Everything You Need To Know About Hyperthyroidism Treatment

The thyroid hormone is a critical hormone gland that controls your body’s metabolism. The thyroid gland releases thyroid hormones into your bloodstream, which regulate most of your body functions.

However, your thyroid gland may sometimes produce too few (underactive thyroid) or too many (overactive thyroid) hormones. These imbalances can be due to various thyroid disorders. The two conditions—hypothyroidism (underactive) and hyperthyroidism (overactive)—have varying causes, signs, diagnoses, and treatments.

Despite the high number of Americans having thyroid disorders, around 60%¹ are unaware that they have that condition. If you’ve been diagnosed with hyperthyroidism and are wondering if it’s treatable, we have you covered in this post.

What is hyperthyroidism?

Before we explore the various hyperthyroidism treatments available today, let’s go into detail about thyroid disorders.

Hyperthyroidism is defined as excessive amounts of thyroid hormones in the body. The condition typically occurs when your thyroid gland produces excess levels of thyroid hormones. When thyroid hormone levels are high, your body’s functions speed up.

Graves’ disease² is the primary and most common cause of hyperthyroidism in developed countries with sufficient iodine intake. This autoimmune disorder is caused by your immune system attacking your thyroid gland.

As a result, the thyroid produces too much hormone leading to hyperthyroidism. Other hyperthyroidism causes include thyroiditis, multinodular goiter, and hyperfunctioning thyroid nodules.

Symptoms of hyperthyroidism

There are various signs of hyperthyroidism that may impact your body. The symptoms vary from individual to individual and may include the following:

• Weight loss (but with increased appetite)

• Frequent bowel movements

• Nervousness or irritability

• Rapid or irregular heartbeat

• Hand tremors

• Trouble tolerating heat

• Goiter—an enlargement in the neck depending on the cause of hyperthyroidism

How is hyperthyroidism (overactive thyroid) diagnosed?

If you notice symptoms of an overactive thyroid, consult a medical professional/endocrinologist.

Your doctor won’t base the diagnosis on physical signs and symptoms since they can be common to other diseases. Instead, they base the diagnosis on symptoms, clinical signs, and lab tests.

Here are several ways to diagnose an overactive thyroid.

Physical exam and medical history

The hyperthyroidism diagnosis first involves a physical assessment, usually carried out at the doctor’s office. First, the endocrinologist will ask you about your medical history. Then, they’ll perform a physical exam that involves examining various parts of your body, including;

• The thyroid—your doctor will feel your thyroid gland to identify if it’s bumpy, tender, or enlarged

• Hands—the doctor will ask you to stretch out your hands to detect tremors in your fingers

• Eyes—redness, swelling, bulging, and other signs of Graves’ eye disease

• Heart—the doctor will examine your heart for irregular or rapid heartbeat

• Skin—warm or moist skin

Blood tests

Your doctor/endocrinologist will conduct blood tests to confirm the diagnosis. This usually involves measuring thyroid-stimulating hormone (TSH), free T4 and free or total T3, and TSH receptor antibodies if your physician suspects Graves’ disease.

Low or nonexistent TSH levels and high T3/T4 levels signal an overactive thyroid. The reason for measuring TSH hormone levels is that it signals the thyroid to manufacture more thyroxine.

Blood tests are essential for older adults who don’t show classic hyperthyroidism symptoms. Do not take biotin at least 12 hours before the blood test because biotin may alter the results.

If the results show an overactive thyroid, your endocrinologist may recommend the following tests.

Radioactive iodine uptake test (RAIU)

The radioactive iodine uptake test³ measures the amount of radioactive iodine your thyroid absorbs. First, your doctor will give you a small dose of radioactive iodine. Then, after a six- to 24-hour interval, the doctor will check to see how much radioactive iodine your thyroid absorbs.

High radioactive iodine indicates that the thyroid gland produces excessive amounts of thyroxine. Consequently, the most likely cause for the higher uptake is hyperfunctioning thyroid nodules or Graves’ disease.

Thyroid isotope scan

The thyroid scan⁴ is an extension of the radioactive iodine uptake tests. First, your doctor will ask you to lie down and tilt your head back. They’ll use a gamma camera to take images of your thyroid gland.

