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Hyperthyroidism: Causes, symptoms and treatment

Hyperthyroidism, also known as hyperthyreosis manifests when the thyroid glands are producing excessive amount of thyroid hormone – thyroxine.

Most of us experience a little bit of fatigue now and then, an occasional irregular period, mental fog and a loss of few kilos. But if you are experiencing these symptoms on a regular basis, with increasing severity, your thyroid gland may be the culprit.

Hyperthyroidism is a condition wherein too much of thyroid hormones are produced by over activity of thyroid glands. The thyroid gland is a small gland located at front of your neck, just below the Adam’s apple.

T4 (tetraiodothyronine) and T3 (triiodothyronine) are the two primary thyroid hormones. Hormone T3 is the more active hormone and has the greatest effect on the body than T4.

The main functions of thyroid hormones are to regulate metabolism, heart functions, breathing, reproductive functions, weight, nervous system and body temperature.

Pituitary gland located in brain regulates rate of thyroid hormone production. Pituitary by releasing hormone TSH stimulates thyroid gland to synthesize thyroid hormones. During overproduction of thyroid hormones, production of TSH reduces as pituitary gland attempts to decrease excessive amount of circulating thyroid hormones (feedback effect).

Hyperthyroidism is more commonly seen in women, people above 60 years of age and those with other thyroid problems.

Symptoms of Hyperthyroidism

High levels of T3, T4 or both can lead to acceleration of metabolic rate – hypermetabolic state. In this state every function of your body tends to speed up.

However, patients with mild disease, patients older than 60 years and those with hyperthyroidism during pregnancy usually do not experience typical signs and symptoms.

Most people with hyperthyroidism may experience enlargement of thyroid gland, which is called goiter. Other symptoms include…

1. Fatigue.

2. Heat intolerance.

3. Excessive sweating.

4. Nails: Rapid growth.

5. Sleeping disturbances.

6. Skin: Itching, thinning.

7. Unexpected weight loss.

8. Hair: Fine, brittle and hair loss.

9. Menstrual cycle: Frequency reduces.

10. Eyes: Double vision, protrusion (graves’ disease).

11. Muscle: weakness (usually thighs and upper arms).

12. Bowel movement: Frequent and loose (diarrhea is uncommon).

13. Brain: Nervousness, irritability, anxiety, inability to concentrate, fine tremors in hands and fingers.

14. Heart: Palpitations, irregular heart beat (arrhythmia) or rapid heartbeat (tachycardia-usually more than 100 beats/minute).

Causes of Hyperthyroidism

1: Graves’ disease: An autoimmune disease wherein body’s own immune cells create antibodies that stimulates thyroid gland to produce more hormones. It runs in families and generally affects women.

2: Thyroiditis: Inflammation of thyroid gland due to virus or immune system dysfunction

  • Silent: overactive thyroid gland without pain.
  • Postpartum: affects women after having a baby.
  • Sub-acute: painful inflammation of thyroid gland.

3: Thyroid nodule:  Lumps or nodules can grow in thyroid gland and can lead to gland’s hyperactivity.

  • Single toxic nodule.
  • Multinodular goiter.

4: Excessive iodine intake: Food, supplements and medications.

5: Benign tumors of thyroid gland.

6: Toxic adenoma and plummer disease.

Diagnosis of Hyperthyroidism

1: Physical examination: It is done to check symptoms including…

  • Weight loss.
  • Finger tremor.
  • Eyes protrusion.
  • Rapid pulse rate.
  • Elevated blood pressure.
  • Thyroid gland enlargement.

2: Blood tests:

  • TSH (typically low).
  • Thyroid hormones (generally elevated).
  • Thyroid-stimulating immunoglobin test (to check graves’ disease).

In case blood tests are abnormal, your doctor may advice for following tests:

3: CT scan or MRI: To check for pituitary tumour.

4 :: Thyroid Scan:  To check for thyroid over-activity.

5 :: Ultrasound of thyroid: To check for nodules or lumps.

6 :: Radioactive iodine uptake test: To check for Iodine absorption.

Treatment of Hyperthyroidism

Treatment depends on your age, severity of disease, overall health and cause of your hyperthyroidism.

1: Anti-thyroid drugs: Medications including methimazole, tapazole, can prevent over production of thyroid hormones.

