What are the Causes and Treatment Options for Hyperthyroidism

hyperthyroidism causes and treatment
Medically reviewed by Dr. Ola Tarabzuni


Hyperthyroidism is a medical condition in which the thyroid gland produces too much thyroid hormone. Hyperthyroidism itself does not typically lead to death if adequately treated. However, if left untreated or if there are complications from the condition, it can lead to serious health problems that may increase the risk of death. The estimated prevalence of hyperthyroidism is around 1.3%. However, the prevalence rate may be higher in specific populations. For example, hyperthyroidism is more common in women than men. Hence, if you want to know about the causes, symptoms and treatments of this disease, read this article till the end.

What is Hyperthyroidism?

An overactive thyroid, also called hyperthyroidism or thyrotoxicosis, is a thyroid gland that produces high levels of thyroid hormones. It is a small butterfly-shaped gland in front of the neck. The thyroid gland produces hormones such as thyroxine (T4) and triiodothyronine (T3), which play an essential role in how your entire body functions, including:

  • Controlling the heart rate
  • Regulating body temperature 
  • Controlling the metabolism

For this reason, if there is an imbalance such as high T4, it can have severe effects on your health.

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Causes of Hyperthyroidism

  1. Graves’ disease:

In this disease, the body’s immune system mistakenly attacks the thyroid gland, which causes it to overproduce thyroid hormone.

  1. Thyroid nodules:

Thyroid nodules are unusual fluid-filled lumps within the thyroid gland, located at the base of the neck, just above your collarbone. These nodules can produce excess thyroid hormone.

  1. Thyroiditis:

It is an inflammation of your thyroid gland, which can sometimes be painful or painless. It causes an imbalance of thyroid hormones in the blood. It may also happen within a year of delivering a baby. 

  1. Consuming excess iodine:

Iodine is a mineral that is essential to create thyroid hormones. If you’re at risk for hyperthyroidism, consuming too much iodine can cause your thyroid to overproduce thyroid hormone. Methimazole (Tapazole), a medication with a high amount of iodine, may also cause hyperthyroidism. 

  1. Pituitary gland disorders: 

Rarely, hyperthyroidism can be caused by a pituitary gland disorder that causes the gland to produce too much thyroid-stimulating hormone (TSH), which in turn stimulates the thyroid gland to produce excessive thyroid hormone.

Types of Hyperthyroidism

Graves’ disease: 

It is an immune system disorder that results in the excess production of thyroid hormones. It is a hereditary condition and is more common in women than men at birth. Furthermore, it accounts for about 60-80% of all cases of hyperthyroidism.

Symptoms of Graves’ disease include the following:

  • Goiter
  • Bulging eyes 
  • Thickened skin
  • fast heartbeat
  • anxiety
  • loss of appetite 

Toxic nodular goiter:

It involves an enlarged thyroid gland with small masses known as nodules that overproduce thyroid hormone. It is also known as Plummer’s disease.  


  • weight loss
  • increased appetite
  • restlessness
  • heat intolerance
  • fatigue
  • muscle cramps
  • frequent bowel movements
  • menstrual irregularities


This is inflammation of the thyroid gland that can cause it to leak thyroid hormone into the bloodstream. There are several types of thyroiditis, such as Hashimoto’s thyroiditis, subacute thyroiditis, and silent thyroiditis.

Symptoms of thyroiditis include:

  • High fever 
  • Rapid heart rate (tachycardia)
  • Feeling agitated or anxious.
  • Delirium.
  • Increased sweating and sensitivity to heat.
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Symptoms of Hyperthyroidism

Many symptoms of hyperthyroidism may develop gradually or suddenly. They’re mild in some people but can be severe in others.

Common Symptoms

Some common symptoms of hyperthyroidism may include the following:

  • nervousness and anxiety 
  • hyperactivity 
  • mood swings
  • difficulty while sleeping
  • heat sensitivity 
  • muscle weakness
  • persistent thirst
  • itchiness
  • loss of appetite 

Rare Symptoms:

Rare symptoms of an overactive thyroid are the following:

  • palpitations
  • twitching or trembling
  • swelling in the neck
  • tremor
  • excessive sweating
  • red palms of your hands
  • a raised, itchy rash called hives (urticaria)
  • patchy hair loss
  • loss of weight
  • eye problems such as redness or vision problems
  • diarrhoea

Hyperthyroidism vs Hypothyroidism

Hyperthyroidism and hypothyroidism are medical conditions that are related to hormone levels. Hyperthyroidism is an overactive thyroid that overproduces thyroid hormone, whereas hypothyroidism is an underactive thyroid that does not produce enough thyroid hormone. Hypothyroidism is more common than hyperthyroidism. These two conditions usually have different signs and symptoms, but sometimes, the symptoms can overlap. For example, irregular growth of the thyroid gland, known as a goitre, can happen in both types of thyroid disease.

