How to Tell if You Are Hyperthyroid

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Here's how you can determine if you have an overactive thyroid condition called hyperthyroidism.

Identify Your Risk Factors

You will want to identify and track your risk factors for hyperthyroidism or Graves' disease, the autoimmune condition that causes hyperthyroidism. These risk factors include gender (women are more at risk), a family history of thyroid problems, previous thyroid problems such as nodules, goiter, hypothyroidism, and thyroid cancer, a previous thyroid surgery, or a personal or family history of any autoimmune disease.

Identify Your Symptoms

Note any common symptoms of hyperthyroidism you are experiencing, including neck enlargement, weight loss, anxiety, insomnia, fatigue, hair loss, heart palpitations, rapid heartbeat, sweating, feeling overheated, high blood pressure, diarrhea, weakness, and eye/vision changes.

Note Your Related Conditions

Identify any related conditions that are more common when you are hyperthyroid. These can include atrial fibrillation, recurrent pregnancy loss, panic disorder, and anxiety disorder. 

See a Doctor for A Full Evaluation and Tests

Meet with your doctor for an in-depth clinical thyroid examination and various blood tests.

These tests should include a TSH (thyroid stimulating hormone) blood test, along with total and free T4 and total and free T3 tests. Your doctor may also test thyroid antibody levels, to identify antibodies that help diagnose autoimmune Graves' disease.

In some cases, imaging tests—such as ultrasound, MRI, CT scans, x-rays, or radioactive iodine uptake (RAI-U)—will be performed to make a thorough and accurate diagnosis.


Review and Understand Your Test Results

You need to review your test results with your doctor, and understand the results. 

  1. Normal range for the TSH test is approximately 0.5 to 5.0. If your TSH level is at the lower end of the range, or below the range, your doctor may determine that you are hyperthyroid (overactive thyroid.)
  1. If your doctor ran a test called total T4 or total thyroxine, normal range is approximately 4.5 to 12.5. If you had a high reading and a low TSH, your doctor might consider that indicative of hyperthyroidism.
  2. If your doctor ran total T4 and you had a high reading, and a high TSH, your doctor might look into a possible pituitary problem.
  3. If your doctor ran a test called free T4 or free thyroxine, normal range is approximately 0.7 to 2.0. If your result was greater than 2.0, your doctor might consider that indicative of hyperthyroidism.
  4. If your doctor ran a test called total T3, normal range is approximately 80 to 220. If your result was greater than 220, your doctor might consider that indicative of hyperthyroidism.
  5. If your doctor ran a  free T3 test, and your result was greater than 4.2, your doctor might consider that indicative of hyperthyroidism.
  6. If your test results come back 'normal' but you have many of the symptoms or risk factors for thyroid disease, make sure you ask for an antibodies test for Graves' disease.
  7. Imaging tests can identify goiter—more common in hyperthyroidism—as well as nodules that may be causing hyperthyroidism. In addition, RAI-U tests can in some cases show hyperthyroidism, as well as evidence that the overactive thyroid may be triggered by the autoimmune condition known as Graves' disease. 

    If all your test results come back normal but you have symptoms or risk factors for thyroid disease, consider going to a reputable holistic, integrative, or complementary physician for further interpretation and diagnosis.

    A Word From Verywell

    Hyperthyroidism can be overlooked or easily misdiagnosed. In some cases, the common hyperthyroidism symptoms like panic attacks, anxiety, difficulty sleeping, loss of appetite, weight loss, and rapid heart rate are assumed by patients to be — or misdiagnosed by doctors as—mental health issues like anxiety disorder, panic disorder, and depression, or attributed to issues such as aging, hormones, and stress.

    It is important that if you have risk factors, hyperthyroidism signs, or symptoms that you have comprehensive evaluation and testing. Do not rely on a doctor who does not do a hands-on examination of your thyroid, as well as detailed blood and imaging tests. Hyperthyroidism can not be ruled out simply by looking at you. Don't accept a mental health diagnosis, or a prescription for an anti-anxiety drug or antidepressant until a complete If you have a family history, risk factors, and signs and/or symptoms of hyperthyroidism, it’s vitally important that you insist on comprehensive evaluation and testing. Don’t accept a mental health or eating disorder diagnosis without thoroughly ruling out the possibility that you are hyperthyroid.


    Bahn, R., Burch, H, Cooper, D, et al. Hyperthyroidism and Other Causes of Thyrotoxicosis: Management Guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists."Endocrine Practice. Vol 17 No. 3 May/June 2011.

    Braverman, L, Cooper D. Werner & Ingbar's The Thyroid, 10th Edition. WLL/Wolters Kluwer; 2012.