2: Radioactive iodine: Iodine is quickly absorbed by overactive thyroid cells and lead to cell death. Any excess iodine is then eliminated from body in few days.

3: Surgery (thyroidectomy): To remove a part or whole of the gland. You may have to take thyroid hormones supplements for rest of your life.

4: Beta-blockers: For reducing heart rate.

5: Diet: Supplement your diet with calcium and sodium as these minerals can prevent hyperthyroidism. Consider taking vitamin D as untreated hyperthyroidism can weaken your bones. Add extra calories and protein to your diet if you experience weight loss or fatigue. Avoid foods containing too much iodine such as kelps.

6: Mind-body techniques: Yoga and meditation can manage stress and can get your body- especially thyroid gland- back in balance. by focusing on your breathing you can learn to manage stress, and more importantly, slow down.

7: Exercise: Exercise can help you feel better, increase energy level and improve your muscle and heart endurance. Weight bearing exercises are recommended for patients with Graves’ disease, as it may regulate bone density.

8: Relaxation techniques: Having positive outlook towards oneself or disease can help you, especially when coping with illness. Relationship between stress and Graves’ disease is well documented by studies. So learning relaxation techniques can help you achieve physical and mental well being.

Post treatment, you may need to undergo regular blood tests to check hormone levels.

Complications and risk factors governing Hyperthyroidism

Untreated Hyperthyroidism can lead to a number of complications, including…

1: Vision loss.

2: Miscarriage.

3: Heart diseases: Atrial fibrillation (dangerous arrhythmia that can cause stroke) and heart failure.

4: Osteoporosis: Weak, brittle bones can result because of hyperthyroidism as it interferes with calcium absorption into bones.

5: Skin issues: Untreated hyperthyroidism can result in graves’ dermopathy – red and swollen skin usually on shins and feet.

6: Impaired brain growth in children: High maternal thyroid levels can result in impaired brain development of the offspring.

7: Thyrotoxicosis crisis: Sudden intensification of hyperthyroidism symptoms. Immediately seek doctor’s advice if you have symptoms including:

  • Fever
  • Agitation
  • Confusion
  • Rapid pulse
  • Restlessness
  • Signs of delirium

Keep in mind that thyroid disease is very common, and with good care, hyperthyroidism can be easily diagnosed and treated.

Hyperthyroid Diet: Foods to eat for Thyroid patients

A hyperthyroid diet supplies ample nutrients and reduce some symptoms that interfere with proper functioning of the thyroid gland.

According to University of Maryland Medical Center a hyperthyroid diet should consist of antioxidant rich fruits and vegetables, omega-3 fatty acids, protein rich foods, healthy fats and foods containing goitrogens.

1/29: Naturally occurring goitrogens

Goitrogens are the compounds present in certain vegetables (cruciferous vegetables), certain legumes and some medications and are considered as anti-thyroid substance.

Following foods are known to possesses goitrogens…

  • Broccoli.
  • Cabbage.
  • Turnip.
  • Cauliflower.
  • Spinach.
  • Radish.
  • Water cress.
  • Mustard.
  • Collards.
  • Daikon.
  • Kale.
  • Bok choy.
  • Rutabaga.
  • Sweet potato.
  • Basil.
  • Oregano.
  • Rosemary.
  • Strawberry.
  • Peaches.
  • Peanuts.
  • Roots of cassava.
  • Brussel sprouts.
2/29: Omega-3 fatty acids

Omega-3 plays a major role in the production of prostaglandins. Prostaglandins are the lipid compounds that help to control inflammation in the body.

Any deficiency of omega-3 fatty acids is associated with hormonal imbalance and inflammation. Severe hormonal imbalance and inflammation can trigger symptoms of hyperthyroidism.

It is beneficial to enrich your diet with foods rich in omega-3 fatty acid

  • Fatty fishes (salmon, mackerel, herring, anchovies).
  • Walnuts.
  • Flexseeds.
  • Cod liver oil.
3/29: Turmeric

Curcumin; the bioactive agent in turmeric, is responsible for suppressing symptoms of hyperthyroidism.

Curcumin regulates enzymes linked with inflammation, cytokines and tumor necrosis factor (factors associated with increased inflammation)

In hyperthyroidism (in particular Graves’ disease) there is an increase in pro-inflammatory cytokines and reduction in the regulatory T cells (which maintains healthy immune system).

