Overview

Many symptoms are associated with hyperthyroidism. However, note that association does not necessarily prove cause and effect!

The following symptoms are often associated with hypothyroidism:

  • Bulging eyes (exophthalmos), eye pain, double vision, light sensitivity, or red/puffy eyes;
  • Enlargement of the thyroid gland (goiter), feeling of a lump in the throat, difficulty swallowing, or hoarseness;
  • Elevated basal body temperature and metabolic rate;
  • Elevated heart rate, palpitations, or irregular heartbeat;
  • Heat intolerance and increased sweating;
  • Fine tremor, especially in hands or fingers;
  • Anxiety, nervousness, and irritability;
  • Underweight or unexplained weight loss, despite normal diet and good appetite;
  • Diarrhea or frequent bowel movements;
  • Change in menstrual cycle, particularly a shorter period;
  • Erectile dysfunction;
  • Fatigue;
  • Thick, red patches of skin on shins or dorsum (top) of feet (rare).

The most severe form of hyperthyroidism is the thyroid storm, which is a medical emergency. Sudden onset of elevated body temperature, elevated heart rate, palpitations, tremors, and anxiety merits immediate referral to the emergency department of the nearest hospital.

Differential Diagnosis (DDX)

The Differential Diagnoses are a list of possible diagnoses that might explain the observed signs and symptoms. They may be an alternative to the diagnosis of hyperthyroid disorder, or may be concomitant or contributing conditions that must also be addressed (or ruled out).

  • Graves' disease;
  • Hashimoto's thyroiditis (early phase);
  • Toxic multinodular goiter [Domino2017];
  • Toxic adenoma [Domino2017];
  • Subacute viral thyroiditis [Domino2017];
  • Lymphocytic thyroiditis [Domino2017];
  • Paradoxical hypothyroid (low basal body temperature with high sympathetic tone);
  • Iatrogenic (iodine supplements, iodine contrast, medications such as amiodarone) [Domino2017];
  • Iatrogenic (overdose of thyroid replacement products);
  • Pituitary adenoma (producing TSH) [Domino2017];
  • hCG-producing tumor (stimulates TSH receptors) [Domino2017];
  • Ectopic center producing T4 (metastasis) [Domino2017];
  • Pheochromocytoma (catecholamine-producing tumor);
  • Anxiety disorder;
  • Paroxysmal supraventricular tachycardia;
  • Recreational drug abuse, e.g., phencyclidine (PCP), lysergic acid diethylamide (LSD), or cocaine;
  • Serotonin syndrome.

References