What is hyperthyroidism?

Hyperthyroidism is characterised by an overactive thyroid gland. It refers to when the thyroid produces and releases high levels of thyroid hormone. The thyroid gland controls how the body uses energy, so much so that its functionality affects almost every organ in the body. As a result, the overproduction of thyroid hormones leads to a quicker metabolic rate, weight loss, a rapid heart rate, increased appetite and anxiety.

What causes hyperthyroidism?

Graves’ disease, an autoimmune disorder that causes an overactive thyroid, is the most common cause of hyperthyroidism. While medical experts are unable to determine the exact causes of the disease, it is suspected that Graves’ disease occurs due to certain disruptions that hinder the immune system from functioning properly.

Some of the other suspected causes of hyperthyroidism include:

Benign thyroid nodules: some benign thyroid nodules (link to thyroid nodules page) have been known to drive the thyroid gland to overproduce thyroid hormone.
High levels of T4 in the blood: high levels of T4 due to supplements can cause hyperthyroidism.
Ovarian tumour: although it is a rare incident, struma ovarii has been found to produce thyroid hormones, which leads to hyperthyroidism.
Thyroiditis: inflammation of the thyroid, which leads to the thyroid gland producing too little or too much thyroid hormone.

What are the symptoms of hyperthyroidism?

Some of the common symptoms of hyperthyroidism include:

Anxiety or nervousness
Excessive sweating
Fatigue
Frequent bowel movements
Hair loss or change in texture (more brittle)
Hot flashes
Irregular menstrual cycles
Muscle weakness
Rapid heart rate
Sleep issues
Swelling or enlargement of the neck
Swelling or inflammation of the eyes
Trembling hands (tremors)
Weight loss
Vision changes

If you suspect that you are experiencing symptoms of hyperthyroidism, schedule an appointment to receive a proper diagnosis.

Who is at risk of hyperthyroidism in Singapore?

Although hyperthyroidism is more common in females, there are several risk factors that increase the likelihood of developing the condition. This includes:

Age: women who are older than 60 years old are more likely to develop hyperthyroidism.
Family history: you have an increased risk of developing hyperthyroidism if you have a family history of thyroid diseases.
Medical conditions: if you have other medical conditions such as pernicious anaemia (vitamin B12 deficiency), type 1 or 2 diabetes, Graves’ disease or primary adrenal insufficiency, then you are more likely to develop hyperthyroidism.
Iodine-rich diet/medication: the risks of you developing hyperthyroidism increase if you are consuming a diet that is rich in iodine or are on medications that are high in iodine.
Nicotine use: you are more at risk of developing hyperthyroidism if you frequently use nicotine products, be it through cigarettes or electrical cigarettes.
Pregnant: women who have been pregnant or had a baby within the past 6 months are more at risk of developing hyperthyroidism due to hormonal changes.

How is hyperthyroidism diagnosed in Singapore?

Diagnosing hyperthyroidism typically starts with examining the physical symptoms, followed by a series of tests. However, this will depend on the severity of your symptoms. At NC Tan Surgery, our doctor will begin by examining:

The eyes: to check for any swelling, bulging, redness or possible signs of Graves’ disease.
The hands: to observe for any tremors.
The heart: to listen for any rapid or irregular heartbeat.
The neck: to determine if your thyroid glands are enlarged.
The skin: to feel if it is moist and warm.

Our doctor will then proceed with either one of the following tests or a combination of several tests to diagnose hyperthyroidism:

Blood tests: our doctor will perform a thyroid screening (link to thyroid screening page) to determine the thyroid hormone level in your blood. You have hyperthyroidism when the T3 and T4 hormone levels are elevated, but the thyroid-stimulating hormone (TSH) is below normal.
Radioiodine scan: a radioiodine scan will help determine which part of the thyroid gland is responsible for causing hyperthyroidism.
Thyroid ultrasound: a thyroid ultrasound utilises a high-frequency sound wave to capture images of the thyroid. This will help our doctor identify thyroid nodules and is the safest diagnostic imaging test for women who are pregnant, breastfeeding or allergic to radioiodine.

How is hyperthyroidism treated in Singapore?

Once a diagnosis has been confirmed, our doctor will outline a treatment plan, which may include the following steps:

Medication: our doctor will prescribe anti-thyroid medications to prevent your thyroid gland from producing thyroid hormone. This is typically the initial step in treating hyperthyroidism, as it offers immediate control of your thyroid gland.
Radioiodine: radioiodine is an oral medication that your overactive thyroid cells will absorb. The medication functions by damaging these cells, thereby triggering your thyroid to shrink. This will eventually cause your thyroid hormone levels to return to normal levels.
Surgery: in more serious cases, our doctor will recommend a thyroidectomy (link to thyroidectomy page), to permanently cure hyperthyroidism. Additionally, surgery is often followed by supplements to help keep hormone levels balanced.

If you are curious to learn more about hyperthyroidism and its treatment options, then we encourage you to speak with our doctor. By arming yourself with the right information, you could be a step ahead of a preventable disease taking control of your life.

Frequently Asked Questions

What are some of the hyperthyroidism-related complications that I should know of?

Some of the complications that can arise when hyperthyroidism is left untreated are:

An irregular heartbeat that leads to stroke, heart failure, blood clots and other cardio-related issues.
An eye disease known as Graves’ ophthalmopathy, whereby you experience double vision, eye pain, light sensitivity and vision loss.
Fertility issues in women, thereby leading to pregnancy complications like premature birth, low birth weight, miscarriage and high blood pressure during pregnancy.
Thinning of the bones (osteoporosis).

How long does it take to treat hyperthyroidism?

The treatment duration will be dependent on the severity of your condition, on top of the time it takes for your thyroid gland to respond to the treatment. On average, it takes roughly between 6 – 12 weeks for your hormones to stabilise. In more severe cases or repeated occurrences of hyperthyroidism, a thyroidectomy is the most effective and definitive way to treat hyperthyroidism.

What are the risks associated with hyperthyroidism treatment?

Some risks that have been linked with hyperthyroidism include;

Liver damage: certain hyperthyroidism medications like methimazole and propylthiouracil (PTU) have been associated with potential liver damage or a severe drop in white blood cell count, although the occurrence is less than 1%. Additionally, some patients may be allergic to the medication.
Radiation: radiation is often a risk, especially since it is associated with cancer. However, there has been no study that proves radioiodine (used to treat hyperthyroidism) stimulates cancer-growing cells.

Rest assured that our doctor will walk you through each treatment step thoroughly, as well as keep you informed of the possible risk factors. Additionally, he is skilled and equipped with the necessary expertise and knowledge to provide a minimally invasive and low-risk treatment without compromising the outcome of the treatment or your well-being.

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