Numerous studies have shown that turmeric can help to reduce inflammatory cytokines and increase regulatory T-cells.

4/29: Berries

Different types of berries have different phytonutrients and the pnenolic compounds. All berries possess antioxidant and anti-inflammatory properties.

Numerous studies have shown that all berries can potentially modulate inflammatory cytokines involved in development of autoimmune diseases such as Graves’ disease.

Remember, all berries are high in oxalates (can lead to kidney stones), so be cautious about eating too many of them. You can choose from

  • Strawberries.
  • Blueberries.
  • Raspberries.
  • Blackberries.
  • Cranberries.
5/29: Kale

Rich in antioxidants, goitrogens and calcium, kale is considered a power food for patients with hyperthyroidism. It is also known for its antiproliferative and cardioprotective effects.

Cooking can inhibit its goitrogenic property, so feel free to eat a few servings of raw kale every day. Hyperthyroidism is linked with a high incidence of osteoporosis and kale exhibits excellent absorbability of its calcium content.

6/29: Organ meats

One major problem with hyperthyroid patients is that patient tends to loose a large amount of weight (due to accelerated metabolism). Eating nutrient rich organ meat can check sudden weight loss; fatigue and can improve blood sugar and mood.

In addition, meats of heart, kidney and liver in particular are rich in coenzyme Q 10 (an antioxidant), which is generally low in people with hyperthyroidism.

7/29: Soy products

The major bioactive substance present in soy is an isoflavone genistein, which possesses anti-thyroid effects.

  • It has estrogenic (interferes with body’s ability to use thyroid hormones) and goitrogenic properties.
  • It inhibits activity of thyroid peroxidase (enzyme required for synthesis of thyroid hormones)
  • Controls secretion of thyroid hormones
8/29: Bugleweed

According to a study conducted by the department of pharmacology and toxicology at university of Munster in Germany, bugleweed can reduce heart rate, palpitations and excessive perspiration in patients with mild hyperthyroidism. University of Maryland medical center recommends consuming 1-2g/day of bugleweed for proper thyroid functioning.

Note: Don’t use bugleweed if you are pregnant or nursing or taking anti-diabetic medications.

9/29: Lemon balm

Lemon balm or calming herb can help ameliorate stress, anxiety and tremors associated with hyperthyroidism.

Also, lemon balm tea can bring mildly elevated thyroid hormones back to normal values by blocking hormone receptors and can regulate overall functioning of thyroid gland.

You can choose from lemon balm tea, capsules or tincture for treating hyperthyroidism. A dosage of 400 to 500mg for three times in a day may be effective to improve your thyroid health, as suggested by university of Maryland medical center.

10/29: Motherwort

Although Motherwort may not directly act on thyroid gland; it can ameliorate some of the symptoms of hyperthyroidism like heart palpitations, anxiety, stress, insomnia and accelerated heart rate.

According to University of Maryland Medical Center, consuming 2 g of motherwort in 1 cup of boiling water can be beneficial for optimal thyroid functioning.

Gromwell: Purple gromwell by keeping the autoantibodies under check, can prevent occurrence of Graves’ disease.

11/29: Passion flower

Passion flower can alleviate many symptoms associated with hyperthyroidism such as anxiety, insomnia, fatigue, hand tremors, confusion and irritability. You can utilize passionflower tea mixed with lemon balm to relive symptoms associated with overactive thyroid.

12/29: Valerian root

Famous for its muscle relaxant and sleep-aiding properties, valerian root can increase the level of gamma amino butyric acid (GABA) – Inhibitory neurotransmitter.

13/29: Hawthorn

Hawthorn has been used for the treatment of cardiovascular diseases from quite a long time. It possesses anti-inflammatory and anti-oxidant properties. Also, it can cure accelerated heart rate and other cardiovascular symptoms associated with hyperthyroidism.

14/29: Green tea

At high doses, green tea consumption can decrease level of both thyroid hormones and increase TSH levels.

Catechins, the flavonoids present in green tea can decrease activity of thyroid peroxidase and 5’-deiodinase I enzymes (Food and chemical toxicology 2010)

15/29: Millets

Studies have shown that millet diets containing C-glycosylflavones as a chief bioactive chemical can produce effects that resemble anti-thyroid medications such as methimazole.

