pregnancy.

In Women:

• Irregular or absent menstrual cycles
• Infertility
• Early menopause-like symptoms

 

During Pregnancy:

• Increased risk of miscarriage
• Preterm labor
• Preeclampsia
• Placental abruption
• Low birth weight
• Fetal hyperthyroidism – due to transplacental passage of TSI antibodies

 

Thyroid function monitoring and treatment during pregnancy is crucial for maternal and fetal health. PTU is preferred in the first trimester, with methimazole often used thereafter.

8. Goiter and Compressive Symptoms

A goiter is an enlargement of the thyroid gland that may occur in various types of hyperthyroidism, especially Graves’ disease and toxic multinodular goiter.

Complications of Large Goiters:

• Neck fullness or tightness
• Difficulty swallowing (dysphagia)
• Hoarseness or voice changes – due to pressure on the recurrent laryngeal nerve
• Shortness of breath or stridor – if the goiter compresses the trachea

 

In rare cases, large goiters extend behind the sternum (retrosternal goiter) and require surgical intervention.

9. Hematological Abnormalities

Prolonged hyperthyroidism may subtly affect the bone marrow and blood cells:

• Mild anemia
• Low white blood cell count (leukopenia)
• Reduced platelet count (thrombocytopenia)

 

These changes are often reversible once thyroid function normalizes.

10. Reduced Quality of Life and Functional Decline

Untreated hyperthyroidism can severely impact daily life and functioning, especially when symptoms persist over months or years.

• Chronic fatigue
• Poor sleep
• Difficulty working or managing daily tasks
• Mental health decline
• Social withdrawal due to irritability or body image issues (weight loss, bulging eyes)

 

These issues highlight the need for holistic, multidisciplinary care—not just biochemical correction, but also emotional and psychological support.

Complications Summary Table

 

Diagnosing Hyperthyroidism

Diagnosing hyperthyroidism requires a careful clinical evaluation, laboratory tests, and sometimes imaging studies to confirm the condition, identify its cause, and determine the most effective treatment strategy. Because symptoms can be non-specific or mimic other disorders (like anxiety, menopause, or heart disease), objective testing is essential.

A structured approach to diagnosis includes:

1. Clinical history and physical exam
2. Thyroid function tests (TFTs)
3. Thyroid antibody tests
4. Imaging studies
5. Additional assessments when needed (e.g., pituitary imaging, biopsy)

 

Clinical History and Physical Examination

Key Symptoms to Ask About:

• Weight loss despite normal or increased appetite
• Palpitations, chest pain, or shortness of breath
• Anxiety, restlessness, or insomnia
• Heat intolerance and excessive sweating
• Tremors or muscle weakness
• Changes in menstrual patterns or fertility
• Vision problems (e.g., bulging eyes, double vision)
• Neck swelling or discomfort
• Bowel frequency

 

Physical Signs to Look For:

• Tachycardia (heart rate >100 bpm)
• Tremor (fine tremor in the hands)
• Goiter (enlarged thyroid gland, may be diffuse or nodular)
• Ophthalmopathy (in Graves’ disease): exophthalmos, lid lag, periorbital edema
• Hyperreflexia (brisk deep tendon reflexes)
• Skin/hair changes: warm, moist skin; thinning hair
• Muscle wasting (especially in shoulders and thighs)

 

A thorough physical exam may provide strong clinical suspicion, but lab and imaging tests are necessary to confirm the diagnosis and uncover the cause.

Thyroid Function Tests (TFTs)

These blood tests are the cornerstone of diagnosis. They assess the levels of thyroid hormones and their regulatory hormones.

✅ Key Tests:

Primary hyperthyroidism: TSH ↓, Free T4/T3 ↑
Subclinical hyperthyroidism: TSH ↓, Free T4/T3 normal
Secondary hyperthyroidism (pituitary): TSH ↑ or inappropriately normal, T4/T3 ↑

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Note: Even if T4 is normal, a low TSH with elevated T3 can confirm hyperthyroidism—this is called T3 toxicosis and may represent an early or milder form.

