The Causes of an Overactive Thyroid

An overactive thyroid is an indicator of one of many disorders and health conditions that affect your thyroid gland's ability to function correctly. While there are simple tests to determine if your thyroid is overactive, it's up to your physician or specialist to narrow down the specific cause. If your physician has informed you that your thyroid is overactive, it's helpful to know how your thyroid gland functions, and the disorders and health conditions that may cause you to have signs and symptoms of hyperthyroidism--as well as treatment options for an overactive thyroid.

  1. Your Thyroid Gland's Mission

    • Your thyroid gland has one mission: to regulate your body's metabolic rate--in fact, thyroid cells are the only cells that can perform this function. Metabolic function includes your ability to gain or lose weight given normal amounts of food intake and exercise. But the thyroid gland is also the overseer of other important functions, including heart and pulse rate, blood pressure and body temperature. The thyroid accomplishes its goal by converting iodine into the thyroid hormone, which is actually made up of two separate hormones: thyroxine (T4) and triiodothyronine (T3). A healthy thyroid produces about 80 percent T4 and 20 percent T3. T3 is roughly four times as "strong" as T4 in terms of effectiveness.

    T3, T4 and TSH

    • In addition to producing T3 and T4, there is another important hormone to learn about--thyroid stimulating hormone (TSH). TSH is released by the pituitary gland whenever it notes that the thyroid gland isn't producing enough thyroid hormone. A low level of TSH in your bloodstream indicates that the pituitary gland sees no need to stimulate the thyroid into producing more thyroid hormone. High levels of T3 and T4 in the bloodstream, combined with a low level of TSH, indicate an overactive thyroid. This leads to a condition called hyperthyroidism.


    • Hyperthyroidism is merely a medical term used to describe the signs and symptoms seen in people with an overactive thyroid; the etiology of hyperthyroidism can be one of several underlying disorders. If you have an overactive thyroid, you might notice certain symptoms. These can include an irregular "fluttering" heartbeat, intolerance to heat, nervousness and anxiety, fatigue, and the inability to fall and remain asleep. Women may experience light menstrual periods, or none. Signs that you and your doctor might notice include a fast heart rate, hand tremors, hair loss, muscular weakness and warm, damp skin. While many people with an overactive thyroid experience weight loss, some actually gain weight because they eat more to keep up with the impossible demands of an above-normal metabolism.

    Causes of Hyperthyroidism

    • The most frequent cause of an overactive thyroid is Graves' disease, which is actually an autoimmune disorder. In addition to an overactive thyroid, people with Graves' disease can also have inflammation behind the eyes that causes swelling, as well as thickened skin on the lower legs, known as pretibial myxedema. Less common causes of an overactive thyroid are thyroid nodules, sometimes called "toxic nodular goiter," which cause excessive thyroid hormone production. Thyroiditis, inflammation of the thyroid gland, can also cause symptoms of hyperthyroidism. Most forms of thyroiditis are transient and require no long-term treatment.

    Treating the Overactive Thyroid

    • Graves' disease or toxic nodular goiter can be treated with anti-thyroid drugs such as methimazole and propylthiouracil (PTU), which prevent the thyroid from overproducing thyroid hormone. Because symptoms of an overactive thyroid may return after you stop taking the drugs, patients are often encouraged to consider a treatment called radioactive iodine treatment. While this is touted as a permanent "fix" for an overactive thyroid, it almost always results in hypothyroidism, a condition that requires lifelong monitoring and treatment. Another way to treat hyperthyroidism is to remove part or all of the thyroid gland surgically--this too can result in hypothyroidism.

    How Should You Treat an Overactive Thyroid?

    • According to the Journal of Nuclear Medicine Technology, in the United States, radioactive iodine treatment is most frequently recommended to patients with an overactive thyroid, particularly those with Graves' disease. However, in Europe, Australia and Asian countries (including Japan and China), anti-thyroid drug treatment is the preferred choice; radioactive iodine treatment is used sparingly. Before you decide on a treatment for an overactive thyroid, have an in-depth discussion with your doctor about the possible side effects of various treatments.

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