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When your thyroid gland goes into overdrive

Misdiagnosis in hyperthyroidism is quite common, because the key symptoms tend to overlap with other health conditions. Simply put, hyperthyroidism is an overactive thyroid gland that produces too much of thyroid hormones known as T3 and T4.

Located in the front section of your neck at the base, it helps to regulate body processes like metabolism, the nervous system, heart rate and body temperature, just to name a few. Undetected or misdiagnosed hyperthyroidism puts a person at risk of damaging their thyroid gland.

This diminishing capacity to properly regulate important body processes can result in problems like the decline of energy, metabolic activity and mental function. It even affects one’s mood, and subsequently, brings about depression.

Important test markers

Until recently, many health professionals were unaware of what to look for when testing for hyperthyroidism. Most doctors would only glance at the numbers of hyperthyroidism tests, without truly understanding the meaning behind them.

As we now know better, here are key markers to examine when diagnosing hyperthyroidism.

Reverse T3: A body under intense stress will have high levels of the cortisol hormone.

Cortisol increases the levels of reverse T3, an inactive form of the T3 thyroid hormone. It mimics, but does not really perform the real functions of T3. On this note, looking at total T3 and T4 levels alone do not tell you the whole story of what’s going on.

Only the free portion of T3 and T4 thyroid hormones are able to maximise their benefits on the body’s cells and those levels are important in helping to determine the health of your thyroid.

Vitamin D and magnesium: Patients with hyperthyroidism are very often found with low levels of vitamin D. If you are found to be low in vitamin D, discuss a supplementation plan with your doctor.

Homocysteine: This amino acid is derived mainly from eating meat, but high levels of it complicate heart health and have been linked to the development of lung issues. Studies also suggest that high levels of homocysteine is linked to patients with hyperthyroidism.

C reactive protein (CRP): The CRP-hs test gives patients and their doctors a better idea of the level of inflammation in the body. T3 and T4 are less effective when inflammation is severe, and inflammation often plays a big role in thyroid problems.

Liver function: A substantial amount of thyroid hormones are processed in the liver. Hence, a poorly functioning liver creates issues with metabolism, and alters the process of T3 and T4 conversion.

With a blood test, doctors can identify if liver enzymes are elevated and plan a corrective course of action.

Thyroid antibodies: Hyperthyroidism can be caused by autoimmune diseases, specifically Graves’ disease and Hashimoto’s thyroiditis. Each of these diseases are linked to different types of antibodies that can be identified in tests, so it is important to test for antibodies.

Understanding if it is your liver function, a lack of critical nutrients or problems with the pituitary glands, is also necessary in order to plan a more accurate course of treatment.

With Graves’ disease, the test is known as either TSH binding inhibiting immunoglobin (TBII) or thyroid stimulating immunoglobin (TSI). For Hashimoto’s thyroiditis, the condition is identified by testing the antibodies attached to thyroid tissues.

Causes and symptoms

Tremors in your hands are one of the symptoms of hyperthyroidism. —


Women have to pay more attention to hyperthyroidism, as it is more prevalent in our gender. If you are genetically prone to the condition, there’s a risk of developing it during pregnancy or within a year after delivery.

Overconsumption of iodine either from supplements, medicine or food, may also cause the thyroid to overproduce hormones. Lumps in the thyroid glands are another culprit causing an overactive thyroid.

Those lumps are known as toxic nodular or multi-nodular goitre and encourage the production of excessive amounts of thyroid hormones. Thyroiditis, which is inflammation of the thyroid gland, can occur when the immune system is weakened or the body is fighting off a virus.

This is temporary as long as you treat the problem and strengthen your immune system. Finally, hyperthyroidism occurs due to the autoimmune diseases discussed above. Graves’ disease, which is hereditary, is the most common cause of hyperthyroidism.

In this condition, the body makes antibodies in order to combat viruses or bacteria, but these antibodies end up aggravating the thyroid instead, causing it to overproduce thyroid hormones.

Hyperthyroidism is tricky to diagnose, as its symptoms are very similar to that of other diseases. Pay extra attention to the following symptoms:

• Anxiety or nervousness

• Irregular heart beat

• Loss of weight

• Trouble falling asleep

• Fatigue

• Tremors in the hands

• Irregular periods

• Muscle weakness

• Changes in bowel movement

• Swelling in the neck

Seafood, which is high in iodine, is a no-no if you have hyperthyroidism. — Reuters


Most of the time, doctors will prescribe antithyroid medications to balance out excess activity. Radiation or surgery are also options to consider in treating hyperthyroidism.

Before some of these treatments are carried out, a low iodine diet is prescribed and you’ll be advised to maintain a similar diet after completing your treatment.

Apart from low iodine, consuming more of the following foods calms the inflammation in your body and reduce chronic symptoms of hyperthyroidism:

• Vitamin D – cereals fortified with vitamin D, mushrooms, cow liver and fatty fish.

• Zinc – beef, cashew nuts, pumpkin seeds, cocoa powder and chickpeas.

• Iron – green leafy vegetables, red meat, chicken, turkey, lentils and whole grains.

• Healthy fats – oils from flaxseed, olive, avocado, sunflower, and unsalted nuts and seeds.

• Selenium – tea, Brazil nuts, couscous, mushrooms and chia seeds.

But there are also foods you should avoid or eat less of. They include:

• Foods that are high in iodine, such as seafood (prawns, lobster, squid etc), milk and dairy products, egg yolks, iodised water and iodised salt.

• Foods that contain nitrates, which makes the thyroid absorb iodine in large quantities, especially processed meat like pepperoni and other cold cuts, and even vegetables like turnips, carrots, cucumber, leeks, parsley, endives and beets.

• Foods containing gluten, which may cause inflammation.

• Soy, as research indicates it interferes with treatment of hyperthyroidism.

The bottom line on hyperthyroidism is that it is treatable. Monitor your symptoms carefully if you suspect that you might be suffering from the condition, then seek your doctor’s help in getting tested and planning a treatment plan.


By Datuk Dr. Nor Ashikin Mokhtar
Published in Star Newspaper, April 8, 2019