What are the symptoms of hyperthyroidism?

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From the Guidelines

Hyperthyroidism symptoms include weight loss, heart palpitations, heat intolerance, and hyperactivity, as well as other nonspecific symptoms such as nervousness, irritability, tremors, excessive sweating, fatigue, muscle weakness, difficulty sleeping, and frequent bowel movements. These symptoms occur because excess thyroid hormones accelerate the body's metabolism, essentially putting bodily functions into overdrive 1. The severity of symptoms varies depending on how much excess thyroid hormone is present, the duration of the condition, and individual factors like age.

Common Symptoms

  • Weight loss despite increased appetite
  • Rapid or irregular heartbeat
  • Nervousness, irritability, tremors in the hands
  • Excessive sweating, heat intolerance
  • Fatigue, muscle weakness, difficulty sleeping
  • Frequent bowel movements
  • Bulging eyes (exophthalmos), particularly in Graves' disease
  • Lighter or irregular menstrual periods in women
  • Enlarged thyroid gland (goiter), causing a visible swelling in the neck

Important Considerations

When present, symptoms of hyperthyroidism are often relatively nonspecific, and the condition can be asymptomatic in some cases 1. The USPSTF found adequate evidence that screening can detect abnormal serum TSH levels in asymptomatic persons, but what constitutes an abnormal TSH level is uncertain 1. Early detection and treatment of asymptomatic persons with abnormal serum TSH levels with or without abnormal T4 levels may be beneficial because it may prevent longer-term morbidity and mortality from fractures, cancer, or cardiovascular disease 1. However, widespread screening and treatment of subclinical thyroid dysfunction can also result in harms due to labeling, false-positive results, and overdiagnosis and overtreatment.

Treatment and Management

Hyperthyroidism is treated with antithyroid medications (such as methimazole) or nonreversible thyroid ablation therapy (for example, radioactive iodine or surgery) 1. Although definitive data are lacking, treatment is generally recommended for patients with a TSH level that is undetectable or less than 0.1 mIU/L, particularly those with overt Graves disease or nodular thyroid disease. If you experience symptoms of hyperthyroidism, seek medical attention promptly as untreated hyperthyroidism can lead to serious complications including heart problems, bone loss, and a dangerous condition called thyroid storm.

From the Research

Symptoms of Hyperthyroidism

The symptoms of hyperthyroidism can vary, but common symptoms include:

  • Anxiety
  • Insomnia
  • Palpitations
  • Unintentional weight loss
  • Diarrhea
  • Heat intolerance 2, 3, 4, 5 Some patients may also experience:
  • Cardiac arrhythmias
  • Heart failure
  • Osteoporosis
  • Adverse pregnancy outcomes 2
  • Dysphagia
  • Orthopnea
  • Voice changes (in patients with toxic nodules) 2
  • Exophthalmos or stare (in patients with Graves' disease) 2

Specific Symptoms by Cause

The symptoms of hyperthyroidism can also vary depending on the underlying cause. For example:

  • Graves' disease: may cause a diffusely enlarged thyroid gland, exophthalmos, or stare 2
  • Toxic nodules: may cause symptoms from local compression of structures in the neck, such as dysphagia, orthopnea, or voice changes 2
  • Thyroiditis: may cause thyrotoxicosis, which can lead to symptoms such as anxiety, insomnia, and palpitations 3, 4, 5

Systemic Effects

Hyperthyroidism can also have systemic effects, including:

  • Cardiovascular manifestations, such as hypertension and tachycardia 4
  • Integumentary, musculoskeletal, immune, ophthalmic, reproductive, gastrointestinal, and cardiovascular system effects 4

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Hyperthyroidism: A Review.

JAMA, 2023

Research

Hyperthyroidism: Diagnosis and Treatment.

American family physician, 2016

Research

Hyperthyroidism.

Gland surgery, 2020

Research

Hyperthyroidism.

Lancet (London, England), 2003

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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