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Hyperthyroidism Hyperthyroidism National Endocrine and Metabolic Diseases Information Service What is hyperthyroidism? Pituitary Hyperthyroidism is a disorder that occurs gland when the thyroid gland makes more thyroid hormone than the body needs. U.S. Department of Health and Hyperthyroidism is sometimes called Human Services thyrotoxicosis, the technical term for too much thyroid hormone in the blood. Thyroid NATIONAL hormones circulate throughout the body in INSTITUTES OF HEALTH the bloodstream and act on virtually every tissue and cell in the body. Hyperthyroidism TSH causes many of the body’s functions to speed up. About 1 percent of the U.S. population has hyperthyroidism.1 Thyroid What is the thyroid? The thyroid is a 2-inch-long, butterfly-shaped gland weighing less than 1 ounce. Located T -T in the front of the neck below the larynx, 3 4 or voice box, it has two lobes, one on each side of the windpipe. The thyroid is one The thyroid’s production of thyroid hormones—T3 of the glands that make up the endocrine and T4—is regulated by thyroid-stimulating hormone system. The glands of the endocrine system (TSH), which is made by the pituitary gland. produce, store, and release hormones into the bloodstream. The hormones then travel through the body and direct the activity of heart and nervous system functions, body the body’s cells. temperature, muscle strength, skin dryness, menstrual cycles, weight, and cholesterol The thyroid gland makes two thyroid levels. hormones, triiodothyronine (T3) and thyroxine (T4). T3 is made from T4 and is Thyroid hormone production is regulated by the more active hormone, directly affecting thyroid-stimulating hormone (TSH), which the tissues. Thyroid hormones affect is made by the pituitary gland in the brain. metabolism, brain development, breathing, When thyroid hormone levels in the blood are low, the pituitary releases more TSH. When thyroid hormone levels are high, 1Golden SH, Robinson KA, Saldanha I, et al. the pituitary responds by decreasing TSH Prevalence and incidence of endocrine and metabolic disorders in the United States: a comprehensive production. review. Journal of Clinical Endocrinology Metabolism. 2009;94(6):1853–1878. What causes With Graves’ disease, the immune system makes an antibody called thyroid stimulating hyperthyroidism? immunoglobulin (TSI) that attaches to Hyperthyroidism has several causes, thyroid cells. TSI mimics the action of TSH including and stimulates the thyroid to make too much • Graves’ disease thyroid hormone. • thyroid nodules More information about Graves’ disease is provided in the National Endocrine and • thyroiditis, or inflammation of the Metabolic Diseases Information Service thyroid (NEMDIS) fact sheet Graves’ Disease at • consuming too much iodine www.endocrine.niddk.nih.gov. • overmedicating with synthetic thyroid Thyroid Nodules hormone, which is used to treat Thyroid nodules, also called adenomas, are underactive thyroid lumps in the thyroid. Thyroid nodules are Rarely, hyperthyroidism is caused by a common and usually noncancerous. About pituitary adenoma, which is a noncancerous 3 to 7 percent of the U.S. population has tumor of the pituitary gland. In this case, them.2 However, nodules may become hyperthyroidism is due to too much TSH. overactive and produce too much hormone. Graves’ Disease A single overactive nodule is called a toxic adenoma. Multiple overactive nodules are Graves’ disease, also known as toxic called toxic multinodular goiter. Often diffuse goiter, is the most common cause found in older adults, toxic multinodular of hyperthyroidism in the United States. goiter can produce a large amount of excess Graves’ disease is an autoimmune disorder. thyroid hormone. Normally, the immune system protects the body from infection by identifying and Thyroiditis destroying bacteria, viruses, and other potentially harmful foreign substances. But Thyroiditis is an inflammation of the thyroid in autoimmune diseases, the immune system that causes stored thyroid hormone to leak attacks the body’s own cells and organs. out of the thyroid gland. At first, the leakage raises hormone levels in the blood, leading to hyperthyroidism that lasts for 1 or 2 months. Most people then develop hypothyroidism— when thyroid hormone levels are too low— before the thyroid is completely healed. 2Gharib H, Papini E, Paschke R, et al. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules. Endocrine Practice. 2010;16(s1)1–43. 