Thyroid Antibody Testing

These blood tests help determine whether the hyperthyroidism is autoimmune in origin.

🧪 Common Antibodies:

Key Insight:

• A positive TSI or TRAb test strongly supports Graves’ disease.
• Antibody levels are especially useful when imaging is contraindicated (e.g., in pregnancy).

 

Radioactive Iodine Uptake (RAIU) and Thyroid Scan

This functional imaging test helps identify the underlying cause of hyperthyroidism by assessing how much iodine the thyroid takes up and how it distributes that iodine.

🧪 How It Works:

• The patient ingests a small dose of radioactive iodine (I-123) or technetium-99m.
• A special gamma camera measures uptake in the thyroid at 6 and 24 hours.
• Uptake levels and distribution pattern are analyzed.

 

Interpretation of RAIU:

Contraindicated in pregnancy and lactation
In those cases, diagnosis relies on antibody testing and ultrasound

Thyroid Ultrasound

An important tool to visualize the structure of the thyroid. It’s non-invasive, safe, and helpful for:

• Detecting nodules, cysts, or goiter
• Differentiating solid vs. cystic masses
• Assessing vascularity (increased blood flow = hyperfunction)
• Guiding fine-needle aspiration (FNA) if cancer is suspected

 

Especially useful when radioactive scanning isn’t possible (e.g., pregnancy).

Additional Tests (If Indicated)

a. Serum Thyroglobulin

• Can help differentiate endogenous hyperthyroidism from exogenous hormone intake
• Low or undetectable thyroglobulin suggests factitious hyperthyroidism (intentional or accidental overdose)

 

b. Pituitary MRI

• Indicated if TSH is normal or elevated despite high T4/T3 (suggests TSH-secreting pituitary adenoma)

 

c. Liver Function Tests & Calcium

• Mild elevations in liver enzymes or hypercalcemia are sometimes seen in hyperthyroid states

 

Step-by-Step Diagnostic Algorithm

1. Start with TSH and Free
2. T4↓ TSH + ↑ Free T4 = Overt hyperthyroidism
3. ↓ TSH + Normal T4/T3 = Subclinical
4. ↓ TSH + ↑ T3 (normal T4) = T3 toxicosis
5. Add T3 if needed Especially if symptoms are strong but T4 is normal
6. Check TSI/TRAb If suspecting Graves’ disease
7. RAIU + Thyroid Scan To determine the cause: Graves’, nodules, thyroiditis, or other
8. Ultrasound When scan isn’t possible or to evaluate nodules/goiter
9. Further testing Based on unique case features (e.g., MRI brain, thyroglobulin)

 

Treatment of Hyperthyroidism

The goal of hyperthyroidism treatment is to restore normal thyroid hormone levels, relieve symptoms, prevent complications, and address the underlying cause. Treatment is not one-size-fits-all; the choice of therapy depends on:

• The cause of hyperthyroidism (e.g., Graves’ disease vs. toxic nodular goiter)
• The severity of hormone excess and symptoms
• The patient’s age and overall health
• Pregnancy status
• Patient preferences

 

There are three primary approaches to treating hyperthyroidism:

1. Antithyroid medications
2. Radioactive iodine therapy
3. Surgical thyroidectomy

Additionally, beta-blockers are used to control symptoms, and supportive care is essential for managing long-term health.

1. Antithyroid Medications (Thionamides)

Antithyroid drugs inhibit the synthesis of thyroid hormones by blocking the thyroid peroxidase enzyme, which is needed to make T3 and T4. These medications are usually first-line therapy, especially in mild to moderate cases or as a bridge to more definitive treatment.

🧪 Main Drugs:

Mechanism of Action:

• Inhibits thyroid peroxidase, blocking iodine oxidation and organification
• PTU also inhibits peripheral conversion of T4 to T3

 

Duration of Use:

• Typically prescribed for 12 to 18 months
• After that, medication may be tapered or discontinued if remission is achieved (especially in Graves’ disease)

 

Side Effects:

• Minor: Rash, itching, joint pain, gastrointestinal upset
• Serious (rare):
  

  • Agranulocytosis (sudden drop in white blood cells) – life-threatening

  • Liver toxicity (more with PTU)

  • Vasculitis (rare autoimmune reaction)

Patients are instructed to report sore throat, fever, or signs of infection immediately, as they may indicate agranulocytosis.

