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Woman holding her throat, illustrated in red where the thyroid is

15 Signs Of An Overactive Thyroid (Part 3 Thyroid Series)

An overactive thyroid gland is known as hyperthyroidism,

This is where the thyroid gland produces too much thyroid hormone and doesn’t listen to the signals from the brain to slow down. The hyperactivity is caused by antibodies made in the thyroid that mimic thyroid stimulating hormone (TSH), the chemical released by the brain that signals to the thyroid what pace it should work at. As a result, the thyroid short-circuits the feedback loop to the brain, completely cutting it out. And keeps triggering itself to make more and more of the thyroid hormones tri-iodothyronine (T3) and thyroxine (T4). This disorder is also known as Grave’s disease.

Grave’s disease is the most common cause of an overactive thyroid gland and can occur at any age. But it is most commonly diagnosed in women between the ages of 20 to 40. Hyperthyroidism affects just over 1% of the population. Other much less common causes of an overactive thyroid gland can include brain tumours in the hypothalamus or pituitary gland which cause overproduction of thyroid stimulating hormone. 

15 symptoms of hyperthyroidism

  • Increased appetite
  • Weight loss despite eating more
  • Irritability and nervousness
  • Diarrhoea
  • Tremor or shakiness
  • Anxiety and depression
  • Fatigue
  • Irregular periods, lighter bleeding or loss of menstruation
  • Swelling of the thyroid (goitre)
  • Feeling overheated
  • Palpitations
  • Bulging of the eyes (exophthalmos
  • Insomnia
  • Difficulty concentrating
  • Shortness of breath
stressed woman

What are the triggers for hyperthyroidism?

  • Extreme emotional stress
  • Extreme physical stress
  • Extreme physiological stress, e.g. infection or pregnancy (the risk of Grave’s disease is seven times higher in the first 12 months after giving birth)
  • Family history of Grave’s disease
  • Other auto immune disease
  • Smoking

What are the dangers of an overactive thyroid gland?

There are significant health risks for people with untreated hyperthyroidism:

Atrial Fibrillation. This is an abnormal heart rhythm that can increase the risk of blood clots in the heart potentially leading to heart attacks or strokes.

Bone Thinning. Our skeleton is in a constant state bone re-modelling. Too much thyroxine causes bone loss to occur at a faster rate than it is replaced resulting in osteopaenia and osteoporosis both of which increase the risk of bone fractures.

Infertility. Not only does hyperthyroidism affect menstrual regularity, in some cases blocking menstruation entirely, it can also prevent ovulation from occurring. Once pregnant, uncontrolled hyperthyroidism increases the risk of maternal complications in pregnancy as well as miscarriage, pre-term labour and birth defects. 

Eye Disease. Untreated swelling caused by hyperthyroidism can eventually lead to blindness.

Thyrotoxicosis. A state of crisis when your body has a surge in hyperthyroid symptoms that can result in fatality.

How is it diagnosed?

This can be done by straightforward blood testing for the levels of TSH, T3 and T4. You would expect to see high levels of T3 and T4 which through the negative feedback loop would result in suppressed level of TSH. Antibody blood testing would reveal the presence thyroid stimulating hormone receptor antibodies (TRab). Ultrasound of the neck might show some changes to the thyroid gland too. 

How is it treated?

The focus of treatment is to slow down the thyroid and get T3 and T4 levels back into the normal range. For the most part treatment of hyperthyroidism results in the gland actually becoming underactive because this is easier to manage in the long term. 

Medications. Medications are the first line treatment option and in most cases after 18 months of these medications, the thyroid starts to become underactive and can then be treated for hypothyroidism.

Radioactive Iodine. Radioactive iodine is taken by mouth and absorbed into the blood stream. The thyroid extracts the iodine from the blood but in turn the radioactivity destroys the thyroid cells. 

Surgery. Removal of part of the thyroid (partial thyroidectomy) or the entire gland (total thyroidectomy) may be considered if all else fails.

A colourful bowl of salad sitting on a teatowel

Things you can do

Stress Management. Stress is a major trigger for hyperthyroidism. All types of stress can be improved with simple things you can build into your daily life. Here are some ideas.

Omega 3. There is evidence that omega 3 supplements can help settle the thyroid gland down by reducing inflammation. Consider fish oil supplements, vegan omega 3 supplements or use flax seeds in your food. 

Anti-inflammatory diet. Eat a diet rich in wholefoods with plenty of colourful veggies and fruit for their anti-oxidant effects. Use turmeric and ginger in your cooking. Avoid processed foods and excess refined sugars.

Selenium. Not only does selenium have anti-oxidant properties that reduce autoimmune activity in the thyroid, there is evidence that selenium supplementation may lead to faster remission from hyperthyroidism. Include brazil nuts, sunflower seeds, fish, lean animal proteins, mushrooms, brown rice, lentils and bananas in your diet to maintain selenium levels.

Nurture your gut bacteria. Looking after your microbiome is an important part of general wellbeing. Eat a diet high in fibre, with lots of plant-based variety. These are also known as pre-biotic foods and nourish the existing good bacteria in your gut. Try fermented foods like unflavoured yoghurt and sauerkraut or add in a pro-biotic supplement. Probiotics are live cultures of bacteria and yeasts that add to your existing gut flora.

Avoid Caffeine. Caffeine is a stimulant and if you’re already suffering from a racing heart beat and feeling shaky, caffeine will only make these symptoms worse. Caffeine can also increase the risk of developing atrial fibrillation. 

Thyroid cancer

A quarter of patients with Grave’s disease can develop little lumps on their thyroid gland called nodules. People with thyroid nodules have an increased risk of developing thyroid cancer and may need regular ultrasound scans of the thyroid gland.

For more information on how the thyroid works and what you can do to protect it, read Part 1 of the Thyroid Series.  

If you think you may have some of the symptoms in this article, ask your GP for a thyroid blood test. It’s quick, it’s easy and it gives enough information to know if you’re all clear or whether you might need some extra checks.

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