Hyperthyroidism (Overactive Thyroid)
Hyperthyroidism is when your thyroid — the butterfly-shaped gland at the bottom of your neck, just above your collarbone — makes too much of a hormone called thyroxine.
Your thyroid controls things how fast your heart beats and how quickly you burn calories. It releases hormones to control your metabolism (all the things your body does to turn food into energy and keep you going).
Hyperthyroidism, also known as overactive thyroid, can speed up your metabolism and cause unpleasant symptoms.
Common signs include:
If you’re an older adult, you’re more ly to have subtle symptoms a faster heart rate or being more sensitive to warm temperatures. Or you could just feel more tired after everyday activities.
Certain medicines can mask the signs of hyperthyroidism. If you take beta-blockers to treat high blood pressure or another condition, you might not know you have it. Be sure your doctor knows about all the medications you take.
When you first get hyperthyroidism, you may feel energetic. This is because your metabolism is sped up. But over time, this increase in your metabolism can break your body down and cause you to feel tired.
Usually, hyperthyroidism develops slowly. If you’re young when you get it, the symptoms might come on suddenly.
Several conditions can cause hyperthyroidism.
- Graves’ disease. This immune system disorder is the most common cause of hyperthyroidism. It’s more ly to affect women under the age of 40.
- Thyroid nodules. These lumps of tissue in your thyroid can become overactive, creating too much thyroid hormone.
- Thyroiditis. An infection or an immune system problem can cause your thyroid to swell and leak hormones. This is often followed by hypothyroidism, in which your thyroid doesn’t make enough hormones. These conditions are usually temporary.
You can also get hyperthyroidism if you get lots of iodine in your diet ( in a medication or supplement) or from taking too much thyroid hormone medication.
About 30% of people with Graves’ disease get a condition called Graves’ ophthalmopathy. It involves your vision and eyes, including the muscles and tissues around them. Symptoms include:
- Bulging eyes
- A gritty feeling, pain, or pressure in your eyes
- Redness or inflammation in or around your eyes
- Eyelids that are puffy or pulled back
- Sensitivity to light
- Double vision or loss of vision
People with Graves’ disease may also get a rare condition called Graves’ dermopathy. It can cause redness and thickening of your skin, usually on the tops of your feet or your shins.
Your doctor will ask about your medical history and look for symptoms including a swollen thyroid, a fast pulse, moist skin, and shaking in your hands or fingers. They’ll give you tests that might include:
- Thyroid panel. This blood test measures levels of thyroid hormones and thyroid-stimulating hormone (TSH).
- Thyroid scan. A technician injects a small amount of radioactive iodine into your bloodstream. Your thyroid absorbs it, and a special camera takes pictures of the gland to look for nodules or other signs of problems.
- Ultrasound. A technician runs a device called a transducer over your neck. It uses sound waves to create images of your thyroid.
- Radioactive iodine uptake test. You swallow a small amount of radioactive iodine. A device called a gamma probe measures how much of the iodine collects in your thyroid. If this uptake is high, you probably have Graves’ disease or thyroid nodules.
Your doctor will help you decide on a treatment your age, your overall health, the kind of hyperthyroidism you have, and how severe it is. Your options might include:
- Antithyroid drugs. Methimazole (Tapazole) and propylthiouracil (PTU) block your thyroid from making too many hormones. Side effects include allergic reactions rash or itching. It’s rare, but these drugs can also cause your body to make fewer white blood cells. This makes you more ly to get infections. Rarely, these medicines can damage your liver, so call your doctor right away if you have symptoms yellow skin or eyes, fatigue, or pain in your belly.
- Beta-blockers. These medications don’t treat your levels of thyroid hormone but can help with symptoms anxiety, shaking, or a fast heartbeat.
- Radioactive iodine. You swallow a small amount of radioactive iodine. Overactive thyroid cells absorb it, and it destroys them. This makes your thyroid shrink and your levels of thyroid hormone go down. You might need to have this treatment more than once. It may also cause hypothyroidism. This is easier to treat than hyperthyroidism: You’ll take a hormone supplement once a day.
- Surgery. If medications aren’t a good option for you, your doctor may remove all or part of your thyroid. This is called thyroidectomy. You might need to take antithyroid medicines before the surgery to prevent complications. Afterward, you might have hypothyroidism and need to take a hormone supplement.
Mayo Clinic: “Hyperthyroidism (overactive thyroid),” “Graves' disease.”
American Thyroid Association: “Hyperthyroidism (Overactive).”
National Institute of Diabetes and Digestive and Kidney Diseases: “Hyperthyroidism (Overactive Thyroid),” “Thyroid Tests.”
Merck Manual Consumer Version: “Hyperthyroidism (Thyrotoxicosis).”
Cleveland Clinic: “Hyperthyroidism.”
Johns Hopkins Medicine: “Hyperthyroidism.”
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4 Steps You Can Take to Avoid Thyroid Problems
If you don't have a thyroid problem, you probably don't spend a lot of time thinking about that butterfly-shaped gland in your neck, which helps regulate metabolism and body temperature (among other things). But thyroid disorders are pretty common—some experts believe 30% of women will develop one in their lifetime.