Pros:

• Non-invasive
• May induce remission, especially in Graves’ disease
• Safe for initial symptom control

 

Cons:

• Requires regular monitoring (every 4–6 weeks)
• Risk of relapse after discontinuation (up to 50%)
• Long-term use not ideal for all patients

 

2. Radioactive Iodine Therapy (RAI)

RAI (usually with I-131) is a definitive, non-surgical treatment that gradually destroys overactive thyroid tissue. It is commonly used in Graves’ disease, toxic multinodular goiter, or toxic adenoma.

How It Works:

• Patient takes a capsule or liquid dose of radioactive iodine
• The overactive thyroid cells absorb iodine, which emits radiation and selectively destroys the tissue
• Thyroid hormone levels drop over several weeks to months

 

Treatment Timeline:

• Full effect may take 6–12 weeks
• Often leads to permanent hypothyroidism, requiring lifelong levothyroxine replacement

 

Contraindications:

• Pregnancy or breastfeeding
• Severe thyroid eye disease (RAI may worsen it)
• Patients with large goiters compressing structures (may need surgery)

 

Pros:

• High success rate (80–90%)
• One-time treatment for many
• Cost-effective

 

Cons:

• Delayed onset of effect
• Risk of permanent hypothyroidism
• Worsening of Graves’ ophthalmopathy in some cases

 

Patients should avoid close contact with young children or pregnant women for several days post-RAI due to radiation precautions.

3. Surgical Treatment – Thyroidectomy

Surgical removal of part or all of the thyroid gland (thyroidectomy) is another definitive treatment, especially in the following situations:

Indications:

• Large goiter causing compressive symptoms
• Suspicion or presence of thyroid cancer
• Graves’ disease with severe eye symptoms
• Patient preference to avoid RAI or long-term medication
• Pregnancy, when medications are not tolerated

 

Types of Surgery:

• Total thyroidectomy – entire gland removed (most common)
• Subtotal/lobectomy – part of gland removed (less common)

 

Surgical Risks:

• Hypoparathyroidism – due to accidental removal of parathyroid glands (causes low calcium)
• Vocal cord paralysis – from injury to recurrent laryngeal nerve
• Bleeding, infection, or scar formation

 

Pros:

• Rapid and definitive cure
• Preferred in patients who want immediate control
• Avoids radiation

 

Cons:

• Requires general anesthesia
• Postoperative risks
• Lifelong hormone replacement needed

 

4. Beta-Blockers (Symptom Control)

Beta-blockers are not curative but are critical for symptom relief. They block the adrenergic effects of excess thyroid hormones on the heart and nervous system.

Common Options:

• Propranolol (most common)
• Atenolol, Metoprolol (longer-acting)

 

Relieves:

• Palpitations
• Tremors
• Anxiety
• Heat intolerance
• Tachycardia

 

In thyroid storm, IV beta-blockers (e.g., propranolol) are life-saving.

Treatment Considerations in Special Populations

Pregnancy:

• PTU preferred in first trimester (lower risk of birth defects)
• Methimazole can be used in second and third trimesters
• RAI contraindicated
• Surgery only considered in second trimester if medications fail
• Close monitoring of fetal thyroid function in Graves’ disease (due to TSI crossing the placenta)

 

Elderly Patients:

• Often present with atypical symptoms (e.g., weight loss, heart failure)
• May have atrial fibrillation as the first sign
• Often start with low-dose antithyroid drugs or RAI
• Beta-blockers important for cardiac protection

 

Choosing the Right Treatment: Comparison Table

Monitoring During Treatment

Regular follow-ups are essential:

• Every 4–6 weeks during initial treatment
• Monitor TSH, Free T4, T3
• Adjust medication doses accordingly
• Watch for side effects or signs of under- or over-treatment
• Long-term follow-up for relapse or hypothyroidism

 

Living with Hyperthyroidism

Being diagnosed with hyperthyroidism can be overwhelming—especially given its wide-ranging effects on the body and mind. However, with the right treatment, self-care practices, and ongoing medical support, most people with hyperthyroidism can live full, healthy, and active lives.

