Hyperthyroidism is a condition wherein the thyroid gland produces excessive thyroid hormones (T3 and T4), leading to an accelerated metabolism. The most common cause is Graves’ disease, an autoimmune disorder, but it can also result from thyroid nodules or excessive iodine intake.
Dr Rupali Satija, DNB Family Medicine explains that while both men and women experience common symptoms such as weight loss, rapid heartbeat, and nervousness, studies suggest some gender-specific differences.
Women -
• More likely to have autoimmune-related hyperthyroidism (Graves’ disease is 7-10 times more common in women)
• Experience menstrual irregularities or lighter periods
• Higher incidence of anxiety and mood disorders
• Greater risk of thyroid eye disease, leading to bulging eyes (exophthalmos)
• Pronounced issues with regard to attention, emotional regulation, and anxiety, likely due to thyroid hormones’ interaction with estrogen
Men -
• Prone to muscle weakness and osteoporosis at an earlier stage
• Higher likelihood of cardiovascular complications, such as atrial fibrillation
• May experience reduced testosterone levels, leading to lower libido and erectile dysfunctions
• Cognitive effects that are more pronounced in spatial abilities (similar to findings in hypothyroidism)
• Greater impairment in visuospatial skills, problem-solving, and impulse control. They may experience reduced testosterone, which can further affect cognition and mood stability.
Symptoms
Physical
• Unexplained weight loss despite normal or increased appetite
• Rapid or irregular heartbeat (palpitations)
• Tremors (shaking hands or fingers)
• Increased sweating and heat intolerance
• Fatigue or muscle weakness
• Thinning hair and brittle nails
Cognitive & Emotional
• Anxiety, irritability, or nervousness
• Difficulty concentrating (brain fog)
• Sleep disturbances
Other effects:
• Goiter (enlarged thyroid gland)
• Bulging eyes (Graves' disease)
• Increased frequency of bowel movements
Can Hyperthyroidism Be Reversed
Dr Rupali emphasises that hyperthyroidism can often be managed and, in some cases, reversed, depending on the underlying cause. Treatment options include -
Medication
• Anti-thyroid drugs (eg: methimazole, propylthiouracil) to reduce hormone production
• Beta-blockers (eg: propranolol) to manage symptoms like rapid heart rate
Radioactive Iodine Therapy
Destroys thyroid cells to reduce hormone production. It often leads to hypothyroidism, which requires lifelong thyroid hormone replacement.
Surgery (Thyroidectomy)
Removal of part or all of the thyroid gland in severe cases
Lifestyle Adjustments
• Stress management (eg: meditation, yoga) to reduce hormone surges
• Dietary modifications
• In some cases, mild hyperthyroidism due to thyroiditis (inflammation of the thyroid) may resolve on its own over time
Reversible Causes
Hyperthyroidism can sometimes be temporary and reversible, depending on its cause. The following conditions can lead to transient hyperthyroidism, which may resolve with proper treatment or on its own.
Thyroiditis (Inflammation of the thyroid)
Subacute Thyroiditis: Often caused by a viral infection, leading to temporary hyperthyroidism followed by hypothyroidism and eventual recovery.
Postpartum Thyroiditis: Occurs in some women after childbirth and typically resolves within a year.
Drug-induced Thyroiditis: Certain medications (eg: amiodarone, interferon, lithium) can cause inflammation, leading to temporary hyperthyroidism.
Excess Iodine Intake
High iodine consumption (from diet, supplements, or contrast dyes used in imaging tests) can overstimulate the thyroid, leading to hyperthyroidism. Reducing iodine intake can often reverse the condition.
Medication-induced Hyperthyroidism
Some medications, such as excessive thyroid hormone replacement therapy (levothyroxine), can lead to hyperthyroidism, if the dosage is incorrect. Adjusting or discontinuing the medication can reverse the condition.
Functional Or Temporary Thyroid Autonomy
Some benign thyroid nodules (toxic adenomas or multinodular goiters) may temporarily produce excess hormones but might stabilise or shrink over time. Sometimes, addressing iodine intake or hormonal balance can help normalise thyroid function.
Stress-induced Hyperthyroidism
Severe stress can trigger excessive thyroid hormone release in some individuals. Stress management (meditation, exercise, therapy) can help restore thyroid balance.
Pregnancy-related Hormonal Changes
Human chorionic gonadotropin (hCG), a hormone produced during pregnancy, can temporarily stimulate the thyroid and cause mild hyperthyroidism. This usually resolves after pregnancy without intervention.
How To Reverse Reversible Hyperthyroidism
Dr Rupali suggests the following measures:
• Treat the underlying cause (eg: viral infection, stress, medication adjustment)
• Monitor iodine intake and avoid excessive supplementation
• Use beta-blockers (eg: propranolol) to control symptoms while the thyroid stabilises
• Follow a thyroid-supportive diet and maintain a healthy lifestyle
Diet Recommendations
Diet plays a key role in managing hyperthyroidism. Some key considerations include:
• Cruciferous vegetables: Broccoli, cabbage, cauliflower (may help slow thyroid function)
• Anti-inflammatory foods: Berries, turmeric, and omega-3-rich foods (eg: salmon)
• Whole grains & fibre: Regulate digestion and prevent diarrhoea
• Dairy & calcium-rich foods: Prevent bone loss (eg: yogurt, cheese)
Foods To Limit Or Avoid
Iodine-rich Foods: Avoid excess seaweed, shellfish, and iodised salt.
Caffeine & Stimulants: These can worsen anxiety and heart palpitations.
Soy products: Soy may interfere with thyroid medications.
Processed & sugary foods: These can contribute to inflammation.