The symptoms of hyperthyroidism are different for each person and may mimic other illnesses or diseases. Older people may not show any symptoms of hyperthyroidism but may be misdiagnosed with depression or dementia. Sometimes, a goiter may form making the neck look abnormally swollen and is caused by an enlarged thyroid. If you have Grave’s disease, you may experience ophthalmopathy (bulging eyes) and develop thick, red skin on your shins and tops of the feet (Grave’s dermopathy). Other symptoms of hyperthyroidism include:

• Weight loss
• Nervousness
• Irritability
• Shaky hands
• Rapid heartbeat
• Irregular heartbeat
• Diarrhea
• Fatigue
• Muscle weakness
• Sleeping problems
• Mood swings

Grave’s disease. The most common cause of hyperthyroidism. This is an autoimmune disorder in which the immune system attacks the thyroid gland and causes the gland to overproduce thyroid hormones.

Thyroid nodules. More common in older people. Thyroid nodules are benign (non-cancerous) growths that form on your thyroid. These nodules may become overactive and produce too much thyroid hormone.

Thyroiditis. Inflammation of the thyroid gland causes thyroid hormones that are stored in the thyroid to leak out, thus increasing thyroid levels above that which the body needs.

Iodine. This mineral is needed by the thyroid gland to secret thyroid hormones. If you take too much iodine, your thyroid will secrete hormones excessively. Iodine is found in cough syrups, seaweed, seaweed-based supplements, and some medicines.

Thyroid medication. People who take thyroid medication to treat an underactive thyroid (hypothyroidism) may take too much and cause hyperthyroidism.

• Age (older than 60)
• Being a woman
• Family history of thyroid disease
• Pernicious anemia
• History of thyroid surgery
• Recent pregnancy
• Type 1 diabetes
• Primal adrenal insufficiency (hormonal disorder)
• Excessive intake of iodine

Your healthcare provider will first ask about your medical history, including that of your family. You will be asked about any supplements and medications you are taking. Your doctor will also ask about your symptoms and then do a physical exam. Lastly, you may be asked to do some tests, including:

Thyroid tests. There are a few tests that examine your levels of thyroid hormones that circulate through your bloodstream. These include TSH (thyroid-stimulating hormone), T3 (triiodothyronine), and T4 (thyroxine) blood tests. During the test, a small sample of your blood will be taken using a small needle. You may also be asked to do a thyroid antibodies test which will detect if your immune system is creating antibodies that are attacking your thyroid. A positive result in this test will indicate if you have an autoimmune disorder, like Grave’s disease.

Imaging tests. These include a thyroid scan, ultrasound, and a radioactive iodine uptake test. An ultrasound and thyroid scan may reveal that you have nodules on your thyroid or an enlarged thyroid (goiter). A radioactive uptake iodine test measures the amount of iodine your thyroid absorbs after you swallow a small amount. The test uses radioactive iodine as it is seen easily in the imaging test.

Treatment for hyperthyroidism usually involves medication. At times, the condition will require radioiodine therapy or surgery. Your treatment will be catered to what is causing the hyperthyroidism and the severity. The purpose of treatment is to regulate your levels to a normal place, relieve symptoms, and prevent long-term health issues. Treatments include:

Medication. Antithyroid medicines are the first line of treatment in helping the thyroid to secrete less thyroid hormone. The most prescribed anti-thyroid medication is methimazole. If you are pregnant, you will be prescribed a different medication, propylthiouracil (methimazole is unsafe for fetuses). Doctors often prescribe beta-blockers to treat uncomfortable symptoms, such as rapid heartbeat, nervousness, and shakiness.

Radioiodine therapy. Another form of therapy calls for the use of radioactive iodine (iodine-131) taken orally with a capsule or liquid. The radioactive iodine targets thyroid tissue, destroying the cells that produce thyroid hormones without damaging other body tissues. Because the thyroid hormone-producing cells were destroyed, you may develop hypothyroidism (low thyroid hormone levels) which is easily treated with thyroid hormone replacement therapy.