Millets produces anti-thyroid effects by inhibiting action of thyroid peroxidase

16/29: Eggs

Eggs are the main source of proteins, riboflavin, vitamin b12, good fats and selenium. As a result, eggs are considered as a chief nutrient source for patients with hyperthyroidism.

However, avoid egg yolk and foods containing egg yolks as it contains highest amount of arachidonic acid (70mg/yolk) – known to cause inflammation in people with autoimmune diseases.

17/29: Dairy

Untreated hyperthyroidism can remove calcium from your blood and excretes it through urine. This is generally compensated by removal of calcium from your bones which if not checked, can lead to osteoporosis.

You can have a plain yogurt everyday to fulfill your protein and calcium requirement. Include a moderate amount of cheese in your diet if you are loosing weight.

Drinking too much milk is not recommended as milk contains considerable amount of iodine. Also a lot of people with Graves’ disease have lactose intolerance. Most of the people with lactose intolerance do well with soy milk, almond milk, yogurt and cheese

18/29: Nuts and Seeds

Nuts and seeds are another nutrient dense food beneficial for hyperthyroid patients. Nuts are excellent source of monounsaturated fatty acids and omega-3 fatty acids.

Nuts are packed with proteins, vitamin E, fiber, magnesium, phosphorus, calcium and selenium. Clinical studies suggest that nuts are capable of reducing oxidative stress and inflammation

Seeds are excellent source of proteins, amino acid tryptophan and glutamate. Tryptophan is converted into serotonin in the body. Low level of serotonin is associated with depression and other mood disorders.

Glutamate helps in synthesis of GABA, which is an anti-stress neurotransmitter that helps to reduce stress and anxiety.

Lectins and phytic acid present in the nuts and seeds can exacerbate existing autoimmune disease such as grave’s disease. However, cooking, fermenting and soaking beans, nuts and seeds can reduce the amount of lectins in these foods and make them easy to digest.

19/29: Vitamin D

Our bones are in continual state of turnover, as new bone replaces old bone at regular interval. But, hyperthyroidism if left untreated can increase bone turnover so that bone breakdown outpaces deposition of new bone.

It does so impairing vitamin D metabolism. Vitamin D is an integral component required for the absorption of calcium. So it’s advisable to enrich your diet with foods rich in vitamin D such as:

  • Vitamin D fortified milk
  • Cheese
  • Fortified juice
  • Beef liver
  • Fatty fish like salmon
20/29: Zinc

Zinc is yet another mineral to be added to a hyperthyroid diet, as the disease depletes zinc.

Good sources of zinc are

  • Nuts
  • Seeds
  • Beans
  • Whole grains
  • Cereals
21/29: Niacin

Niacin or vitamin B3 can disrupt thyroid hormones as they interfere with the synthesis of thyroid hormones. You can up your niacin requirement by consuming foods like eggs, yeast, meat, milk and fish or by taking niacin supplements (preferably 1,200-1,500mg/day)

22/29: Vitamin E

Although iodine is required in synthesis of thyroid hormones, excess amounts of iodine can be dangerous and can lead to overproduction of thyroid hormones.

According to study published in journal of endocrinology 2011, vitamin E supplementation can reduce iodine-induced thyroid toxicity and overproduction of thyroid hormones.

  • Fish
  • Avocados
  • Kiwi fruit
  • Wheat germ oil
  • Green leafy vegetables
23/29: Indian Gooseberry

Indian gooseberry or Amla is the powerhouse of vitamin C and can control overproduction of T3 and T4 hormones.

One of the causes of hyperthyroidism is oxidative stress or accumulation of a lot of free radicals. Vitamin C rich foods like gooseberry can effectively combat free radicals and reverse symptoms of hyperthyroidism.

You can combine two to three mashed goose berries without seeds with a teaspoon of honey. Consume this mixture for two times in a day for the desired benefits.

Not an amla fan? You can opt from many of vitamin C rich foods like:

  • Kiwi, Guava, Citrus fruits, Lemon and Broccoli.
24/29: Other B complex vitamins

Hyperthyroidism diet should consist of food that provide optimum nutrients required to cope with stress and food that provide nutrients that this disease depletes.

Of these, all B-complex vitamins are very important as due to accelerated metabolism our body depletes a large amount of these vitamins.