An autoimmune disorder can throw your gland whack, but it's thought that lifestyle factors ( stress or diet) also can play a role. Hyperthyroidism (aka an overactive thyroid) can cause rapid weight loss, an unusually fast heartbeat, and anxiety; while hypothyroidism (an underactive thyroid) can trigger constipation, weight gain, and extreme fatigue.
If you suspect you have a thyroid problem, consult your doctor about potential treatment options. But in addition to medical treatment, there are a few lifestyle changes that can help keep your thyroid on track. We spoke to Ashita Gupta, MD, an integrative endocrinologist at Mount Sinai West in New York City, about how to maintain a healthy thyroid. Here, her four big recommendations.
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One of the most important things you can do to maintain a healthy thyroid is eat a well-balanced diet.
“Seventy percent of our autoimmune system is found in our intestines, known as GALT, or gut-associated lymphoid tissue,” Dr. Gupta explains.
“When the intestinal lining becomes inflamed, it can trigger an immune response. Studies show that this plays a role in the development of thyroid disease.”
To help keep inflammation in check, Dr. Gupta recommends following a Mediterranean diet.
She suggests aiming for four to five servings of vegetables and three to four servings of fruit each day, along with plenty of lean proteins and fatty fish, such as salmon, herring, anchovies, and mackerel. For other healthy fats, Dr.
Gupta s extra-virgin olive oil, expeller-pressed organic canola oil, sunflower oil, safflower oil, coconut oil, nuts, nut butters, and avocados.
Be wary of certain foods
No surprise here: Dr. Gupta says you should steer clear of processed foods packed with sugar and preservatives, dyes, or fat- and sugar-free substitutes.
“Processed foods including trans fats, high fructose corn syrup, MSG, and refined sugar can cause intestinal inflammation and in turn, trigger autoimmune flare-ups,” she says.
“This is not specific to the thyroid, but the autoimmune system can affect various parts of the body.”
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A less obvious culprit? Cruciferous veggies such as cauliflower, cabbage, kale, kohlrabi, watercress, Bok choy, and Brussels sprouts. They may be packed with good-for-you nutrients vitamin C and folate, but eating them raw in high doses could mess with your thyroid.
“Uncooked cruciferous vegetables contain natural chemicals called goitrogens (goiter producers) that can interfere with thyroid hormone synthesis,” she says.
But don't panic just yet, kale lovers: “The goitrogens in these foods are inactivated by cooking, or even by light steaming, so you can still consume them for their valuable antioxidant and cancer-protective effects.” (Phew!)
Consider supplements… But talk to your doctor first
You've probably heard that there's a connection between thyroid health and iodine, which is essential for the synthesis of thyroid hormones. “Worldwide, iodine deficiency is one of the causes of an enlarged thyroid gland and hypothyroidism,” Dr. Gupta says.
“However, iodine deficiency is rare in developed countries due to supplementation in table salt and certain foods such as dairy and bread.” In other words, you're probably already getting enough iodine in your diet as is. In fact, too much iodine can trigger hyperthyroidism in susceptible individuals, so Dr.
Gupta doesn't recommend taking iodine pills without consulting your doctor.
On the other hand, if you suspect your thyroid may need a boost, speak to your doctor about taking selenium or vitamin D, both of which have been linked to improved thyroid health.
“Clinical research shows that taking 200 mcg daily of the mineral selenium can reduce anti-thyroid antibodies,” says Dr. Gupta. “Alternatively, you can get the mineral by eating one to two Brazil nuts each day.
” (Yup, it's that simple!)
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As for vitamin D, some research suggests it could be important in regulating the immune system: “Severe deficiency of vitamin D may be associated with autoimmune disease, so have your physician check your vitamin D levels and advise you about supplementation if the level is below normal,” she says.
Dr. Gupta also recommends taking probiotics, which offer a whole host of health benefits.
“Probiotics can help modulate the immune system, enhance gut motility, and improve intestinal permeability,” she says.
She suggests looking for over-the-counter blends that contain the active cultures Saccahromyces boulardii and Lactobacillus acidophilus or eating natural sources yogurt and kefir.
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Try your best to avoid these environmental toxins
According to the National Institute of Environmental Health Sciences, long-term exposure to endocrine disruptors—chemicals that interfere with your body's endocrine system—may trigger endocrine problems in humans.
A few to be aware of are perfluorinated chemicals (PFCs) in some carpets, flame-resistant and waterproof clothing, and non-stick cookware, all of which were linked to thyroid disease in a 2010 study.
Similarly, in 2011 researchers found that exposure to phthalates (found in fragranced products and soft plastics) and bisphenol-A (found in some hard plastics and canned food linings, although many manufacturers are removing them) could cause disruptions in thyroid hormone levels.
Dr. Gupta also recommends avoiding antibacterial soaps that contain triclosan, an ingredient that has altered hormone regulation in studies of animals (human studies are still ongoing), according to the FDA.
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Although it would be impossible to avoid these completely, the key is to reduce your exposure as much as you can, especially if you're pregnant or have little ones in the house—developing fetuses, infants, and children are more vulnerable to any effects of environmental chemicals.
Following some general guidelines can go a long way. “Just use [regular] soap and water to wash your hands instead,” she says. “Use essential oils when fragrance is needed.”
Other things you can do include, choosing more fresh or frozen foods over canned, storing food in porcelain or glass rather than plastics, and keeping your home well-ventilated.