(Graves Disease; Overactive Thyroid)


The thyroid gland is a butterfly-shaped gland in the front of the neck. It produces hormones that control metabolism. Hyperthyroidism occurs when the thyroid gland becomes overactive and produces too much thyroid hormone.
The Thyroid Gland
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Hyperthyroidism may be caused by:

Risk Factors

Factors that may increase your chance of hyperthyroidism include:


Symptoms come on slowly. As the thyroid becomes more overactive, symptoms may appear.
Hyperthyroidism may cause:


You will be asked about your symptoms and medical history. A physical exam will be done.
Tests may include:


Treatment will depend what is causing the hyperthyroidism. It will also be adjusted if you are pregnant. Talk to your doctor about the best treatment options for you.
Options include:

Antithyroid Drugs

Antithyroid medications work best for Graves disease. They will reduce thyroid activity. Smoking can interfere with some of the medications. If you smoke, talk to your doctor about how you can successfully quit.
All theses medications can cause a rash, fever and painful joints. Serious adverse reactions include increased risk of infection and liver damage.
If the disease goes into remission, you may no longer need medication.


This type of medication can relieve rapid heart rate and nervousness.

Radioactive Iodine

Radioactive iodine is taken orally. It is then absorbed by the thyroid gland. Once there, it damages most of the thyroid cells. These cells can no longer produce thyroid hormones. Within days, the excess iodine passes out of the body in the urine or changes into a nonradioactive state. This treatment reduces the activity of the thyroid. Sometimes the treatment can decrease the thyroid levels too much. In this case, you will need to take a daily thyroid hormone replacement.


Thyroidectomy is uncommon for the treatment of hyperthyroidism. It will remove part or all of the thyroid. It may be an option when medical therapy fails.
After a thyroidectomy, you may need to take daily thyroid, calcium, or vitamin D supplements.

Eye Protection

If there are eye symptoms like dry red eyes or double vision, your doctor may prescribe:
  • Eye protection before sleep
  • Artificial tears
  • Sunglasses
You may be referred to an eye specialist.


There are no current guidelines to prevent hyperthyroidism.


The American Thyroid Association

Graves Disease and Thyroid Foundation


Health Canada

Thyroid Foundation of Canada


American Association of Clinical Endocrinologists. Medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism. Endocrine Practice. 2002;8(6):457-469.

Hyperthyroidism and thyrotoxicosis. EBSCO DynaMed website. Available at: Updated November 10, 2014. Accessed December 16, 2014.

Shomon M. Frequently asked questions on Graves disease & hyperthyroidism. Thyroid-Info website. Available at: Accessed December 16, 2014.

Van Geest RJ, Sa sim IV, Koppeschaar HP, et al. Methylprednisolone pulse therapy for patients with moderately severe Graves orbitopathy: a prospective, randomized, placebo-controlled study. Eur J Endocrinol. 2008;158(3):229-237.

1/30/2009 DynaMed's Systematic Literature Surveillance Nyirenda MJ, Taylor PN, Stoddart M, Beckett GJ, Toft AD. Thyroid-stimulating hormone-receptor antibody and thyroid hormone concentrations in smokers vs nonsmokers with Graves disease treated with carbimazole. JAMA. 2009;301(2):162-164.

7/6/2009 DynaMed's Systematic Literature Surveillance Safety: propylthiouracil. US Food and Drug Administration website. Available at: Updated August 29, 2013. Accessed December 16, 2014.

6/10/2014 DynaMed's Systematic Literature Surveillance Alhefdhi A, Mazeh H, Chen H. Role of postoperative vitamin D and/or calcium routine supplementation in preventing hypocalcemia after thyroidectomy: a systematic review and meta-analysis. Oncologist. 2013;18(5):553-542.

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