Hyperthyroidism (overactive thyroid): when the metabolism is constantly running at full speed

A constant feeling of restlessness, unusual exhaustion and the impression that the body simply cannot relax – these can be warning signs that the thyroid gland is more active than it should be. Often associated with feelings of inner balance, the thyroid gland plays a key role in regulating energy, mood and stress management. A balanced thyroid gland thus contributes to a stable emotional state, while disruptions in thyroid function can lead to mood swings, nervousness or even depression and can therefore significantly affect everyday life.

But what actually happens in the body when the thyroid gland becomes overactive, and how can it be regulated? We have summarized everything you need to know on the subject.

What is an overactive thyroid?

Did you know? Hyperthyroidism, also known as an overactive thyroid, is when the thyroid gland produces too many hormones. These hormones – mainly thyroxine (T4) and triiodothyronine (T3) – are crucial for metabolism and even influence almost all bodily functions [1]. Normally, the thyroid gland ensures that energy consumption and heat production are in balance. So it is really important!

However, this balancing act can be disrupted by overproduction. The cells work much too hard, which can lead to a number of sometimes quite unpleasant symptoms. Early detection and treatment are not only important for your well-being, but also to prevent serious consequences such as thyroid autonomy or latent hyperthyroidism, in which the hyperthyroidism does not yet show any clear symptoms but can place a heavy long-term strain on

What are the symptoms of hyperthyroidism?

However, an overactive thyroid not only affects the psyche and metabolism, but can also have a significant impact on the cardiovascular system. In particular, untreated hyperthyroidism can be harmful to older people, as it can lead to cardiovascular disease.

Really unpleasant! An overactive thyroid can manifest itself in a variety of ways and affect many areas of the body. Typical symptoms are [2]:

Unwanted weight loss
Faster heartbeat
Nervousness and inner restlessness
Sleep disorders
Excessive sweating
Trembling hands
Increased irritability
Warm, moist skin
Prominent eyes (signs of Graves' disease)

But that's not all. An enlarged thyroid or goitre is another common sign of hyperthyroidism. This enlargement occurs because the thyroid gland tries to maintain the excessive production of hormones, which often becomes visible externally.

Reminder for pregnant women and those who want to become pregnant: Hyperthyroidism can be particularly problematic during pregnancy, as it can increase the risk of complications such as premature birth and insufficient fetal

Can an overactive thyroid be dangerous?

Yes, unfortunately, in extreme but rare cases of an untreated thyroid gland hyperfunction, a thyrotoxic crisis can arise – a life-threatening worsening of the symptoms. This crisis can trigger high fever, cardiac arrhythmias and impaired consciousness and requires immediate medical attention. Extreme caution is advised here [3]!

What causes and risk factors are there?

The most common cause of hyperthyroidism is Graves' disease, an autoimmune disorder in which the immune system causes the thyroid gland to overproduce. But there are other causes and rarer triggers, such as thyroid nodules (hot nodules or an autonomous adenoma) that produce hormones in an uncontrolled manner [3]. Certain thyroid inflammations (thyroiditis) such as Hashimoto's thyroiditis can also trigger symptoms of hyperfunction. Further examinations are urgently needed here.

If you have a family history of hyperthyroidism, you are also at increased risk. Oh yes, our modern lifestyle can also play a role. Stress, smoking and large amounts of iodine, e.g. from an increased iodine intake or iodine-containing contrast agents, can throw the thyroid gland out of balance [4]. If you are aware of these possible causes, you can take countermeasures at an early stage and take care of your health.

Which thyroid value is the most important?

If you suspect that your thyroid is out of sync, it's going to be an exciting ride: a few blood tests need to be checked. When diagnosing hyperthyroidism, several steps are necessary to get a clear picture. First, the thyroid-stimulating hormone (TSH) and the thyroid hormones thyroxine (T4) and triiodothyronine (T3) are checked.

The most important thyroid value here is TSH: it provides information about how well the thyroid gland is working and regulates the production of the thyroid hormones T3 and T4. If the TSH value and thus the TSH level is low while T4 and T3 are elevated, this could indicate hyperthyroidism [5].

When does the TSH level become dangerous?

It's actually quite logical: the TSH level becomes critical when it is either greatly increased or greatly decreased. Specifically, a TSH level above 4.0 mU/L may indicate an underactive thyroid (hypothyroidism), while a level below 0.4 m Extremely high or low levels are truly alarming, and you should have a check-up quickly to find out exactly what is wrong and what can be done about it.

