Signs & Symptoms

Q&A on how to recognize (and treat) an overactive thyroid

An overactive thyroid can cause alarming symptoms. We interviewed Dr. Brian Lake, an endocrinologist treating thyroid disease and diabetes at Gessler Clinic in Winter Haven, about the disease’s warning signs and treatments.

Central Florida Health News (CFHN): What are the symptoms of an overactive thyroid (hyperthyroidism)?  Is it possible to have no symptoms? 

Dr. Brian Lake: Symptoms include palpitations (feeling the heart race), weight loss, tremulousness or jitteriness, anxiety, insomnia, heat intolerance with increased sweating, and frequent bowel movements.  It is possible to have a mild case without many symptoms; many times it is found through laboratory testing.

CFHN: How can you be sure the thyroid gland is causing the symptoms?

Dr. Lake: Blood tests, along with a physical exam, can be performed to evaluate thyroid function and determine why it is overactive.

CFHN: When is it important to see a doctor? 

Dr. Lake: If you suspect you may have an overactive thyroid, you should see a doctor as soon as possible.

CFHN: Why is it important to seek treatment?

Dr. Lake: Untreated or undertreated hyperthyroidism can lead to abnormal heart rhythms, such as atrial fibrillation, as well as increased stress on the heart.  It can also lead to bone loss over time, with increased risk of osteoporosis and fracture.

CFHN: How is it treated? 

Dr. Lake: With anti-thyroid medications such as Methimazole, to lower thyroid functions, and beta-blockers to help with symptoms of palpitations and tremor / jitteriness.  We also consider use of radioactive iodine or surgery as definitive treatment if there is thyroid enlargement.

CFHN: Are there any home remedies for an overactive thyroid?

Dr. Lake: None that I am aware of.  Many over-the-counter medications that state they are for the thyroid, (i.e. kelp), contain large amounts of iodine.  This can actually make an overactive thyroid significantly worse.  I generally recommend against use of over-the-counter supplements for the thyroid.

CFHN: What causes an overactive thyroid?  Can it be inherited?

Dr. Lake: The most common cause is Graves’ disease, which is an autoimmune thyroid disease that causes the thyroid to over-secrete hormone.  It can also cause bulging and redness of the eyes and thyroid enlargement.  Other causes are thyroid nodules that over-secrete hormone, or a thyroiditis that can happen rarely after an illness.  It is generally not inherited, but it can run commonly in families.

CFHN: What, if anything, can be done to prevent having an overactive thyroid?

Dr. Lake: Unfortunately, there is nothing to prevent hyperthyroidism.

CFHN: Can a person’s diet contribute to an overactive thyroid?  If so, how?

Dr. Lake: The only thing in a diet that may contribute to hyperthyroidism would be large iodine content foods or supplements.  Generally, foods such as shellfish, that are high in iodine, are not enough to contribute to hyperthyroidism.  It is generally kelp or iodine over-the-counter supplements that can possibly bring out hyperthyroidism.

CFHN: Does the problem ever resolve on its own?  If so, when?

Dr. Lake: Occasionally, patients are diagnosed with a thyroiditis after an illness that causes their hyperthyroidism.  This generally resolves on its own over the course of about three months.  With Graves’ disease, hyperthyroidism can sometimes go into remission on anti-thyroid medications within a year.  This happens about 10-20 percent of the time.

CFHN: Is goiter frequently caused by an overactive thyroid?  How is it treated?

Dr. Lake: A goiter is an enlarged thyroid gland.  This can happen commonly with an overactive thyroid, but can be caused by other issues as well.  It is generally monitored with thyroid ultrasound if it is asymptomatic.  If it begins to cause problems with swallowing or breathing, we consider taking the thyroid gland out surgically.  This resolves both the hyperthyroidism and thyroid goiter at the same time.  Thyroid hormone can be taken, one pill per day, to bring thyroid levels to the normal range.

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