2 Hyperthyroidism Several types of thyroiditis can cause Overmedicating with Synthetic hyperthyroidism followed by hypothyroidism: Thyroid Hormone • Subacute thyroiditis. This condition Some people who take synthetic thyroid involves painful inflammation and hormone for hypothyroidism may take too enlargement of the thyroid. Experts much. People who take synthetic thyroid are not sure what causes subacute hormone should see their health care thyroiditis, but it may be related to provider at least once a year to have their a viral or bacterial infection. The thyroid hormone levels checked and follow condition usually goes away on its own the health care provider’s instructions about in a few months. the dosage. • Postpartum thyroiditis. This type of Some other medications may also interact thyroiditis develops after a woman with synthetic thyroid hormone to raise gives birth. For more information, see hormone levels in the blood. People who the section titled “What happens with take synthetic thyroid hormone should ask pregnancy and thyroid conditions?” their health care provider about interactions • Silent thyroiditis. This type of when starting new medications. thyroiditis is called “silent” because it is painless, as is postpartum What are the symptoms of thyroiditis, even though the thyroid may be enlarged. Like postpartum hyperthyroidism? thyroiditis, silent thyroiditis is probably Hyperthyroidism has many symptoms that an autoimmune condition and can vary from person to person. Some sometimes develops into permanent common symptoms of hyperthyroidism are hypothyroidism. • nervousness or irritability Consuming Too Much Iodine • fatigue or muscle weakness The thyroid uses iodine to make thyroid • heat intolerance hormone, so the amount of iodine consumed influences the amount of thyroid hormone • trouble sleeping the thyroid makes. In some people, • hand tremors consuming large amounts of iodine may • rapid and irregular heartbeat cause the thyroid to make excess thyroid hormone. • frequent bowel movements or diarrhea Sometimes significant amounts of iodine • weight loss are contained in medications—such as • mood swings amiodarone, which is used to treat heart problems—or in supplements containing • goiter, which is an enlarged thyroid that seaweed. Some cough syrups also contain may cause the neck to look swollen and large amounts of iodine. See “Eating, Diet, can interfere with normal breathing and and Nutrition” for more information on swallowing iodine. 3 Hyperthyroidism Who is likely to develop Hyperthyroidism in the Aging hyperthyroidism? Population Women are two to 10 times more likely Hyperthyroidism is more common in people than men to develop hyperthyroidism.1 older than age 60 and is often caused by Certain factors can increase the chances of thyroid nodules. Older adults do not always developing thyroid disorders. People may display the more common symptoms of the need more regular testing if they disorder. For this reason hyperthyroidism in this age group is sometimes misdiagnosed as • have had a thyroid problem before, such depression or dementia—loss of intellectual as goiter or thyroid surgery abilities, sometimes with emotional • have a family history of thyroid disease disturbance and personality changes. • have pernicious anemia, a B12 For example, older adults with deficiency; type 1 diabetes; or primary hyperthyroidism may seem disinterested adrenal insufficiency, a hormonal or withdraw socially. Older adults with disorder hyperthyroidism may lose their appetites, whereas younger people with the condition • eat large amounts of food containing tend to have increased appetites. Older iodine, such as kelp, or use iodine- adults may also have different physical containing medications such as symptoms and may be more at risk from amiodarone, a heart medication subclinical hyperthyroidism than younger • are older than age 60 patients. • were pregnant or delivered a baby For people older than age 60, subclinical within the past 6 months hyperthyroidism increases their chance of Getting tested routinely helps uncover developing a rapid, irregular heartbeat, thyroid problems—especially subclinical a condition known as atrial fibrillation, problems. Subclinical means a person has which may lead to heart failure or stroke. no apparent symptoms. Some health care Untreated hyperthyroidism can also speed providers treat subclinical hyperthyroidism the bone-thinning disease osteoporosis, immediately. Others prefer to leave it particularly in women, and increase the untreated but monitor their patients for signs likelihood of bone fractures. that the condition is worsening. 4 Hyperthyroidism What happens with Postpartum thyroiditis. This inflammation of the thyroid gland affects about 4 to pregnancy and thyroid 10 percent of women in the first year conditions? after giving birth.4 Postpartum thyroiditis Hyperthyroidism. During pregnancy, causes hyperthyroidism that usually lasts
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