The thyroid scan shows how your thyroid collects and absorbs iodine. It can help differentiate diffuse absorption, such that may be seen in Graves’ disease, from patchy uptake of a possible multinodular goiter.

It may also reveal nodules or lumps on your thyroid, swelling, inflammation, thyroid cancer, or goiter.

Thyroid ultrasound

Your doctor may use a thyroid ultrasound to examine your thyroid gland for abnormalities, including nodules, tumors, and cysts. It’s usually a painless procedure that utilizes sound waves to create images of your thyroid.

Your doctor may inject contrast agents into your bloodstream to improve the ultrasound image quality. A thyroid ultrasound is safe and doesn't expose you to radiation.

Treatment for hyperthyroidism

When you’re diagnosed with an overactive thyroid, your doctor will discuss the various treatments for hyperthyroidism that are currently available. Additionally, they’ll help you choose a suitable treatment for your specific situation.

Here are some treatment options.

Medications

Various medications exist for the treatment of hyperthyroidism. They include the following:

Antithyroid medicines

Antithyroid medicines prevent your thyroid gland from producing excessive hormones, gradually reducing hyperthyroidism symptoms. These include thionamides: propylthiouracil (PTU) and methimazole (MMI). They are safe for children, adults, and pregnant women.

In the context of Graves’ disease, antithyroid medications can either be used as an adjunct to normalize thyroid function until surgery or radiotherapy or for longer periods to control hyperthyroidism while awaiting the underlying autoimmune processes to go into remission.

Additionally, they are not used for hyperthyroidism caused by subacute thyroiditis, as the symptoms, in this case, are typically short-lived.

The side effects of antithyroid medicines include:

• Allergic reactions like itching and rashes

• Liver damage/failure (rare cases)

• Increased infection susceptibility due to a reduced number of white blood cells in your body

Beta-blockers

Your doctor may recommend beta-blockers to obstruct the action of thyroid hormones in your body. Although beta-blockers don’t change hormone levels in your blood, they can help control hyperthyroidism symptoms, including nervousness, rapid heartbeat, and shakiness.

Their onset of action is quick and will help you feel better within a short period.

However, beta-blockers are not a standalone treatment. Doctors usually pair them with other hyperthyroidism treatments for increased effectiveness, as beta blockers are only symptomatic treatments.

Radioactive iodine ablation

Depending on the underlying cause, radioiodine therapy⁵ can be the most common treatment for an overactive thyroid. Your doctor or endocrinologist will give you radioactive iodine as a liquid or capsule. The radioactive iodine is taken by mouth.

Radioiodine therapy slowly destroys the thyroid gland within 6–18 weeks. However, it doesn’t impact other body tissues.

Unfortunately, you’ll most likely develop hypothyroidism when you use radioactive iodine to treat an overactive thyroid, as your thyroid gland will be ablated. Therefore, you will need to take thyroid hormone supplements for the rest of your life to maintain optimal hormone levels.

Radioactive iodine is contraindicated for pregnant or nursing women. Additionally, if you undergo radioactive iodine therapy, you should stop breastfeeding at least 6–12 weeks before the treatment.

Surgical treatments

Surgical treatments for hyperthyroidism are rarely used. They are mainly recommended for pregnant women who can’t undergo radioactive iodine or take antithyroid drugs, for cases of concomitant thyroid malignancy, or for patients with goiters that produce symptomatic compression.

If your endocrinologist recommends a thyroid surgery⁶ (thyroidectomy), all or part of your thyroid gland will be removed to correct your thyroid disorder. Total thyroidectomy is typically preferred.

As the surgery removes your thyroid gland, you’ll need to take hormone supplements for the rest of your life.

Lifestyle changes

Sometimes your doctor may recommend adjusting your lifestyle to help treat your thyroid disorder. Also, you may need to combine other treatment options with a lifestyle change to treat hyperthyroidism effectively.

You’ll need to check on your diet. Consuming too much iodine might cause or worsen hyperthyroidism. As a result, you may need to keep off or minimize foods high in iodine.

Significant sources of iodine include sea vegetables, animal protein foods, and sometimes fortified foods. This includes seed weed, fish, table salts (labeled with iodine), and multivitamins.

