I saw that you've answered a question about hypothyroidism in the past, but I was wondering if you could talk a bit about hyperthyroidism as well. Two years ago, my doctor suspected (through blood tests) that I might be hyperthyroid, but nothing was done because my symptoms were mild and a second round of tests came back normal. Lately, I've been noticing things that I've heard are symptoms of hyperthyroidism (anxiety, irritability, increased bowel movements, etc.), and I am not sure what to do about it. Does hyperthyroidism require treatment, and should I be worried about thyroid cancer?

Dear Reader,

Your change in symptoms warrants a return visit to your health care provider. This is especially important because the symptoms you’ve noticed are, in fact, symptoms associated with hyperthyroidism, a condition that (to answer your second question), should be treated earlier rather than later. In terms of thyroid cancer, research indicates that thyroid cancer rarely accompanies hyperthyroidism, only occurring in about 1% of people diagnosed with the disease. In cases where thyroid cancer has accompanied hyperthyroidism, it has not been fatal and has been quite treatable. Still, a visit to your health care provider could help to rule out hyperthyroidism and thyroid cancer as the cause for your symptoms.

Hyperthyroidism (overactive thyroid) can accelerate the body’s metabolism, causing sudden weight loss, nervousness, irritability, and irregular or rapid heartbeat. Basically, an overactive thyroid causes your body to produce too much thyroid hormone (for information on hypothyroidism, an under active thyroid, see Hypothyroidism symptoms from the Go Ask Alice! archives). Other symptoms of hyperthyroidism can include increased appetite, sweating, anxiety, and tremors. Some people with hyperthyroidism develop a goiter, a swelling at the base of the neck. The most common form of hyperthyroidism is called Graves’ disease, an autoimmune condition which is caused by the body’s immune system attacking the thyroid gland. This is what causes the increased hormone production.

You mentioned that during your last visit, your health care provider did not recommend treatment because of the mild symptoms and blood tests coming back normal the second time. Make sure your provider knows, even if your blood tests come back normal again, that the symptoms seem to be more pronounced now than two years ago. If this provider seems to not take your concerns seriously, consider getting a second opinion. Left untreated, hyperthyroidism can lead to significant complications, such as:

  • Osteoporosis (weakening of the bones)
  • Eye problems
  • Heart problems

The preferred treatment for hyperthyroidism is radioactive iodine therapy. It is safe and effective and is administered in just a single dose, usually orally in liquid or capsule form. For most people, there are few side effects. Though less popular, antithyroid medications are often used, especially in such cases where radioactive iodine therapy is not recommended (e.g. during pregnancy). This type of medication is also usually taken orally, though it can be absorbed into the skin as a cream. Usually, antithyroid medications have to be taken at least twice daily. They gradually reduce the amount of thyroid hormone in the body over a two to eight month period. The oldest treatment, surgery, removes all or part of the thyroid gland. While often effective, this treatment is usually a last resort, reserved for people who refuse or are unable to complete iodine therapy, or do not respond to the other, less invasive treatments.

Testing and treatment usually starts with your general practitioner. If you are a Columbia student, you can make an appointment for a physical and screening using Open Communicator. Kudos to you for paying attention to your body and noticing these changes! This attentiveness will help keep you healthy.


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