Hyperthyroidism

Overview

Hyperthyroidism is the condition in which the thyroid gland makes too much thyroid hormone, speeding up the body’s metabolism. It is confirmed by a suppressed (very low) TSH with a raised free T4 or free T3. It causes the body to run too fast — affecting the heart, weight, temperature, mood and digestion — and, left untreated, can strain the heart and bones over time. It is less common than an underactive thyroid but is very treatable.

This page is the clinical overview of hyperthyroidism as a condition. For a borderline suppressed TSH with normal hormone levels, see Subclinical Hyperthyroidism; for the most common cause, see Graves’ Disease; for heart-related symptoms, see Thyroid-related Palpitations.

Symptoms

• Weight loss despite a normal or increased appetite.
• Feeling hot, sweating and heat intolerance.
• Palpitations, fast or irregular heartbeat.
• Anxiety, irritability, restlessness and tremor.
• Frequent loose stools.
• Difficulty sleeping and fatigue despite high energy.
• Muscle weakness, especially in the thighs.
• Eye changes (bulging, redness) in Graves’ disease.
• Lighter or irregular periods.

Causes and risk factors

• Graves’ disease — autoimmune stimulation of the gland (the most common cause).
• Toxic nodular goitre — one or more nodules producing excess hormone.
• Thyroiditis — temporary release of stored hormone, often with a later hypo phase.
• Excess iodine or iodine-containing medicines (amiodarone).
• Over-replacement with thyroid hormone tablets.
• Family history of thyroid or autoimmune disease.
• Female sex and young to middle adulthood.

How it is diagnosed

Diagnosis is made on blood tests: a suppressed TSH with a raised free T4 (and/or free T3) confirms overt hyperthyroidism. The underlying cause is then identified — often with thyroid antibodies (TSH receptor) and a thyroid uptake scan or ultrasound — because the cause determines the best treatment.

Investigations

• TSH, free T4 and free T3.
• TSH receptor antibodies to identify Graves’ disease.
• Thyroid uptake scan or ultrasound to distinguish causes where needed.
• ECG if palpitations or irregular heartbeat are present.
• Bone density assessment in some long-standing cases.

Management

Treatment depends on the cause, severity and your circumstances. Options include anti-thyroid tablets (carbimazole or propylthiouracil) to reduce hormone production, radioactive iodine to calm the overactive gland, or surgery to remove part or all of the gland. Beta-blockers may be used short-term to control palpitations and tremor while the underlying problem is treated. Each route has different benefits and follow-up needs, and the choice is made together with you.

Follow-up

Thyroid levels are rechecked every few weeks initially, then less often once stable. After radioactive iodine or surgery, many people eventually become underactive and need levothyroxine, so long-term monitoring continues regardless of the treatment chosen.

How we help

Dr. Nayak confirms the diagnosis and its cause, controls symptoms quickly, and guides you through the treatment options with clear follow-up. Heart-related symptoms and coexisting conditions are assessed alongside. Consultations are available in-clinic in Bhubaneswar and over teleconsultation.

Related conditions and patient concerns

• Subclinical Hyperthyroidism
• Graves’ Disease
• Low TSH
• Thyroid-related Palpitations
• Thyroid-related Weight Changes
• Goitre / Enlarged Thyroid
• Thyroid Nodules
• Palpitations & Cardiovascular Symptoms