Further diagnosis and tests

Fortunately, there are many options for testing. In addition, imaging techniques such as an ultrasound of the entire thyroid gland are often performed. This allows changes in the structure or possible nodules to be detected. A scintigraphy with a radioactive substance can also show how active the thyroid gland is and which areas may be working too ambitiously [5]. Internal medicine covers a broad field when it comes to the diagnosis and treatment of diseases such as hyperthyroidism. ICD codes are particularly useful for clearly classifying diseases and making them internationally understandable.

The doctor then wants to know exactly what is going on: a visit to the doctor involves a comprehensive anamnesis, in which not only the current symptoms but also family risks and environmental factors are discussed. Based on this information and the test results, an individual treatment plan is then drawn up – tailored to the patient's personal needs.

What treatment options are there?

Medication

The treatment options for hyperthyroidism are many and depend on several factors, including the extent of the disease, the age of the patient and any concomitant illnesses. One common method is drug therapy, in which antithyroid drugs are used to reduce the production of thyroid hormones and alleviate the symptoms [6]. However, these drugs can have side effects and require regular monitoring by a doctor.

Radioactive iodine therapy

Radioactive iodine may be used in a procedure called radioactive iodine therapy. This procedure targets and destroys overactive thyroid tissue to normalize hormone production [6]. It is an effective and widely used This approach may be particularly appropriate for patients who do not respond adequately to medication or who cannot tolerate it.

Alternative methods for hyperthyroidism

On top of this, there are alternative therapies such as homeopathy, which are considered complementary to conventional medicine. Although alternative therapies are often considered less invasive and more natural, they should always be used in consultation with an experienced doctor to minimize interactions and risks. No matter which treatment method is chosen, the goal is always to achieve a balance of thyroid hormones and improve the quality of life of those affected.

Some dietary supplements, such as selenium, vitamin D, omega-3 fatty acids, vitamin B complex and zinc, can help with thyroid problems and contribute to general well-being [7]. However, it is crucial to discuss their use with a doctor to avoid interactions and possible risks.

Can hyperthyroidism be prevented?

Healthy lifestyle? This also makes a lot of sense here! There are some simple but effective measures that can be taken to reduce the risk of hyperthyroidism: a balanced diet is key here – the German Society of Endocrinology (DGE) recommends taking care not to consume too many iodine-rich foods or supplements [3]. Similarly, not smoking can have a positive effect on thyroid function. Stress management is also extremely important, as chronic stress can put a lot of strain on the thyroid gland.

Regular visits to the doctor are especially important if there is a history of thyroid disease in the family. This way, potential problems can be identified and addressed early on. A healthy lifestyle, including exercise and enough sleep, also helps to keep the thyroid healthy and fully supported [8]. Remember: a healthy body + a healthy mind = a better chance of a healthy thyroid.

What are the warning signs of an underactive thyroid?

But it can also go to the other extreme. If you feel constantly tired and drained or notice unusual changes in your body, it could be caused by an underactive thyroid, also known as hypothyroidism. The following warning signs or possible symptoms may occur [9]::

Constant tiredness and lack of energy
Unplanned weight gain despite an unchanged diet
Excessive sensitivity to cold
Dry skin and hair loss
Constipation
Memory problems or difficulty concentrating

Doesn't sound too good either, does it? With these symptoms, it can therefore also be useful to have your thyroid levels checked.

Sources:

[1] https://www.thyroid.org/hyperthyroidism/
[2] https://www.niddk.nih.gov/health-information/endocrine-diseases/hyperthyroidism
[3] https://www.deutsches-schilddruesenzentrum.de/schilddruesenerkrankungen/schilddruesenueberfunktion/
[4] https://www.mayoclinic.org/diseases-conditions/hyperthyroidism/symptoms-causes/syc-20373659
[5] https://labtestsonline.org/tests/thyroid-stimulating-hormone-tsh
[6] https://www.endocrine.org/patient-engagement/endocrine-library/hyperthyroidism
[7] https://www.hashimoto-thyreoiditis.de/therapie/spurenelemente-und-vitamine
[8] https://www.btf-thyroid.org/thyroid-and-diet-factsheet
[9] https://www.thyroid.org/hypothyroidism/