Hyperthyroidism: Causes, Symptoms, and Treatment Options

Hyperthyroidism is a concerning health issue impacting millions all over the world, and has a notable prevalence in India. According to recent studies, approximately 12 percent of the Indian population suffers from thyroid disorders, with hyperthyroidism constituting a substantial portion of these cases. Though the cases of hyperthyroidism are increasing, there is still a lack of awareness about this disorder and how to deal with it. To help address the gap, in this article, we delve into all critical aspects of hyperthyroidism, providing insights into its symptoms, causes, diagnosis, and treatment options, along with some easy to follow preventive measures. Let’s begin with understanding the disorder. 

What is Hyperthyroidism?

Hyperthyroidism is a condition in which the thyroid gland starts overproducing thyroid hormones. These hormones, primarily thyroxine (T4) and triiodothyronine (T3), play a crucial role in regulating the body's metabolism. A surplus of these hormones results in an accelerated metabolism, which can cause a variety of symptoms and health issues that may affect multiple systems in the body. 

What is the Difference between Hyperthyroidism and Hypothyroidism?

Simply put, hyperthyroidism is the opposite of hypothyroidism. In hyperthyroidism, the thyroid glands overproduce thyroid hormones, whereas in hypothyroidism, the thyroid gland produces too little thyroid hormones, which slows down the metabolism, leading to issues such as weight gain, fatigue, and depression.

What causes Hyperthyroidism?

Hyperthyroidism can be caused by several conditions and factors, including:

• Graves' disease: An autoimmune disorder and the most common cause of hyperthyroidism, where the immune system attacks the thyroid, causing it to produce too much hormone.
• Thyroid nodules: Lumps in the thyroid gland that can become overactive and produce excessive thyroid hormones.
• Thyroiditis: Inflammation of the thyroid gland, which can cause the gland to release stored thyroid hormone into the bloodstream.
• Excessive iodine intake: Consuming too much iodine through diet or medications can lead to overproduction of thyroid hormones.
• Pituitary adenomas:Pituitary adenomas is rare, benign tumours of the pituitary gland that can stimulate the thyroid to produce more hormones.
• Medications: Certain drugs, such as those used to treat heart conditions, can sometimes cause hyperthyroidism as a side effect.

What are the Symptoms of Hyperthyroidism?

Hyperthyroidism can cause a wide range of symptoms due to the overproduction of thyroid hormones, which accelerate the body's metabolism. Common symptoms include:

• Rapid heartbeat: A high-speed pulse, often over 100 beats per minute.
• Weight loss: Unintentional weight loss despite an increased appetite.
• Increased appetite: Feeling hungry more often and eating more than usual.
• Nervousness and anxiety: Feeling jittery, anxious, or irritable.
• Tremors: Shaking hands or fingers.
• Sweating: Excessive sweating and sensitivity to heat.
• Changes in menstrual patterns: Lighter, less frequent periods or irregular cycles.
• Fatigue: Persistent tiredness or muscle weakness.
• Goiter: Goiter is an enlarged thyroid gland, often appearing as a noticeable swelling on the neck.
• Sleep disturbances: Difficulty sleeping or insomnia.
• Hair and skin changes: Thinning hair and brittle skin.
• Exophthalmos: Bulging eyes, particularly associated with Graves' disease.

Note: These symptoms can vary in severity and may develop gradually. If you experience any of these symptoms, it is important to consult a healthcare provider for proper diagnosis and treatment.

How is Hyperthyroidism Diagnosed?

Diagnosing hyperthyroidism involves a combination of medical history, physical examination, and specific tests. Here are the primary methods used:

• Medical history and physical examination:
• The doctor will review your symptoms and medical history and conduct a physical exam to check for signs, such as an enlarged thyroid gland (goitre), rapid heartbeat, tremors, and bulging eyes.
• Blood tests:
• Thyroid-Stimulating Hormone (TSH) test: Low levels of TSH indicate hyperthyroidism.
• Free Thyroxine (T4) and Triiodothyronine (T3) tests: Elevated levels of these thyroid hormones confirm hyperthyroidism.
• Radioactive iodine uptake test:
• This test measures the amount of iodine the thyroid gland absorbs from the blood. High uptake suggests that the thyroid gland is producing too much hormone.
• Thyroid scan:
• A small amount of radioactive iodine is taken orally or injected, and a scan shows how much iodine the thyroid absorbs and helps identify the cause of hyperthyroidism.
• Ultrasound:
• An ultrasound of the thyroid can help detect nodules or inflammation.
• Antibody tests:
• Tests for specific antibodies can help diagnose autoimmune hyperthyroidism, such as Graves' disease.

These diagnostic tools help healthcare providers determine the presence and cause of hyperthyroidism, guiding appropriate treatment.

What are the Complications of Hyperthyroidism?

Hyperthyroidism, if left untreated or inadequately managed, can lead to several serious complications:

• Heart problems: These include rapid heart rate, atrial fibrillation (an irregular, often rapid heart rhythm), and congestive heart failure.
• Osteoporosis: Hyperthyroidism can lead to weakened bones due to excessive calcium loss, increasing the risk of fractures.
• Eye problems: Particularly with Graves' disease, symptoms can worsen, leading to severe eye pain, double vision, and even vision loss.
• Thyrotoxic crisis (Thyroid storm): A sudden and severe intensification of symptoms, such as high fever, rapid heart rate, and delirium, requiring emergency medical treatment.
• Skin changes: Thick, red skin usually on the shins and tops of the feet, known as pretibial myxedema.
• Pregnancy complications: Untreated hyperthyroidism can lead to premature birth, low birth weight, preeclampsia, and miscarriage.
• Mental health issues: Increased risk of anxiety, mood swings, and in severe cases, depression and cognitive impairment.