Some common symptoms of hyperthyroidism include the following:

  • Hand tremor
  • Weight loss
  • Nervousness
  • Anxiety
  • Fast heart rate
  • Brittle skin
  • Muscle weakness

Common symptoms of hypothyroidism are following

  • Constipation
  • Fatigue
  • Cold intolerance
  • Weight gain
  • Dry skin
  • Forgetfulness

Many factors can lead to the development of these conditions, including autoimmune disorders, thyroid nodules, thyroiditis, iodine deficiency or excess, and certain medications. Treatment options for hyperthyroidism may include medications, radioactive iodine therapy, or surgery to remove the thyroid gland. In contrast, treatment options for hypothyroidism usually involve lifelong thyroid hormone replacement tablets or therapy.

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Diagnosis of Hyperthyroidism

Your doctor can diagnose hyperthyroidism in different ways, including:

  • Physical examination of your neck to see if your thyroid is more extensive than usual.
  • Blood tests check the levels of thyroid hormone in your body.
  • Imaging tests.

Physical exam 

If you experience any symptoms of hyperthyroidism, your healthcare provider may check the following:

  • Your thyroid: Your doctor may gently feel your thyroid by touching the outside of the neck to check if it’s bumpy or enlarged.
  • Your eyes: Your doctor may examine your eyes to look for signs of thyroid eye disease (ted).
  • Your heart: Your doctor may use a stethoscope to check if the heartbeat is rapid or irregular.
  • Your hands: Your doctor may ask you to stretch your hands to check whether you have a tremor. 

Blood tests for diagnosing hyperthyroidism

An examination of your blood may be conducted to look for high thyroid hormone levels. Tests may include:

  • Thyroid-stimulating hormone (TSH) test
  • Free thyroxine (T4) test
  • Total triiodothyronine (T3) test
  • Thyroid receptor antibodies (TRAb) test
  • Thyroid peroxidase antibody (TPOAb) test

Imaging Tests for diagnosing hyperthyroidism

A closer look at the thyroid can help your doctor diagnose hyperthyroidism and its possible cause. Imaging tests your doctor could use to check your thyroid include the following:

  • Radioactive iodine uptake (RAIU) test: You will be given a small dose of radiotracer to swallow. A tiny amount of radioactive iodine is given orally to the patient during this test. Then, this amount of radioactive iodine taken up by the thyroid gland is measured using a special scanner. If your thyroid has absorbed lots of radioactive iodine, your thyroid gland is overproducing thyroxine (T4). If this is the case, you are likely to have Graves’ disorder or thyroid nodules.
  • Thyroid ultrasound: Ultrasound is a painless method of creating images of your thyroid using high-frequency sound waves. It’s a non-intrusive procedure that allows your doctor to see your thyroid on a computer screen. Your doctor may use this test to look for nodules on your thyroid.
  • Thyroid scan: You take a small dose of radiotracers in liquid or capsule form in this procedure. To measure the thyroid’s absorbed amount of radioactivity, you will lie on an examination table with your head tilted back. A gamma camera will take several images of your thyroid to provide information about your thyroid’s size, shape, position, and function. Depending on the amount of radioactive material, certain parts of your thyroid may appear “bright” on a computer screen. You may undergo a thyroid scan if your doctor suspects you have thyroid cancer, inflammation, goitre, or swelling.

Treatment of Hyperthyroidism

There are many treatments for hyperthyroidism, depending on its cause. Your doctor will determine the treatment plan that is best for you.

  • Antithyroid drugs: methimazole (Tapazole) or propylthiouracil (PTU) are the drugs that block the ability of your thyroid to produce hormones. These drugs offer quick control of your thyroid.
  • Surgery: Your doctor may remove your thyroid gland through a thyroidectomy. This will correct your hyperthyroidism but may cause underactive thyroid (hypothyroidism), requiring lifelong thyroid supplements to keep hormone levels balanced.
  • Radioactive iodine: This treatment involves taking a small amount of radioactive iodine, which is absorbed by the thyroid gland and destroys the overactive thyroid cells. This treatment is usually done as a one-time dose and may take several weeks to months to work. 

