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Heart palpitations
Bulging eyes
Fatigued
Diarrhea
Hands have fine tremors
Lost weight recently
Tachycardia
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A condition involving an overactive thyroid gland. It's a disorder where the immune system mistakenly attacks the thyroid gland and causes an overproduction of thyroid hormone. It is more common in women than men. Some symptoms include anxiety, weight loss, tremors, changes in menstrual cycles, increase in bowel movements, fatigue, and palpitations.
Your doctor may ask these questions to check for this disease:
The treatment aims to stop the thyroid gland from overproducing hormones. Options include anti-thyroid medications, radioactive iodine therapy, and surgery. Simultaneously, medications may be prescribed to control symptoms like anxiety.
Reviewed By:
Unnati Patel, MD, MSc (Family Medicine)
Dr.Patel serves as Center Medical Director and a Primary Care Physician at Oak Street Health in Arizona. She graduated from the Zhejiang University School of Medicine prior to working in clinical research focused on preventive medicine at the University of Illinois and the University of Nevada. Dr. Patel earned her MSc in Global Health from Georgetown University, during which she worked with the WHO in Sierra Leone and Save the Children in Washington, D.C. She went on to complete her Family Medicine residency in Chicago at Norwegian American Hospital before completing a fellowship in Leadership in Value-based Care in conjunction with the Northwestern University Kellogg School of Management, where she earned her MBA. Dr. Patel’s interests include health tech and teaching medical students and she currently serves as Clinical Associate Professor at the University of Arizona School of Medicine.
Hidetaka Hamasaki, MD (Endocrinology)
Dr. Hamasaki graduated from the Hiroshima University School of Medicine and the Graduate School of Medicine, Jichi Medical University. He completed his residency at the Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine Hospital and the Department of Internal Medicine, Kohnodai Hospital, National Center for Global Health and Medicine. He has served in the National Center for Global Health and Medicine Hospital and Kohnodai Hospital and joined Hamasaki Clinic in April 2017. Dr. Hamasaki specializes in diabetes and treats a wide range of internal medicine and endocrine disorders.
Content updated on Dec 5, 2025
Following the Medical Content Editorial Policy
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Q.
Heart Racing? Why Hyperthyroidism Symptoms Occur & Medical Next Steps
A.
A racing or pounding heart can be caused by hyperthyroidism, where excess thyroid hormone overstimulates your heart and nervous system, speeding your pulse and sometimes triggering arrhythmias like atrial fibrillation. Next steps: track symptoms and see your doctor for TSH and free T4/T3 testing, and discuss treatments such as antithyroid medication, beta-blockers, radioactive iodine, or surgery; seek emergency care for chest pain, fainting, or severe shortness of breath. There are several factors to consider, including causes like Graves disease and important risks and red flags; see below for complete details that can shape your next move.
References:
* Klein I, Danzi KM. The Cardiovascular Manifestations of Hyperthyroidism. Endocrinol Metab Clin North Am. 2018 Sep;47(3):551-562. doi: 10.1016/j.ecl.2018.04.004. Epub 2018 Jul 17. PMID: 30129759.
* Vargas-Uricoechea H, Bastidas B. Cardiovascular complications of hyperthyroidism. Ther Adv Endocrinol Metab. 2014 Dec;5(6):119-27. doi: 10.1177/2042018814548922. PMID: 25102559; PMCID: PMC4121773.
* Kahaly GJ, Bartalena L, Hegedüs L, Leenhardt L, Poppe K, Pearce SH. 2018 European Thyroid Association Guideline for the Management of Graves' Hyperthyroidism. Eur Thyroid J. 2018 Aug;7(3):167-186. doi: 10.1159/000490530. Epub 2018 Jul 27. PMID: 30151248; PMCID: PMC6109915.
* Ross DS, Burch HB, Cooper DS, Greenlee MC, Laurberg P, Maia AL, Rivkees SA, Samuels MA, Sosa MC, Stan MN, White BH, Zimmermann D. 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis. Thyroid. 2016 Oct;26(10):1343-1421. doi: 10.1089/thy.2016.0229. PMID: 27521071.
* Chaker L, Korevaar TIM, Medici M, De Jongh RT. Diagnosis and management of hyperthyroidism: a review. J Clin Endocrinol Metab. 2021 Mar 23;106(4):e1781-e1793. doi: 10.1210/clinem/dgab042. PMID: 33755030; PMCID: PMC8004514.