Proper management and treatment are essential to prevent these complications and maintain overall health.

How is Hyperthyroidism Treated?

The choice of treatment for hyperthyroidism depends on the underlying cause, the severity of the condition, the patient's age, and overall health. Here are the primary treatment options:

• Antithyroid drugs: Medications like methimazole (Tapazole) and propylthiouracil (PTU) help reduce thyroid hormone production. These drugs are often used for long-term management or as a short-term solution before other treatments.
• Radioactive iodine: This treatment involves taking radioactive iodine orally, which is absorbed by the thyroid gland. The radiation destroys overactive thyroid cells, reducing hormone production. This method is highly effective but may lead to hypothyroidism, requiring lifelong thyroid hormone replacement.
• Surgery: Thyroidectomy, or surgical removal of the thyroid gland, is considered for patients who do not respond to other treatments or have large goitres causing symptoms. Post-surgery, patients usually need lifelong thyroid hormone replacement therapy.
• Beta blockers: While they do not reduce thyroid hormone levels, beta blockers such as propranolol could be prescribed to help manage associated symptoms such as rapid heart rate, tremors, and anxiety, by blocking the effects of thyroid hormones on the body.

Choosing the appropriate treatment involves a thorough discussion with a healthcare provider to consider the benefits, risks, and individual patient needs.

How to prevent hyperthyroidism?

Preventing hyperthyroidism can be challenging, especially when it is caused by autoimmune conditions like Graves' disease. However, there are general steps that can help reduce the risk or manage potential triggers:

• Monitor iodine intake: Excessive iodine can trigger hyperthyroidism in susceptible individuals. Be cautious with iodine supplements and high-iodine foods, particularly if you have a history of thyroid issues.
• Regular check-ups: Regular thyroid function tests can help detect any abnormalities early, especially if you have a family history of thyroid disorders.
• Manage stress: Chronic stress can impact thyroid function. Engage in stress-reducing activities like yoga, meditation, and regular exercise.
• Avoid smoking: Smoking is linked to increased risk of thyroid disease, including Graves' disease. Avoid smoking to reduce your risk.

Dietary recommendations for hyperthyroidism

In addition to the aforementioned, diet can play a role in managing hyperthyroidism symptoms and supporting overall thyroid health. Here are some dietary recommendations for hyperthyroidism:

• Low-iodine foods: Limit foods high in iodine such as seaweed, iodized salt, and certain seafood. Opt for low-iodine alternatives.
• Cruciferous vegetables: Foods like broccoli, cauliflower, kale, and cabbage can help reduce thyroid hormone production. However, they should be consumed in moderation as part of a balanced diet.
• High-calcium foods: Hyperthyroidism can lead to weakened bones. Include calcium-rich foods like dairy products, almonds, and leafy green vegetables to support bone health.
• Vitamin D: Ensure adequate vitamin D intake to support calcium absorption and bone health. Spend time in sunlight and consider vitamin D supplements if needed.
• Antioxidant-rich foods: Fruits and vegetables high in antioxidants, such as berries, tomatoes, and bell peppers, can help reduce inflammation and support overall health.
• Lean proteins: Include lean protein sources such as chicken, turkey, beans, and legumes to maintain muscle mass and overall strength.
• Avoid caffeine: Caffeine can exacerbate symptoms like nervousness and rapid heartbeat. Limit intake of coffee, tea, and other caffeinated beverages.
• Stay hydrated: Drink plenty of water to stay hydrated and support metabolic processes.

A balanced diet, regular monitoring, and stress management can help in managing hyperthyroidism effectively. Always consult with a healthcare provider or a nutritionist for personalised dietary advice and treatment plans.

When should I see my Healthcare Provider?

It is important to consult your healthcare provider if you experience any of the following signs or symptoms, as they may indicate hyperthyroidism or other thyroid-related issues:

• Persistent symptoms: If you experience symptoms such as rapid heartbeat, unexplained weight loss, increased appetite, nervousness, anxiety, tremors, excessive sweating, or difficulty sleeping that persist over time.
• Eye problems: If you notice bulging eyes, redness, irritation, or vision changes, particularly if you have been diagnosed with Graves' disease.
• Thyroid enlargement: If you detect swelling at the base of your neck, which could indicate an enlarged thyroid gland (goitre).
• Menstrual changes: If you experience irregular menstrual cycles or changes in menstrual flow.
• Unusual fatigue: If you feel excessively tired or weak without a clear reason.
• Heat intolerance: If you have difficulty tolerating heat or excessive sweating.
• Muscle weakness: If you notice persistent muscle weakness, especially in the upper arms and thighs.
• Heart issues: If you experience palpitations, chest pain, or shortness of breath.
• Family history: If you have a family history of thyroid disease and are experiencing any related symptoms.

Additionally, regular check-ups are advisable if you have:

• Pre-existing conditions: Conditions like autoimmune diseases, which can increase your risk of thyroid disorders.
• Thyroid medication: If you are currently taking medication for thyroid issues, regular monitoring is essential to ensure the treatment is effective and to adjust dosages as needed.

Early detection and treatment of hyperthyroidism can prevent complications and improve quality of life. If you experience any of the above symptoms or have concerns about your thyroid health, make an appointment with your healthcare provider for a thorough evaluation.

Final words

Recognizing and managing hyperthyroidism is crucial for maintaining overall health and preventing serious complications. If you experience symptoms or have risk factors for hyperthyroidism, seeking professional medical advice is essential. Max Hospitals offer comprehensive care with specialists experienced in diagnosing and treating thyroid disorders. Consulting a specialist at Max Hospitals ensures you receive personalised, expert care tailored to your specific needs, helping you achieve optimal health and well-being.