“Living with hyperthyroidism” goes beyond just taking medication. It involves adapting your lifestyle, understanding your body’s signals, building a support network, and learning how to navigate the ups and downs of your condition.

Understanding Your Diagnosis

Education is one of the most powerful tools in managing any chronic illness. Knowing the cause of your hyperthyroidism (e.g., Graves’ disease vs. toxic nodular goiter) helps guide your treatment, track symptoms, and anticipate possible complications or relapses.

What you should know:

• Your thyroid hormone levels (TSH, T3, T4)
• Your treatment plan and its goals
• Whether you have any autoimmune components (e.g., Graves’ ophthalmopathy)
• Expected side effects of medications or therapies
• When and how often to have follow-up labs or imaging

 

Keep a health journal to track symptoms, medication side effects, energy levels, and questions for your doctor.

Diet and Nutrition

While no specific “thyroid diet” cures hyperthyroidism, certain dietary choices can help support thyroid function, reduce inflammation, and protect bone and heart health.

Foods to Limit or Avoid:

• Excess iodine: Seaweed (kelp), iodized salt, iodine-rich supplements can worsen hormone production in Graves’ disease
• Caffeine and stimulants: Coffee, energy drinks, and other stimulants can worsen tremors, palpitations, and anxiety
• Highly processed foods: Can contribute to inflammation and poor energy stability

 

Foods to Embrace:

• Calcium and Vitamin D-rich foods: Dairy, leafy greens, salmon – to combat bone loss
• Antioxidant-rich fruits and vegetables: Berries, tomatoes, broccoli, spinach – support immune health
• Whole grains and lean proteins: For stable energy
• Magnesium-rich foods: Nuts, seeds, legumes – helps with sleep, muscle cramps, and anxiety

 

Consider consulting a registered dietitian with experience in thyroid health.

Exercise and Physical Activity

Regular physical activity has numerous benefits for people with hyperthyroidism, including improving cardiovascular fitness, muscle strength, mood, and bone health.

Best types of exercise:

• Low-impact cardio: Walking, swimming, cycling – good for heart health without overexertion
• Strength training: Helps rebuild muscle mass lost due to high metabolism
• Yoga and tai chi: Promote relaxation, balance, and emotional calm
• Stretching: Eases muscle stiffness and improves posture

 

Avoid high-intensity workouts during active hyperthyroidism or thyroid storm risk.

Mental and Emotional Health

Hyperthyroidism has a powerful impact on mental well-being, often causing:

• Anxiety, restlessness
• Irritability or mood swings
• Difficulty concentrating
• Depression (especially post-treatment or during hypothyroid phases)

 

Strategies for emotional balance:

• Mindfulness meditation or breathing exercises – reduce sympathetic nervous system overdrive
• Cognitive-behavioral therapy (CBT) – helpful for managing anxiety and coping with chronic illness
• Support groups – talking to others who understand your journey can be incredibly validating
• Speak with a mental health professional if you’re struggling with mood, sleep, or panic

 

Sleep and Energy Management

Insomnia is a common and frustrating symptom of hyperthyroidism. Some patients feel wired, wake frequently, or suffer from a racing mind at night.

Tips for better sleep:

• Maintain a consistent sleep schedule
• Wind down with a routine (reading, warm bath, herbal tea)
• Limit screens and blue light before bedtime
• Avoid caffeine after midday
• Try calming practices like journaling or guided sleep meditations

 

Fatigue is common—even after treatment—so prioritize rest and pace your activities to avoid burnout.