Q.
Methimazole Side Effects? Why Your Body Reacts & Medically Approved Next Steps
A.
Methimazole treats hyperthyroidism but can cause mild effects like rash, nausea, headache, and joint pain, and rarely serious problems such as agranulocytosis and liver injury, with warning signs including fever, sore throat, mouth sores, jaundice, dark urine, severe fatigue, or right upper abdominal pain. There are several factors to consider, and medically approved next steps include keeping up with thyroid, blood count, and liver tests, not stopping the drug suddenly, and seeking urgent care for the red flag symptoms above, with dose changes or alternative treatments if needed; see complete details below to guide your next steps.
References:
* Okada T, Oya Y, Hiroi R. Antithyroid Drugs: The Clinical Implications of Their Side Effects. J Clin Med. 2022 Feb 28;11(5):1257. doi: 10.3390/jcm11051257. PMID: 35261541; PMCID: PMC8900085.
* Ross DS, Burch HB, Cooper DS, et al. 2016 Guidelines of the American Thyroid Association for the Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis. Thyroid. 2016 Dec;26(12):1343-1422. doi: 10.1089/thy.2016.0229. Erratum in: Thyroid. 2017 Jan;27(1):141. PMID: 27989568.
* Patel R, Bhansali A, Dhoat N, et al. Drug-induced liver injury secondary to antithyroid drugs: an experience from a tertiary care center in North India. Postgrad Med J. 2019 Jul;95(1125):376-379. doi: 10.1136/postgradmedj-2018-136195. Epub 2018 Dec 25. PMID: 30588691.
* Wang Y, Li Z, Liu B, et al. Risk factors for methimazole-induced agranulocytosis in Graves' disease: A systematic review and meta-analysis. Clin Endocrinol (Oxf). 2020 Dec;93(6):683-690. doi: 10.1111/cen.14322. Epub 2020 Sep 17. PMID: 32943340.
* He X, Li J, Liu Z, et al. Incidence of antithyroid drug-induced agranulocytosis and hepatotoxicity: A systematic review and meta-analysis. J Clin Endocrinol Metab. 2018 Mar 1;103(3):1022-1031. doi: 10.1210/jc.2017-02013. PMID: 29358245.
Q.
Racing Heart? Why Graves Disease Attacks Your Thyroid + Medically Approved Next Steps
A.
Graves disease is an autoimmune attack that overstimulates your thyroid through TSI antibodies, driving high thyroid hormone that can make your heart race or go irregular, raise blood pressure, and trigger anxiety, tremors, weight loss, heat intolerance, and eye changes, with a risk of atrial fibrillation. There are several factors to consider; medically approved next steps include prompt evaluation with TSH, free T4/T3, TSI and possibly a thyroid uptake scan, then treatment with antithyroid drugs, radioactive iodine, or surgery, plus beta blockers for symptom control and urgent care for chest pain or severe shortness of breath. See below for the full checklist of tests, options, and warning signs.
References:
* Kahaly GJ, Diana T, Chiovato L. Graves' disease: Mechanisms of disease and therapeutic strategies. Nat Rev Endocrinol. 2020 Sep;16(9):515-530. doi: 10.1038/s41574-020-0371-9. Epub 2020 Jul 16. PMID: 32671043.
* Minelli L, D'Angelo R, Campa D, Barbon D, Zatelli MC, Rossi M, Degli Uberti EC. Graves' Disease Management in the Modern Era. Int J Mol Sci. 2021 Jul 28;22(15):8047. doi: 10.3390/ijms22158047. PMID: 34329048; PMCID: PMC8345758.
* Smith TJ. Immunology of Graves' Disease: An Overview. Thyroid. 2022 Mar;32(3):214-224. doi: 10.1089/thy.2021.0396. PMID: 35056976; PMCID: PMC8922574.
* Burch HB, Cooper DS. Current and Emerging Treatment Options for Graves' Disease. Endocr Pract. 2022 Oct;28(10):978-986. doi: 10.1016/j.eprac.2022.07.009. Epub 2022 Aug 23. PMID: 36014460.
