The hyperthyroid state is due to the overactivity of the thyroid gland, where there is an increased production of thyroid hormones. This elevated level of thyroid hormone is secreted into the bloodstream which in turn increase the metabolic rate of the entire body.

Some of the most common causes for the hyperthyroid state include a solitary nodule or multiple nodules, also known as a multinodular goiter.  The whole thyroid gland may become enlarged in many middle-aged or younger persons. This very common autoimmune thyroid disease is called Graves' disease.

As a result of the increased metabolism/ activity of the body, the patient feels restless, tense or excited, and even emotionally upset. Fine tremors of the fingers/hands are usually noticed when the patient is asked to stretch forward both his arms with fingers opened wide. The heart rate in patients with hyperthyroidsm may be markedly increased, causing symptoms of palpitations. There may be a change in the blood pressure, with an elevation of the upper (systolic) number, and a decrease of the lower (diastolic) number. The difference between the systolic and diastolic blood pressure numbers is known as the pulse pressure, which increases in the hyperthyroid state. More serious effects on the heart include arrhythmias such as atrial fibrillation or supraventricular tachycardia.

Another symptom of an overactive thyroid gland is a loss of weight in spite of an increased appetite. The skin is moist and warm even in cold weather, and one can easily feel this by touching the hands of the patient.  In patient's with Graves' disease, the eyes may look prominent or appear bulging which is known as exophthalmos.

The patient may not be aware of the early signs and symptoms of the hyperthyroid state.  Therefore, it is important that when the patient does seek medical attention, because of a constellation of symptoms including weight loss, nervousness, tremors, and palpitations, the health professional recognize that these may be related to hyperthyroidism.  Appropriate evaluation includes asking about a family history of Graves disease, physical examination evaluating for a thyroid nodule, and laboratory studies and diagnostic studies confirming the diagnosis.  Sometime, the patient may be unaware of the symptoms until later into progression of the disease or may neglect seeking medical attention until there are serious symptoms including profound muscle weakness (thyrotoxic myopathy) severe hypertension and tachycardia which may represent a thyrotoxic crisis requiring emergent medical treatment.

As with any medical illness, early diagnosis and treatment by the health professional is the best approach to maintaining a healthy and active lifestyle.