Hyperthyroidism: Symptoms, Causes, and Management Overview

Hyperthyroidism (overactive thyroid) results from excessive thyroid hormone production, accelerating systemic metabolism.

Common Symptoms

• Weight loss despite normal/increased appetite
• Palpitations, tachycardia, arrhythmias (atrial fibrillation)
• Heat intolerance, excessive sweating
• Tremor, anxiety, irritability, insomnia
• Fatigue, proximal muscle weakness
• Frequent bowel movements, diarrhea
• Menstrual irregularities, infertility
• Goiter (diffuse or nodular)
• Eye signs (Graves': lid lag, exophthalmos, stare)

Primary Causes

• Graves' disease: TSH receptor antibodies (TRAb) stimulate thyroid — 70–80% of cases.
• Toxic multinodular goiter: Autonomous nodules — common in iodine-deficient areas, elderly.
• Toxic adenoma: Single hyperfunctioning nodule (Plummer's disease).
• Thyroiditis: Subacute, postpartum, silent — transient thyrotoxicosis from hormone leak.
• Exogenous: Excess levothyroxine, iodine-containing drugs (amiodarone), contrast.

Diagnosis and Treatment

• TSH suppressed (<0.01), free T4/T3 elevated.
• TRAb, uptake scan, ultrasound differentiate etiology.
• Treatment: antithyroid drugs (methimazole), radioiodine ablation, or thyroidectomy — tailored to cause, age, preference, comorbidities.

Untreated hyperthyroidism risks thyroid storm, osteoporosis, atrial fibrillation, and heart failure.