How do doctors determine the best hyperthyroidism treatment?

There are various treatments for hyperthyroidism. But how do you determine a suitable hyperthyroidism treatment? Multiple factors play a role in determining that.

First, a treatment plan is reached after a hyperthyroidism diagnosis. Your doctor will run some tests to determine your hormone levels and the severity of your condition.

Sometimes you may decide on a suitable hyperthyroidism treatment based on personal preference. Other times you have no option but to go with the doctor’s recommendation.

Your treatment plan will depend on several factors, including;

• The cause of your hyperthyroidism

• Your age

• Physical condition

• The severity of your disorder

• Possible allergies or side effects

• Personal preference

It’s best to discuss the available options with your healthcare professional before choosing a hyperthyroidism treatment. This is because some treatments might not be ideal or safe for you based on your age or underlying health conditions.

What are the risk factors for hyperthyroidism?

Some people are at greater risk of developing an overactive thyroid than others. Therefore, you should take preventive measures to minimize vulnerability if you’re at risk.

Some factors that increase your risk of experiencing an overactive thyroid include:

Medical conditions

Some medical conditions like viral infections, pregnancy, or a history of other autoimmune disorders may put you at significant risk of hyperthyroidism.

Age

Although hyperthyroidism can happen at any age, you’ll likely get it if you’re 60 or older. Also, you’re more likely to develop Graves’ disease, a significant cause of hyperthyroidism, from ages 30 to 50⁷.

Gender

Generally, women are more likely to have an overactive thyroid than men.

Genetic factors

If you have a family history of Graves’ disease or any form of overactive thyroid, you are at risk of hyperthyroidism.

Diet

Incorporating a lot of iodine into your diet increases your risk of hyperthyroidism.

Is hyperthyroidism preventable?

There are various ways you can lower the risk of getting hyperthyroidism. Lifestyle and diet changes, for example, can help minimize the risk of getting hyperthyroidism.

You should then eat a balanced diet to reduce the risk. You might also want to avoid foods rich in iodine, like seaweed.

Daily physical activity is essential for managing symptoms of hyperthyroidism. Quit or minimize smoking as it increases your risk of developing the condition.

Untreated hyperthyroidism can result in various complications, including thyroid storms and pregnancy complications. A thyroid storm is a life-threatening condition with symptoms such as rapid heart rate, fever, and high blood pressure.

Therefore, preventive measures are crucial to reduce the risk of an overactive thyroid.

When to speak to an endocrinologist

Hyperthyroidism, if left untreated, can affect most parts of your body, including your vascular and skeletal systems. Some complications from untreated hyperthyroidism include stroke, atrial fibrillation, osteoporosis, and congestive heart failure.

Therefore, knowing when to see an endocrinologist for an overactive thyroid is crucial. Ideally, you may be unable to tell if you have hyperthyroidism from physical symptoms. Most people with thyroid disorders are not aware they have the condition.

It’s essential to see an endocrinologist once you notice symptoms of hyperthyroidism. The healthcare provider will examine your condition and recommend a suitable hyperthyroidism treatment.

Also, if you’ve previously been diagnosed with an overactive thyroid, you might want to see an endocrinologist regularly to confirm if your treatment is working. If not, the endocrinologist will reassess your condition and recommend another treatment plan.

Moreover, see an endocrinologist if you experience strange symptoms after undergoing a particular treatment for hyperthyroidism.

The lowdown

An overactive thyroid can affect your body’s system and functioning. This thyroid condition can stem from Graves’ disease, thyroiditis, and excess iodine, among other causes. Symptoms include weight loss, irregular or rapid heartbeat, nervousness or irritability, and more.

There are various treatments for hyperthyroidism. Your doctor or endocrinologist will diagnose your condition before recommending a treatment plan.

Hyperthyroidism diagnosis involves physical exams, thyroid scans and ultrasounds, and blood tests. Treatments include antithyroid medicines like methimazole, beta-blockers, radioactive iodine therapy, thyroidectomy, and lifestyle changes.

You should see an endocrinologist when you experience signs of an overactive thyroid. If your hyperthyroidism treatment isn’t working or is causing complications, consult your doctor.