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Hyperthyroidism

Also listed as: Thyroid - overactive

Signs and Symptoms
What Causes It?
What to Expect at Your Provider's Office
 
Treatment Options
Special Considerations
Supporting Research

Hyperthyroidism is when your thyroid gland, located at the front of your neck, produces too much thyroid hormone, causing your metabolism to speed up. This may seem like a good thing, but when your body works too hard it can take a big toll on your heart, bones, and mood. Hyperthyroidism has three forms that share several symptoms. The most common form is Graves disease. Hyperthyroidism may be caused by taking too much thyroid hormone when you are being treated for hypothyroidism. Hyperthyroidism is more common in women than men and usually occurs after age 60.

Signs and Symptoms

  • Rapid heart rate and palpitations
  • Shortness of breath
  • Goiter (swelling of the thyroid gland)
  • Moist skin and increased perspiration
  • Shakiness and tremor
  • Anxiety
  • Increased appetite accompanied by weight loss
  • Insomnia
  • Swollen, reddened, and bulging eyes (in Graves disease)
  • Occasionally, raised, thickened skin over the shins, back of feet, back, hands, or even face
  • In crisis: fever, very rapid pulse, agitation, and possibly delirium
  • Changes in menstrual periods

What Causes It?

Researchers suspect that Graves disease (the most common form of hyperthyroidism) is caused by an antibody that mistakenly stimulates the thyroid to produce too much hormone. Toxic nodular goiter is caused by a noncancerous tumor in nodules that make up the thyroid gland. Secondary hyperthyroidism results when the pituitary (a small gland located at the base of the brain that regulates the release of hormones from several other glands) overrides the thyroid's normal instructions, and orders it to make too much thyroid hormone.

What to Expect at Your Provider's Office

Your health care provider will ask you to extend your fingers to see if you have a telltale tremor. Your health care provider will also examine your thyroid gland while you swallow. A blood test can confirm that you have elevated levels of thyroid hormone. Your doctor may also order a radioactive iodine uptake test to determine why your thyroid is producing too much hormone.

Treatment Options

Drug Therapies

Your health care provider will most likely prescribe a single dose of liquid radioactive iodine, which calms down your thyroid gland. Often the thyroid then becomes underactive. Up to half of patients who receive radioactive iodine treatments for an overactive thyroid develop permanent hypothyroidism within a year of therapy. Such patients may have to take replacement thyroid hormone. Alternatively, your health care provider may give you thyroid depressive medication. You may also be prescribed beta-blockers to help slow a rapid heartbeat. If drug treatment fails, you may need surgery to remove part of your thyroid. If so, you will need to take replacement thyroid hormone.

Complementary and Alternative Therapies

Alternative therapies may be effective at minimizing symptoms of mild thyroid dysfunction. Keep all of your doctors informed regarding all complementary treatments you are taking. Some complementary and alternative therapies can interfere with conventional medical therapies. Work with a provider who is knowledgeable in complementary medicine to find the right mix of treatments for you.

Nutrition and Supplements

Following these nutritional tips may help reduce symptoms:

  • Eliminate suspected food allergens, such as dairy (milk, cheese, and ice cream), wheat (gluten), soy, corn, preservatives, and chemical food additives. Your health care provider may want to test you for food allergies.
  • Eat foods high in B-vitamins and iron, such as whole grains (if no allergy), fresh vegetables, and sea vegetables.
  • If you take thyroid hormone medications, talk to your doctor before consuming soy products. There is some evidence that soy may interfere with absorption of thyroid hormone.
  • Iron may also interfere with the absorption of thyroid hormone medication.
  • Eat antioxidant foods, including fruits (such as blueberries, cherries, and tomatoes) and vegetables (such as squash and bell pepper).
  • Avoid refined foods, such as white breads, pastas, and sugar.
  • Eat fewer red meats and more lean meats, cold water fish, or beans for protein. Limit your intake of processed meats, such as fast foods and lunch meats.
  • Use healthy cooking oils, such as olive oil or coconut oil.
  • Reduce or eliminate trans fatty acids, found in commercially baked goods such as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.
  • Avoid alcohol and tobacco. Talk to your doctor before using caffeine containing products, such as teas and soft drinks. Caffeine impacts several conditions and medications.
  • Exercise, if possible, 30 minutes daily, 5 days a week.