B-complex vitamins are essential to build strong immune system and it also stabilizes digestive system, which often goes off-track owing to increased metabolism in hyperthyroidism

25/29: Cinnamon

Hyperthyroidism can also be caused by thyroiditis (inflammation of thyroid gland). Cinnamon extracts can combat inflammation by inducing the expression of tristetrapolin mRNA levels in areas of pro-inflammatory cytokine, according to a report in journal of diabetes science and technology in 2010.

26/29: Skullcap

In addition to lemon balm, Medical technologist Elaine Moore suggests using skullcap tea or tincture for ameliorating symptoms of hyperthyroidism. Skull cap, a member of mint family has been used to combat hyperthyroidism symptoms like stress, anxiety, insomnia, heart palpitations and tremors.

27/29: Oats

Oats may benefit hyperthyroidism patients as it can cure the weakness and fatigue caused due to excess secretion of thyroid hormones.

These excess hormones can boost metabolic process and stimulates sympathetic nervous system, which can in turn, increase stress levels and leads to fatigue in the body.

Oats makes an excellent nerve tonic that is beneficial in nervous debility. 1-2 servings per day of oats can help you fight off with some of debilitating symptoms of hyperthyroidism.

28/29: Ginger

Loaded with potassium, magnesium and zinc, ginger is a perfect addition to the hyperthyroid diet. Because of its anti-inflammatory property it is an important ingredient required for improving thyroid functioning.

29/29: Apple cider vinegar

Needless to say, apple cider vinegar has been used from ages for its antioxidant properties. It has shown to regulate acid-base balance and prevents weight loss, which is commonly seen in hyperthyroidism

Please Note: Once again, this doesn’t mean that simply supplementing your diet with above mentioned food items will cure your condition. However, following these home remedies might help to manage the symptoms better.

Hyperthyroid: Foods not to eat for thyroid patients

Diet and food makes the difference in people suffering from hyperthyroidism. Some of the foods that a hyperthyroidism patient should avoid are mentioned as…

These foods can increase your risk for diabetes and in turn diabetes is very strongly associated with thyroid diseases.

1/8: Bad fats

Trans fats and saturated fats are generally considered unhealthy fats as these are linked with high incidence of inflammation. Avoid red, processed meat, cold cuts, high fat dairy products and commercially baked foods such as cakes, pastries, biscuits, cookies and French fries.

2/8: Seaweed

Seaweed is the richest source of iodine (1 serving gives 4,500micrograms). While the recommended dose of iodine is only 150microgram/day.

According to national endocrine and metabolic disease information service, consuming too much iodine can cause overproduction of thyroid hormones, which can exacerbate your condition.

3/8: Iodised salt

Again, with more than recommended dose of iodine, iodized salt can aggravate your symptoms. Instead use sea-salt that contains lower iodine concentration.

4/8: Polysaccharides

A lot of people with Graves’ disease cannot digest polysaccharides (barley, rye, corn, potato, and yam) because of lack of enzymes required to break polysaccharides.

5/8: High Glycaemic food

Food that causes sudden rise is blood sugar are high glycaemic food that includes all purpose floor, sweets, sugar, white rice, packed juices, processed and instant foods.

6/8: Suspected food allergens

Consuming food you are allergic to can aggravate your hyperthyroidism symptoms.

Potential culprits that cause allergic reaction include milk, gluten, artificial additives, egg yolk, soy and corn. If you suspect a food allergy follow an elimination diet under the guidance of a diet and nutrition counselor.

7/8: Sugar and sugar substitutes

Avoid sugar, artificial sweeteners (processed foods, chewing gum, candies) and high fructose corn syrup (in carbonated drinks, packed juices), as these provide fuel for intestinal bacteria and can lead to leaky gut syndrome. A connection between leaky gut syndrome and autoimmune diseases has already been documented by several studies.

8/8: Alcohol, Caffeine and Nicotine

Alcohol, caffeine and Nicotine are stimulants and can influence your mood, sleep and thyroid function. These addictions also interferes with thyroid functioning and medications.

Writers Note: A simple addition/omission of the above mentioned food items from the diet will not cure your condition. Following these home remedies might help to manage the symptoms better. Please consult a related professional for your specific needs.

Related article…

[1] Yoga helps with Thyroid problems like Hypothyroidism

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