Long-Term Medical Management

Hyperthyroidism requires ongoing monitoring, even after initial treatment. Many patients enter remission, but relapse is possible—especially with autoimmune causes like Graves’ disease.

Routine follow-ups may include:

• TSH, Free T4, and T3 testing every 6–12 weeks initially
• Bone density scans (if prolonged disease or post-menopausal)
• Eye exams (for Graves’ disease)
• Adjustments to levothyroxine if you become hypothyroid post-treatment

 

Medication management:

• Take antithyroid medications consistently, and at the same time each day
• Inform your doctor about side effects (especially sore throat, fever)
• Never self-adjust or stop medication without consultation

 

Fertility, Pregnancy, and Hyperthyroidism

Hyperthyroidism can affect fertility in both men and women. Women may experience irregular periods or ovulation problems, while men may notice decreased libido or sperm quality.

If you’re planning to become pregnant:

• Ensure thyroid levels are well-controlled before conception
• Discuss safe treatment options (PTU in the first trimester, methimazole after)
• Monitor TSI antibodies if you have Graves’—they can affect the fetus
• Work closely with your endocrinologist and obstetrician

 

Advocacy, Empowerment, and Support

Living with hyperthyroidism means becoming an active participant in your health. Empowerment through education, community, and advocacy leads to better outcomes and emotional resilience.

Advocate for yourself by:

• Asking questions at appointments
• Keeping a record of lab results and symptoms
• Seeking second opinions when uncertain
• Educating friends and family about your condition
• Joining online forums or local support groups

 

Helpful organizations:

• Thyroid Foundation of America
• British Thyroid Foundation
• Graves’ Disease and Thyroid Foundation
• Facebook or Reddit groups for peer support

 

Frequently Asked Questions (FAQs) About Hyperthyroidism

What causes hyperthyroidism?

Hyperthyroidism occurs when the thyroid gland produces too much thyroid hormone. The most common cause is Graves’ disease, an autoimmune disorder where the immune system mistakenly attacks the thyroid. Other causes include toxic nodular goiter (nodules in the thyroid that produce excess hormone), thyroiditis (inflammation of the thyroid), and excessive iodine intake, which can overstimulate the thyroid in sensitive individuals. In rare cases, it can also result from taking too much thyroid hormone medication.

What are the first symptoms of hyperthyroidism?

Early symptoms are often subtle and can be mistaken for stress or anxiety. Common initial signs include:

• Unexplained weight loss despite normal or increased appetite
• Rapid or irregular heartbeat (palpitations)
• Nervousness, anxiety, or irritability
• Increased sweating or intolerance to heat
• Tremors, especially in the hands
• Fatigue or muscle weakness
• Difficulty sleeping (insomnia)
• Frequent bowel movements or diarrhea
  Symptoms can develop gradually or appear suddenly, depending on the underlying cause.

 

What lifestyle causes hyperthyroidism?

While lifestyle alone doesn’t directly cause hyperthyroidism, certain habits and factors may increase the risk or worsen the condition:

• High iodine intake, especially from supplements or seaweed-based products
• Excessive stress, which can affect immune function and trigger autoimmune thyroid disease
• Smoking, particularly in those with Graves’ disease, as it increases the risk of eye complications
• Overuse of thyroid medication, which can lead to hormone imbalance
  Maintaining a balanced lifestyle with proper nutrition, stress management, and regular checkups can help support thyroid health.

 

How to fix hyperthyroidism?

Treatment for hyperthyroidism depends on the cause, severity, age, and overall health of the individual. Options include:

• Anti-thyroid medications (like methimazole or propylthiouracil) to reduce hormone production
• Radioactive iodine therapy, which destroys overactive thyroid cells gradually
• Beta-blockers to manage symptoms like rapid heartbeat and anxiety
• Thyroid surgery (thyroidectomy) in certain cases, especially for large goiters or cancer
  It’s essential to work closely with an endocrinologist to determine the best course of action and monitor hormone levels regularly.

 

Can food trigger hyperthyroidism?

