Overactive Thyroid: What To Do
Hyperthyroidism: the thyroid producing too much hormone, speeding many body processes.
Last revised
It causes weight loss, palpitations and anxiety that are often attributed to stress, and it carries real cardiac and bone risk if untreated.
Key takeaways
- Main test: TSH, suppressed, with raised T4 or T3
- Commonest cause: Graves' disease
- Most useful single change: Seek assessment for unexplained weight loss with palpitations or tremor.
- Commonest mistake: Attributing palpitations and anxiety to stress without a thyroid test.
- See a doctor if any of the signs under "When to get help" below apply to you.
Do
- Seek assessment for unexplained weight loss with palpitations or tremor
- Report eye symptoms, which need specialist assessment in Graves' disease
- Take antithyroid medication exactly as prescribed
- Stop smoking, which worsens thyroid eye disease considerably
Do not
- Attributing palpitations and anxiety to stress without a thyroid test
- Ignoring a sore throat or fever while on carbimazole
- Stopping treatment when symptoms improve
The figures behind the list
Each item above follows from these, published in the guidance named at the foot of the page.
| Measure | Figure |
|---|---|
| Main test | TSH, suppressed, with raised T4 or T3 |
| Commonest cause | Graves' disease |
| Treatments | antithyroid drugs, radioiodine, or surgery |
| Carbimazole warning | sore throat or fever needs an urgent blood count |
| Associated risks | atrial fibrillation and osteoporosis |
Where to go next
- Overactive Thyroid: A Beginner-Friendly Start
- Answers to the Common Questions on Overactive Thyroid
- Overactive Thyroid — the reference entry
- What the Guidance Really Says About Thyroid Function Tests
- Thyroid Lumps: What Published Guidance Supports
When to get help
Seek urgent medical advice for a sore throat, mouth ulcers, fever or bruising while taking carbimazole or propylthiouracil — these can indicate a dangerous fall in white cells and need an immediate blood count. Call 999 for fever with agitation, a very rapid heart rate, vomiting and confusion, which can indicate thyroid storm. Report double vision or eye pain urgently.
Where this comes from
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarised or generalised beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to a GP, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 999.