Thyroid surgery. Least-used form of treatment for hyperthyroidism. In this surgery, the surgeon removes some to most of the thyroid gland (thyroidectomy). This surgery is indicated for pregnant women or people with a large goiter.

Hyperthyroidism needs to be treated by a licensed medical healthcare provider. Some natural remedies can interact with your current medications. Further, before taking supplements, you should have a blood test to identify nutrient deficiencies like calcium. Be sure to discuss with your healthcare provider before taking any natural remedies and supplements. The following are supplements and treatments that may help relieve symptoms and supplement deficiencies:

Vitamin D. Helps your body absorb calcium and phosphorus. Studies have shown that low vitamin D levels may be associated with autoimmune thyroid disorders like Grave’s disease and some types of thyroid cancers.

Probiotics. A healthy gut requires beneficial bacteria known as microbiota to help absorb minerals and nutrients. Probiotics contain these live microorganisms and are found in food sources (like yogurt, kombucha, and fermented foods) or can be taken as a supplement. Probiotics have been shown to benefit people who have thyroid diseases and helpful in regulating fluctuating thyroid hormone levels while encouraging the absorption of beneficial micronutrients, including zinc, selenium, and iron.

L-carnitine.  A naturally-occurring amino acid stored in our muscles that is responsible for energy production. A recent study has shown that L-carnitine inhibits the thyroid hormones, T3 and T4, and may be capable of reversing hyperthyroid symptoms. Food sources of L-carnitine are meat (try lean chicken), fish, avocado, tempeh, asparagus, peanut butter, and rice.

The most important lifestyle modification is dietary. You should avoid eating certain foods that are high in iodine. Highly processed foods and iodized salt are high in iodine. You may also experience excessive weight loss due to overactive metabolic processes from too much thyroid hormone. Talk with a nutritionist about a nutrient-rich diet plan that helps you healthily gain weight. An overactive thyroid can lead to weakened bones due to loss of calcium leeched from the bones. Talk to your doctor about taking a calcium supplement as dairy products contain iodine.

If hyperthyroidism is left untreated, it can cause the following complications:

• Irregular heartbeat leading to stroke, heart failure, blood clots, etc.,
• Osteoporosis
• Hip fractures
• Fertility problems (in women)
• Pregnancy complications(i.e., premature birth, low birth weight, high blood pressure)
• Graves’ ophthalmopathy (can lead to vision loss)
• Cardiovascular disease
• Cerebrovascular disease
• Thyroid storm

Thyroid storm. This life-threatening condition occurs when the thyroid produces overly excessive amounts of thyroid hormones. A thyroid storm causes high body temperature, tachycardia (rapid heartbeat), high blood pressure, atrial fibrillation, and an increased rate of breathing. All of these together can prove fatal if left untreated. Common causes of a thyroid storm are:

• Untreated or undertreated hyperthyroidism
• Surgery
• Stroke
• Severe emotional distress
• Infection
• Congestive heart failure
• Diabetic ketoacidosis
• Pulmonary embolism

A thyroid storm is a medical emergency and requires immediate medical intervention. If you are someone you know is exhibiting symptoms, call 9-1-1. A person experiencing a thyroid storm may show the following symptoms:

• Unconsciousness
• Agitation
• Shaking
• Restlessness
• Confusion
• Diarrhea
• High fever
• Talking fast

There is an abundant amount of information available regarding clinical trials for hyperthyroidism hosted by the U.S. National Library of Medicine. You can find this information at ClinicalTrials.gov by following this link here.

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Knezevic, J., et. al. (2020, June). Thyroid-gut-axis: How does the microbiota influence thyroid function? Nutrients, 12(6), 1769-. Retrieved from PMC: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7353203/#:~:text=Probiotics%20have%20shown%20beneficial%20effects,selenium%2C%20zinc%2C%20and%20copper.

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