Certain foods may influence thyroid function, particularly in people who are sensitive or already have a thyroid condition:

• Iodine-rich foods like seaweed, kelp, and iodized salt can overstimulate the thyroid
• Caffeine may worsen symptoms like anxiety and tremors
• Processed and sugary foods can increase inflammation and hormonal imbalance
  However, food alone typically doesn’t cause hyperthyroidism but can impact symptom severity. A diet rich in whole foods, lean proteins, and antioxidants is beneficial.

 

Can stress trigger hyperthyroidism?

Yes, chronic stress can contribute to hormonal imbalances and potentially trigger autoimmune thyroid conditions such as Graves’ disease. Stress affects the hypothalamic-pituitary-adrenal (HPA) axis, which interacts with the thyroid. While stress might not directly cause hyperthyroidism, it can worsen symptoms or increase the risk in genetically predisposed individuals. Managing stress through mindfulness, therapy, exercise, and adequate sleep is crucial.

What part of the body itches with thyroid problems?

Itching associated with thyroid issues is usually due to dry skin or changes in skin texture. Common areas affected include:

• Scalp (can lead to flakiness or dandruff)
• Legs and arms, especially the shins
• Face or neck, particularly if there is a visible goiter or inflammation
  Autoimmune thyroid diseases like Hashimoto’s or Graves’ may also trigger allergic-type skin reactions or rashes in some cases.

 

What is a thyroid belly?

“Thyroid belly” is a colloquial term often used to describe bloating or abdominal weight gain related to thyroid hormone imbalance. While more common in hypothyroidism, where metabolism slows down, people with fluctuating thyroid levels (including those being treated for hyperthyroidism) may experience this. Symptoms may include:

• A puffy appearance around the abdomen
• Digestive discomfort or bloating
• Water retention or swelling
  It’s not a medically recognized term but is often used to describe how thyroid issues affect body composition.

 

How does a person with hyperthyroidism act?

People with hyperthyroidism may appear:

• Hyperactive or restless
• Anxious, irritable, or moody
• Unable to concentrate or focus
• Impatient and easily frustrated
  These behaviors are linked to the increased metabolism and overstimulation of the nervous system caused by excess thyroid hormone. In some cases, it can even mimic symptoms of bipolar disorder or ADHD.

 

How to check thyroid at home?

There are a few at-home methods to monitor thyroid health:

• Neck self-exam: Look in the mirror and tilt your head back. Swallow a sip of water and watch for any lumps or asymmetry in the neck (below the Adam’s apple).
• At-home thyroid test kits: These involve a finger-prick blood sample to measure TSH, T3, and T4 levels, and sometimes thyroid antibodies.
• Monitoring symptoms: Keeping track of changes in energy, weight, mood, and skin/hair can also offer insight into possible thyroid issues.
  However, diagnosis and interpretation should always be confirmed by a healthcare provider.

 

What are the 20 signs of thyroid problems?

Here are 20 potential signs that may indicate a thyroid issue (hyperthyroidism or hypothyroidism):

1. Fatigue
2. Weight gain or loss
3. Anxiety or depression
4. Irritability
5. Hair thinning or hair loss
6. Dry skin
7. Constipation or frequent bowel movements
8. Irregular or heavy periods
9. Sensitivity to cold or heat
10. Brain fog or memory problems
11. Swelling in the neck (goiter)
12. Hoarseness
13. Muscle weakness
14. Slow or fast heart rate
15. Sleep disturbances
16. Brittle nails
17. Puffy face
18. Eye problems (bulging eyes in Graves’ disease)
19. Hand tremors
20. Slowed reflexes or restlessness
    These symptoms vary depending on whether the thyroid is overactive or underactive.

 

Can you live long with hyperthyroidism?

Yes, many people with hyperthyroidism live long, healthy lives, especially with early diagnosis and proper management. If left untreated, however, it can lead to complications such as:

• Heart problems, including atrial fibrillation
• Osteoporosis, due to calcium loss from bones
• Thyroid storm, a rare but life-threatening condition
  With regular medical follow-ups, appropriate treatment, and lifestyle adjustments, the outlook is excellent.