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Alright, just to recap. Over the past few days I have talked about the function of the thyroid and the problems of hypothyroidism. Now, let’s switch gears! What happens when you have hyperthyroidism, or over active thyroid? What are the symptoms associated with it and how is it treated?

What Is Hyperthyroidism?

Simply put, hyperthyroidism is an overactive thyroid. Your TSH is low, because there is already too much thyroid hormone circulating – so the thyroid stimulating hormone is turned OFF. The causes of hyperthyroidism may be the result of taking too high a dose of synthroid for hypothyroidism or an actual overactive thyroid. Hyperthyroidism can significantly accelerate your body’s metabolism. While that may sound like a good thing, it can actually cause heart enlargement, heart dysrhythmias, and many other health problems.

Symptoms of Hyperthyroidism

It can also cause a wide variety of signs and symptoms, including:

  • Sudden weight loss, even when your appetite and diet remain normal or even increase
  • Rapid heartbeat (tachycardia) — commonly more than 100 beats a minute — irregular heartbeat (arrhythmia) or pounding of your heart (palpitations)
  • Increased appetite
  • Nervousness, anxiety and irritability
  • Tremor — usually a fine trembling in your hands and fingers
  • Sweating
  • Changes in menstrual patterns
  • Increased sensitivity to heat
  • Changes in bowel patterns, especially more frequent bowel movements
  • An enlarged thyroid gland (goiter), which may appear as a swelling at the base of your neck
  • Fatigue, muscle weakness
  • Difficulty sleeping

Complications of Hyperthyroidism:

Hyperthyroidism can lead to a number of complications:

  • Heart problems. Some of the most serious complications of hyperthyroidism involve the heart. These include a rapid heart rate, a heart rhythm disorder called atrial fibrillation and congestive heart failure — a condition in which your heart can’t circulate enough blood to meet your body’s needs. These complications are generally reversible with appropriate treatment.
  • Brittle bones. Untreated hyperthyroidism can also lead to weak, brittle bones (osteoporosis). The strength of your bones depends, in part, on the amount of calcium and other minerals they contain. Too much thyroid hormone interferes with your body’s ability to incorporate calcium into your bones.
  • Eye problems. People with Graves’ ophthalmopathy develop eye problems, including bulging, red or swollen eyes, sensitivity to light, and blurring or double vision.
  • Red, swollen skin. In rare cases, people with Graves’ disease develop Graves’ dermopathy, which affects the skin, causing redness and swelling, often on the shins and feet.
  • Thyrotoxic crisis. Hyperthyroidism also places you at risk of thyrotoxic crisis — a sudden intensification of your symptoms, leading to a fever, a rapid pulse and even delirium. If this occurs, seek immediate medical care.

While the thought of rapid weight loss sounds like a good thing, hyperthyroidism can actually lead to significant changes in your features.

It’s really not worth the rapid weight loss, is it?

How Is Hyperthyroidism Diagnosed?

Diagnosis of hyperthyroidism is based on your symptoms and the results of blood tests that measure the level of TSH and sometimes the level of the thyroid hormone, thyroxine. A low level of thyroxine and high level of TSH indicate an underactive thyroid. That’s because your pituitary produces more TSH in an effort to stimulate your thyroid gland into producing more thyroid hormone.

After a physical examination, it may also be helpful to have a thyroid ultrasound. The thyroid ultrasound will show any changes that could be related to cyst, inflammation or cancer. Depending on the outcome of that test, a thyroid biopsy may be recommended. Please know: this is usually not needed, but could be recommended. Also, most people do not present with the above facial features – those can occur over time when this condition is left untreated.

Another possible test might be a radioactive iodine uptake test. For this test, you take a small, oral dose of radioactive iodine (radioiodine). Over time, the iodine collects in your thyroid gland because your thyroid uses iodine to manufacture hormones. You’ll be checked after two, six or 24 hours — and sometimes after all three time periods — to determine how much iodine your thyroid gland has absorbed.

Treatment of Hyperthyroidism

  • Radioactive iodine. Taken by mouth, radioactive iodine is absorbed by your thyroid gland, where it causes the gland to shrink and symptoms to subside, usually within three to six months. Because this treatment causes thyroid activity to slow considerably, 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 propylthiouracil and methimazole (Tapazole). Symptoms usually begin to improve in six to 12 weeks, but treatment with anti-thyroid medications typically continues at least a year and often longer.
  • Beta blockers. These drugs are commonly used to treat high blood pressure. They won’t reduce your thyroid levels, but they can reduce a rapid heart rate and help prevent palpitations. For that reason, your doctor may prescribe them until your thyroid levels are closer to normal.
  • Surgery (thyroidectomy). If you can’t tolerate anti-thyroid drugs and don’t want to have radioactive iodine therapy, you may be a candidate for thyroid surgery, although this is an option in only a few cases. After removal of the thyroid, you will require lifelong synthroid treatment to replace the hormones made by the thyroid.

If you are experiencing any of the symptoms mentioned it is very easy to see your healthcare provider and have blood drawn. Especially in women, a TSH is becoming a common screening lab at your yearly physical. Ask your health care provider if one has been drawn on you. You owe it to yourself!

I would love to hear about your thyroid stories. Have you been diagnosed with thyroid cancer, hypothyroidism or hyperthyroidism? I would love for you to leave a comment!

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