Understanding Hyperthyroidism

15 Jun 2020

By Dr. Alaina Gair, ND

What is hyperthyroidism? 

Understanding Hyperthyroidism can be complex. Hyperthyroidism is an overactive thyroid disease. Overproduction of thyroid hormone (thyroxine) causes increased metabolism and symptoms like anxiety, unintentional weight loss and irregularity in your heartbeat. It may sound like the better thyroid disease to have since it comes with increased metabolism and weight loss while hypothyroidism comes with weight gain. People with hyperthyroidism often feel very unwell and may struggle with fatigue, sweating, difficulty sleeping, goiter and palpitations. 

 

The overproduction of T4 can occur for a number of reasons, here are 3 common causes: 

 

• Thyroiditis: when inflammation of the thyroid gland causes excess release of T4 into the bloodstream. This can be seen as part of an autoimmune disease or following pregnancy. 
• Graves’ Disease: this is the most common form of hyperthyroidism. This autoimmune disease creates antibodies that signal to the thyroid to produce and release too much T4. Graves’ disease can present with a symptom called opthalmopathy, where swelling of the muscles and tissue behind the eyes cause the eyeballs protrude and have a bulging appearance. 
• Thyroid nodules: benign (noncancerous) lumps in the thyroid that can release too much T4. 

 

Testing for hyperthyroidism

 

In addition to a comprehensive medical history and physical exam, your doctor or naturopath will use blood testing of hormones to assess, diagnose and monitor your thyroid health.  Testing will show a low thyroid stimulating hormone and elevated T4. To determine if hyperthyroidism is autoimmune, your doctor will also ask for thyroid antibodies and may also assess other autoimmune disease markers. Imaging the thyroid with ultrasound can also be important in determining the cause of hyperthyroidism. 

 

How common is hyperthyroidism? Is it genetic? 

 

Hyperthyroidism is diagnosed in about 1% of North Americans but is more common in women. Other factors that can put you at higher risk of developing hyperthyroidism are: 

 

• Family history of Graves’ disease or another thyroid disease 
• High iodine levels – from consuming in diet or medications 
• Pregnancy 
• Pernicious anemia
• Type 1 diabetes
• Primary adrenal insufficiency 

 

How is hyperthyroidism treated? 

 

There are 3 general treatment approaches for hyperthyroidism and your endocrinologist will recommend the best option for your case. 

 

• Medication: Antithyroid medications cause the thyroid to make less thyroid hormone but are not usually a permanent solution. A medication will be chosen based on your case and can take several weeks to show improvements in your symptoms and blood testing. Beta blockers are a group of medications used most commonly to lower blood pressure. They can be helpful in hyperthyroidism because by easing your symptoms while you wait for your antithyroid medication to take effect. Symptoms like tremor, palpitations, anxiety/nervousness and fast heartbeat can show improvement with this intervention.  
• Radioiodine therapy: Taking radioactive iodine (orally – as a liquid or capsule) slowly destroys thyroid gland cells that produce T4. This approach to treatment can result in hypothyroidism and if that occurs, you will require replacement hormone therapy with synthetic T4 (ex: Synthroid). 
• Surgery: In rare cases, surgical removal of the thyroid may be recommended to control excess production of T4. A surgeon may remove half or the whole thyroid depending on your case. After surgery your thyroid hormones will be tested again and you may be prescribed synthetic T4 (Synthroid) if you have developed hypothyroidism. This approach means your endocrinologist can titrate your T4 dose to an ideal level for you! 

 

Can a naturopathic doctor support me if I have hyperthyroidism? 

 

As you may have gathered by now, hyperthyroidism is more complicated to treat than hypothyroidism. There aren’t any naturopathic approaches to treatment that replace the conventional treatments discussed above. However, where naturopathic medicine often thrives is alongside conventional medicine. Your naturopathic doctor can help you prepare for and recover from surgery, optimize your diet for thyroid function and ensure you are feeling your best during treatment by recommending the most appropriate supplements. If you do develop hypothyroidism following radioactive iodine or surgery, your naturopath can ensure you are converting your synthetic T4 into T3 efficiently and discuss other options for replacement support. 

 

If you’re interested in checking how your thyroid is working or discussing hyperthyroidism, book a virtual initial consultation with Dr. Alaina Gair, ND.