Thyroid overactive living in adults

Overview

An overactive thyroid (also called hyperthyroidism) means your thyroid gland — a small butterfly-shaped gland in your neck — makes too much thyroid hormone. This hormone controls how your body uses energy, so having too much speeds up your body's processes, like your heart rate and metabolism.

Yes, overactive thyroid affects about 1 in 100 people in the UK. It's more common in women and people over 60.

It can affect adults of any age, but is most often diagnosed in people between 20 and 50. Women are up to 10 times more likely to develop it than men.

Symptoms

Common symptoms

• Feeling anxious, nervous, or irritable
• Rapid or irregular heartbeat (palpitations)
• Unexplained weight loss despite eating normally or more
• Increased sweating and feeling hot all the time
• Trembling hands (tremor)
• Fatigue or muscle weakness
• Frequent bowel movements
• Difficulty sleeping

Symptoms in older adults

• Heart problems like atrial fibrillation (irregular heartbeat)
• Weight loss and loss of appetite
• Depression or confusion
• Falls and fractures due to muscle weakness

Causes

Main causes

• Graves' disease: an autoimmune condition where your immune system attacks your thyroid, causing it to produce too much hormone.
• Thyroid nodules: lumps in the thyroid that make extra hormone.
• Thyroiditis: inflammation of the thyroid that releases stored hormone into your blood.
• Taking too much thyroid hormone medication (if you have an underactive thyroid).

Risk factors

• Being female
• Having a family history of thyroid problems
• Having another autoimmune condition, such as type 1 diabetes or rheumatoid arthritis
• Recent pregnancy (postpartum thyroiditis)
• High iodine intake (from diet or supplements)

When to see a doctor

See a doctor urgently if:

• If you have chest pain, difficulty breathing, or a very fast heart rate, get emergency help.
• If you have a fever with confusion and rapid heartbeat, call emergency services.

Book a routine appointment if:

• Make an appointment with your GP if you have symptoms like weight loss, sweating, or feeling nervous that last for more than a few weeks.

Diagnosis

Your doctor will ask about your symptoms, examine your neck, and order blood tests to measure thyroid hormone and TSH (thyroid-stimulating hormone) levels.

Tests that may be done

• Blood tests: TSH (thyroid-stimulating hormone), T3 and T4 (thyroid hormones)
• Thyroid ultrasound: to check for nodules or inflammation
• Radioactive iodine uptake scan: shows how well your thyroid takes up iodine

What to expect at your appointment

Diagnosis is straightforward. You may need to see an endocrinologist (a hormone specialist) for further testing and treatment planning.

Treatment

Treatment aims to lower your thyroid hormone levels to normal. The right choice depends on your age, overall health, and the cause of your overactive thyroid.

Self-care at home

• Get plenty of rest and learn to manage stress.
• Avoid caffeine and other stimulants that can worsen heart symptoms.
• Eat a balanced diet with enough calcium and vitamin D to protect your bones.
• If you smoke, try to quit — smoking can make Graves' disease worse.

Medical treatments

Medications called antithyroid drugs can reduce how much hormone your thyroid makes. Radioactive iodine treatment involves taking a capsule or liquid that slowly destroys overactive thyroid cells. Both treatments require regular follow-up. In some cases, surgery to remove part or all of the thyroid may be recommended. Your doctor will decide the best approach for you.

When is surgery considered?

Surgery (thyroidectomy) may be an option if you cannot take antithyroid drugs, have a large goiter, or need a quick solution (e.g., during pregnancy in some cases). After surgery, you will need lifelong thyroid hormone replacement medication.

Living with this condition

Many people manage well with treatment. You'll need regular blood tests and medication adjustments. Keep a list of your symptoms and share any concerns with your healthcare team.

Lifestyle tips

• Stay active with gentle exercise like walking or yoga.
• Practice relaxation techniques like deep breathing or meditation.
• Keep a consistent sleep schedule.
• Avoid stimulants like energy drinks and limit alcohol.

Diet and exercise

Aim for a balanced diet rich in fruits, vegetables, and lean protein. Limit iodine-rich foods like seaweed and shellfish if advised by your doctor. Exercise moderately—too much can stress your heart. Ask your doctor before starting a new exercise routine.

Mental health and emotional wellbeing

Anxiety, mood swings, and irritability are common. Talk to your doctor if you feel depressed or overly anxious. Counselling or support groups can help you cope.

Prevention

Most cases cannot be prevented because they are caused by immune system problems or genetics. However, you can reduce your risk of complications by getting diagnosed early and following your treatment plan.

Screening programmes

Routine screening for overactive thyroid is not recommended for everyone. However, if you have a family history of thyroid disease, your doctor may suggest periodic blood tests.

Complications

If left untreated

• Heart problems: atrial fibrillation, heart failure
• Bone thinning (osteoporosis) and increased fracture risk
• Thyroid storm: a life-threatening condition with severe fever, rapid heartbeat, and confusion

Long-term outlook

With proper treatment, most people with an overactive thyroid lead normal, healthy lives. It is a manageable condition. Work closely with your healthcare team to find the treatment that works best for you.

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