Living with Hyperthyroidism

People with hyperthyroidism generally have a good quality of life, with no particular restrictions regarding their diet, exercise, work or sexual activity. 

Your doctor may recommend avoiding challenging physical exercise during the active symptomatic phase of hyperthyroidism. Medical treatment of hyperthyroidism is usually very well tolerated and does not limit daily activities. 

If your hyperthyroidism requires iodine treatment, you must continue to follow the guidelines indicated by the doctor, such as: 

  • Avoiding public transport
  • Keeping yourself hydrated
  • Avoiding contact with children or pregnant women
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Diet to control hyperthyroidism

People with hyperthyroidism should eat food that includes plenty of fruits and green vegetables, dairy products with low fat, whole grains, protein sources, and unsaturated fats to promote thyroid health

The best diet for hyperthyroidism includes the following:

  1. fermented foods
  2. leafy greens such as spinach
  3. fresh fruit
  4. olive oil
  5. lean meats and liver
  6. brazil nuts

Avoid food that is rich in iodine because it may worsen the condition.

Risk factors 

Some common factors that could increase the risk of developing hyperthyroidism are the following:

  • Genetic factors
  • A medical history includes pernicious anaemia, Type 1 diabetes and Addison’s disease.
  • Excess of iodine in your diet.
  • Pregnancy

Complications in hyperthyroidism:

Untreated, hyperthyroidism can cause severe health issues, including:

  • a rapid heartbeat that can lead to blood stroke, heart failure, and other heart-related issues
  • thinning bones, osteoporosis 
  • muscle problems
  • periods and fertility issues
  • atrial fibrillation 
  • delirium 

Pregnancy issues

 If you have hyperthyroidism during pregnancy, then it can increase the risk of the following:

  • pre-eclampsia
  • miscarriage
  • premature labour and birth
  • low birth weight of the baby

Treatment for hyperthyroidism during pregnancy may include medications such as propylthiouracil, which can help control thyroid hormone levels.

Underactive thyroid

Treatment for hyperthyroidism often results in highly decreased hormone levels, also known as underactive thyroid (hypothyroidism).

Some common symptoms of an underactive thyroid may include the following:

  • sensitivity to cold
  • tiredness
  • weight gain
  • constipation 
  • depression 

Eye problems

The most common eye problem associated with hyperthyroidism is called Graves’ ophthalmopathy, which can cause a range of eye symptoms, including:

  • eyes feeling dry and gritty
  • sensitivity to light
  • watering eyes
  • blurred or double vision 
  • red eyes
  • swollen or pulled-back eyelids
  • bulged eyes

It’s essential for people with hyperthyroidism to have regular eye exams to monitor for any eye problems, especially if they have Graves’ disease. Treatment for Graves’ ophthalmopathy may include medications to reduce inflammation, radiation therapy, or surgery in severe cases.

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As a result of hyperthyroidism, the thyroid gland produces excessive thyroid hormones, leading to weight loss, increased appetite, nervousness, sweating, and rapid heartbeats. If treated on time, this condition can be managed. While hyperthyroidism can cause significant health complications, it is usually treatable, and most people with the disorder can live a normal, healthy life. Hyperthyroidism can be prevented or alleviated by early diagnosis, improving quality of life, and reducing the risk of severe complications. In order to receive an accurate diagnosis and appropriate treatment, people with symptoms of hyperthyroidism should seek medical attention promptly.

FAQs about Hyperthyroidism Answered by Your Doctors Online Team

What are the signs if your thyroid medication is too high?

A high dose of hyperthyroidism medication can trigger symptoms like jitters, anxiety, weight loss, diarrhoea and mood swings. You may also feel restless and low on energy. Heart palpitation is another common sign.

What does thyroid hormone do?

It is a hormone that controls the body’s metabolism, growth and development of the human body. It regulates body weight, energy levels, internal temperature, skin, hair and nail growth.

Can thyroid cause dizziness and balance problems?

Yes. Dizziness and imbalance issues are symptoms of thyroid problems. Your postural stability is affected in cases of hyperthyroidism.

What does the thyroid gland control?

The thyroid controls metabolism with a few specific hormones, which are T4 (thyroxine) and T3 (triiodothyronine). These hormones are crucial in regulating the body’s metabolism, growth, and development. The thyroid creates these two hormones and tells the body’s cells how much energy to use.

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