* Ross DS, Burch HB, Cooper DS, Greenlee MC, Laurberg P, Maia AL, Rivkees SA, Samuels MA, Sosa MC, Stan MN, Swiglo DJ, Talan M, Tuttle RM, Seervai N; American Thyroid Association Hyperthyroidism Guidelines Task Force. 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis. Thyroid. 2016 Oct;26(10):1343-1421. doi: 10.1089/thy.2016.0229. PMID: 27521074; PMCID: PMC5056775.
Q.
Is it Hormones? Why Your Endocrine System is Key & Medically Approved Next Steps
A.
Hormone imbalances in the endocrine system can explain fatigue, mood and sleep changes, weight shifts, and menstrual irregularities, but other conditions can look similar, so there are several factors to consider; see below for what matters most. Medically approved next steps include tracking symptoms, seeing a primary care clinician for targeted labs like TSH, free T4, A1C, cortisol, and reproductive hormones, considering an endocrinology referral when indicated, and focusing on evidence based sleep, nutrition, activity, and stress support while avoiding self treatment. Many endocrine issues are very treatable, and red flags such as chest pain, severe shortness of breath, fainting, confusion, or extreme blood sugar changes need immediate care; full details and decision points are below.
References:
* Katsiki, N., Papanas, N., Mikhailidis, D. P., & Mantzoros, C. S. (2023). The human endocrine system: A comprehensive review of its structure, function, and disorders. *Current Opinion in Endocrine and Metabolic Research, 31*, 100466.
* Smythe, S. J., & Speight, N. (2018). Endocrine disorders in primary care. *British Journal of Hospital Medicine, 79*(6), 332–338.
* Papadopoulou, D., Retsou, V., Tasiopoulou, G., Ziakas, A., & Ntaios, G. (2023). The Role of Lifestyle Interventions in Managing Endocrine Disorders. *Journal of Clinical Medicine, 12*(3), 1079.
* Müller, T. D., Blüher, M., Tschöp, M. H., & DiMarchi, R. D. (2021). The intricate interplay of hormones in maintaining metabolic homeostasis. *Nature Reviews Drug Discovery, 20*(3), 221–242.
* Kumar, R., & Singh, V. (2022). Endocrine Homeostasis: From Fundamentals to Clinical Applications. *Archives of Medical Research, 53*(7), 653–660.
Q.
Racing Heart? Why Your Body is Overheating: The Graves’ Disease Medical Guide to Relief
A.
Racing heart and overheating are often caused by Graves’ disease, a treatable autoimmune form of hyperthyroidism that speeds up metabolism; other clues include weight loss, tremor, anxiety, and sometimes eye changes. There are several factors to consider; see below for how it is diagnosed, when symptoms are an emergency, and what could change your next steps. Proven treatments include antithyroid medicines, beta blockers for symptom relief, radioactive iodine, or surgery, and early care helps prevent heart rhythm problems and other complications; full guidance is outlined below.
References:
* Kahaly GJ, et al. Hyperthyroidism and the Cardiovascular System. Endocr Rev. 2021 May 27;42(3):219-271. doi: 10.1210/endrev/bnaa023. PMID: 33499109.
* Burch HB, et al. Graves' Disease: Diagnosis and Treatment. Endocrinol Metab Clin North Am. 2018 Sep;47(3):503-514. doi: 10.1016/j.ecl.2018.04.004. PMID: 30122216.
* Ross DS, et al. 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis. Thyroid. 2016 Oct;26(10):1343-1427. doi: 10.1089/thy.2016.0229. PMID: 27521074.
* Silva JE. The Role of Thyroid Hormones in Thermoregulation. Front Endocrinol (Lausanne). 2021 Feb 23;12:629391. doi: 10.3389/fendo.2021.629391. PMID: 33708027; PMCID: PMC7938368.
* Kahaly GJ, et al. Graves' disease: current treatment options and future perspectives. Nat Rev Endocrinol. 2020 Feb;16(2):100-116. doi: 10.1038/s41574-019-0275-8. PMID: 31748729.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1Bartalena L. Diagnosis and management of Graves disease: a global overview. Nat Rev Endocrinol. 2013 Dec;9(12):724-34. doi: 10.1038/nrendo.2013.193. Epub 2013 Oct 15. PMID: 24126481.
https://www.nature.com/articles/nrendo.2013.193Grave's Disease - Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/graves-disease/symptoms-causes/syc-20356240