You may address nutritional deficiencies with the following supplements:

  • A daily multivitamin daily, containing the antioxidant vitamins A, C, E, the B-complex vitamins, and trace minerals such as magnesium, calcium, zinc, and selenium.
  • Omega-3 fatty acids, such as fish oil, to help decrease inflammation and help with immunity. Omega-3 fatty acids can have a blood thinning effect. If you are taking blood thinning medications, speak to your doctor before taking Omega-3 fatty acids.
  • Vitamin C, as an antioxidant and for immune support.
  • Alpha-lipoic acid, for antioxidant support. Can potentially interfere with certain chemotherapy agents.
  • L-carnitine, for decreasing thyroid activity. May have blood-thinning effects and therefore increase anti-clotting effects of certain medicines, such as warfarin (Coumadin).
  • Probiotic supplement (containing Lactobacillus acidophilus), 5 - 10 billion CFUs (colony forming units) a day, when needed for maintenance of gastrointestinal and immune health. Some acidophilus products may need refrigeration -- read labels carefully.
  • Do not take an iodine supplement unless directed by your doctor. Iodine is only effective in cases of iodine deficiency, which is uncommon in the developed world. And excessive iodine can cause hypothyroidism.

Herbs

Herbs are a way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). People with a history of alcoholism should not take tinctures. Unless otherwise indicated, make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures singly or in combination as noted. If you are pregnant or nursing, speak to your doctor before using any herbal products.

  • Green tea (Camellia sinensis) standardized extract, 250 - 500 mg daily, for antioxidant effects. Use caffeine free products.
  • Lemon balm (Melissa officinalis), 300 - 500 mg 3 times daily, to normalize an overactive thyroid. Steep 2 tbs. lemon balm in one cup of boiling water. Strain and cool.

Avoid the following herbs:

  • Bladderwrack (Fucus vesiculosus). It may stimulate hyperthyroidism.
  • Ashwaganda (Withania somminfera). There has been some debate about whether ashwaganda also stimulates hyperthyroidsim. Some herbalists may still recommend ashwaganda in hyperthyroid patients. It is best to consult a trained herbal practitioner for advice.
  • Caffeinated green tea products and Chinese or Korean ginseng (Panax ginseng). These herbs are too stimulating.

Homeopathy

Few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider remedies for the treatment of symptoms based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account your constitutional type -- your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for you.

Acupuncture

Acupuncture may help correct hormonal imbalances.

Massage

Therapeutic massage may help relieve stress.

Special Considerations

Thyroid problems during pregnancy can cause serious complications. Some patients with hyperthyroid disease experience a decline in bone mineral density. This can be reversed after treatment for hyperthyroidism.

Supporting Research

Atis G. Hyperthyroidism: a risk factor for female sexual dysfunction. J Sex Med. 2011;8(8):2327-33.

Bagnasco M, Bossert I, Pesce G. Stress and autoimmune thyroid diseases. Neuroimmunomodulation. 2006;13(5-6):309-17.

Bahn R, Levy E, Wartofsky L. Graves' disease. J Clin Endocrinol Metab. 2007;92(11):2 p following 14A.

Dominguez LJ, Bevilacqua M, Dibella G, et al. Diagnosing and managing thyroid disease in the nursing home. J Am Med Dir Assoc. 2008;9(1):9-17.

Feldman: Sleisenger & Fordtran's Gastrointestinal and Liver Disease, 8th ed. 2006. Philadelphia, PA: Saunders Elsevier Inc.

Fumarola A. Therapy of hyperthyroidism in pregnancy and breastfeeding. Obstet Gynecol Surv. 2011;66(6):378-85.

Ho CH, Chang TC, Guo YJ, Chen SC, Yu HJ, Huang KH. Lower urinary tract symptoms and urinary flow rates in female patients with hyperthyroidism. Urology. 2011;77(1):50-4.

Klein I, Danzi S. Thyroid disease and the heart. Circulation. 2007;116(15):1725-35.

Nayak B, Hodak SP. Hyperthyroidism. Endocrinol Metab Clin North Am. 2007;36(3):617-56, v. Review.

Nygaard B. Hyperthyroidism. Am Fam Physician. 2007;76(7):1014-6.

Vanderpas J. Nutritional epidemiology and thyroid hormone metabolism. Annu Rev Nutr. 2006;26:293-322.

Van de Ven AC, Erdtsieck RJ. Changes in bone mineral density, quantitative ultrasound parameters and markers of bone turnover during treatment of hypothyroidism. Neth J Med. 2008;66(10):428-32.

Wu P. Thyroid disorders and diabetes. It is common for a person to be affected by both thyroid disease and diabetes. Diabetes Self Manag. 2007;24(5):80-2, 85-7.


Review Date: 4/4/2012
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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