Hyperthyroidism is a condition where the body either produces or secretes an excess of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). Thyroid hormones are critical for metabolic function. When they are too high, otherwise known as thyrotoxicosis, it can kick the body into overdrive which depletes energy reserves. This hypermetabolic state can have negative consequences resulting in hyperthyroidism symptoms like exercise intolerance, insomnia, and fatigue. Organ systems rely on the body’s ability to balance thyroid hormones, which is why both hyperthyroidism and hypothyroidism cannot be left untreated. Without antithyroid drugs for hyperthyroidism, the body can start breaking down its own tissues to create the energy necessary for it to function.
The goal of hyperthyroidism medications is to either reduce the release or the production of thyroid hormones. Additionally, some drugs work by blocking thyroid hormone effects on the body. Different classes of medications for hyperthyroidism can prevent excess thyroid hormone from causing physiologic exhaustion. Some patients choose to permanently alter their thyroid tissue through surgery or a one-time oral iodine treatment, resulting in hypothyroidism.
About Hyperthyroidism in Women
Causes
Grave’s disease is an autoimmune disease and the most common cause of hyperthyroidism. Autoantibodies attack the thyroid stimulating hormone (TSH) receptor. TSH is a hormone released by the pituitary gland. It tells the thyroid how much and when to release the hormones it produces called thyroxine (T4) and triiodothyronine (T3). When the body targets its own TSH receptor in Grave’s disease, excess thyroid hormone is produced.
Toxic multinodular goiter is the second-most common cause of hyperthyroidism. The thyroid becomes enlarged with many nodules. It is labeled toxic because one or more of these nodules are producing an abundance of thyroid hormone, without being checked by the pituitary gland.
Toxic adenoma is another leading cause of hyperthyroidism. A benign thyroid tumor independently overproduces thyroid hormone without requiring any signaling from TSH.
Symptoms
Hyperthyroidism symptoms are a reflection of a hypermetabolic state. Initially energizing, the body eventually depletes itself. Over time this condition can become life-threatening by stressing out the immune system and thermoregulation, ramping the metabolism into overdrive, weakening muscle and bone, and straining the heart.
Hyperthyroidism symptoms often include:
- Heart palpitations
- Weight loss
- Anxiety
- Insomnia
- Excessive sweating and/or heat intolerance
- Bulging eyes
- Hair loss
- Diarrhea
- Hyperactivity followed closely by fatigue
- Goiter
Therapies
Hyperthyroidism medications address complications from an overactive thyroid, and low dose naltrexone (LDN) can support autoimmune forms of hyperthyroid disease like Graves’ disease. While there is no cure for thyroid disease, medication or a surgical procedure is often necessary to prevent long-term complications from overstimulation of the heart and nervous system.
Antithyroid drugs like methimazole block thyroid peroxidase, the enzyme responsible for helping generate T3 and T4. Similarly, propylthiouracil (PTU) also stops thyroid hormone synthesis and prevents the conversion of T4 into T3, the more active hormone form. Beta-blockers like propranolol can help control select symptoms quickly, such as heart palpitations and tremors, but they do not address the root cause of the hyperthyroidism thyroid problems.
Radioactive iodine (I-131) is a one-time oral therapy that permanently changes thyroid tissue; surgery will have a similar result. Both can result in hypothyroidism, which will require different therapeutic support.
Commonly Asked Questions About Hyperthyroidism
Hyperthyroidism is a condition where the body either produces or secretes an excess of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). When they are too high, otherwise known as thyrotoxicosis, it can kick the body into an overactive state which can have negative consequences if left untreated. Hyperthyroidism symptoms can include exercise intolerance, insomnia, and heart palpitations: a reflection of a hypermetabolic state.
It is more common for hyperthyroidism to result in weight loss, as opposed to weight gain. This condition results in a hypermetabolic state, which can rapidly deplete the body of its energy reserves. Weight loss is common because the metabolism is in overdrive, eventually breaking down the body’s own muscle tissue as a source of energy.
Yes, there can be a cure for hyperthyroidism depending on the cause. If a hyperthyroid state is due to a singular malfunctioning thyroid nodule, such as a toxic adenoma, removing the nodule via surgery or radioactive iodine can restore proper functioning of the thyroid. Using similar methods to address a toxic multinodular goiter will correct the hyperthyroidism, but often will result in a hypothyroid state requiring supplemental thyroid replacement therapy. Temporary thyroiditis may also resolve in time without intervention. Graves’ disease is an autoimmune form of hyperthyroidism that may go into remission, but there is no cure for autoimmunity.
