Overactive thyroid (hyperthyroidism) - causes, symptoms and diet

Understanding hyperthyroidism (hyperthyroidism)

Hyperthyroidism occurs when the thyroid gland produces too many hormones. These hormones - thyroxine (T4) and triiodothyronine (T3) - accelerate the metabolism and influence the heart, digestion, nerves and many other bodily functions. In the case of hyperthyroidism, these processes are constantly running at full speed, which leads to a variety of symptoms. Graves' disease - an autoimmune disease - is the most common cause of hyperthyroidism worldwide. In addition, functional autonomies of the thyroid gland (so-called "hot nodules") or temporary thyroid inflammation can also trigger hyperthyroidism. In contrast to hypothyroidism, in which too few hormones are present, hyperthyroidism means an excess of thyroid hormones in the body.

Who is affected? Overall, hyperthyroidism occurs in around 1-2% of the population (women are significantly more frequently affected than men):contentReference[oaicite:1]{index=1}. The disease often begins between the ages of 30 and 50, but can occur at any age. Genetic predisposition and autoimmune processes play a major role - the main cause of Graves' disease is a misdirected immune response in which antibodies stimulate the thyroid gland to overproduce. Long-term iodine deficiency can also contribute indirectly: in iodine-deficient regions with goitre formation, areas of the thyroid gland that have become autonomous tend to become hyperthyroid (so-called iodine-induced hyperthyroidism) in the event of a sudden high iodine intake. Conversely, in rare cases an extreme excess of iodine (e.g. by very high doses of algae preparations or iodine-containing contrast media) can trigger hyperthyroidism in sensitive people - this is known as the iodine-Basedow effect:contentReference[oaicite:2]{index=2}:contentReference[oaicite:3]{index=3}:contentReference[oaicite:4]{index=4}:contentReference[oaicite:5]{index=5}:contentReference[oaicite:6]{index=6}.

Why is hyperthyroidism problematic? An excess of thyroid hormones puts a strain on the entire organism. If left untreated, severe hyperthyroidism can lead to dangerous complications such as cardiac arrhythmia (atrial fibrillation), bone loss (osteoporosis) and even a life-threatening thyrotoxic crisis. Even mild forms (subclinical hyperthyroidism, i.e. still normal T3/T4 values with already suppressed TSH) increase the risk of bone fractures by around 30%:contentReference[oaicite:8]{index=8}:contentReference[oaicite:9]{index=9}. It is therefore important to recognize hyperthyroidism at an early stage and treat it in a targeted manner. Depending on the cause, standard therapy consists of thyrostatic drugs (drugs that slow down hormone production) and, if necessary, radioiodine therapy or surgical removal of thyroid tissue. These treatments can usually control the hyperthyroidism effectively, although some side effects do occur (e.g. antithyroid drugs can drastically reduce the white blood cells or put a strain on the liver; radioiodine or surgery often result in hypothyroidism). This makes it all the more important to support the body through lifestyle and diet. Although dietary adjustments do not replace medical treatment, they can help to alleviate symptoms and promote the long-term health of the thyroid gland - always in consultation with the doctor, of course.

Symptoms of hyperthyroidism

Hyperthyroidism can manifest itself in a number of characteristic symptoms because the metabolism is running at "turbo speed", so to speak. Typical symptoms include

• Palpitations and high blood pressure: those affected often suffer from an accelerated heartbeat and palpitations, including cardiac arrhythmia. Resting heart rates of over 100 beats/minute are not uncommon. In the long term, this can put a lot of strain on the heart.
• Nervousness and inner restlessness: Many patients feel driven, tense and irritable. Sleep disorders often occur - be it difficulty falling asleep or restless, short sleeps with frequent awakenings.
• Heavy sweating and sensitivity to heat: Hyperthyroidism increases body temperature, which leads to heat intolerance. Patients sweat more, have moist, warm skin and quickly feel uncomfortable in warm environments.
• Unexplained weight loss with a good appetite: The body burns more calories due to the increased basal metabolic rate. Many sufferers lose weight despite normal or even increased food intake. At the same time, cravings and increased thirst can occur.
• Trembling and muscle weakness: A fine tremor of the hands is typical. There is also muscle weakness and rapid fatigue - even everyday activities suddenly become more difficult.
• Psychological changes: In addition to irritability, feelings of anxiety, panic attacks or depressive moods can also occur. Some also report concentration problems and a feeling of "flight of thought".
• More frequent bowel movements or diarrhea: Digestion is accelerated. This manifests itself in increased bowel movements, sometimes also diarrhea and abdominal pain.
• Skin, hair and nails: The skin is often thin, warm and moist. Diffuse hair loss and brittle nails can occur, as the rapid metabolism impairs the supply of nutrients to the skin, hair roots and nail bed.
• Menstrual irregularities and potency problems: Women may experience menstrual cycle disorders - for example irregular or absent periods. Fertility may be temporarily reduced. Men may notice reduced potency.
• Eye symptoms (in Graves' disease): About half of Graves' disease patients develop eye problems, known as endocrine orbitopathy. These are characterized by bulging eyes (exophthalmos), swollen eyelids, a feeling of pressure behind the eyes, increased tearing, sensitivity to light and double vision. In severe cases, vision may be impaired. Note: These eye changes occur almost exclusively in the autoimmune form of Graves' disease.

Not everyone affected has all of the symptoms mentioned - the severity and combination can vary greatly from person to person. Older patients in particular sometimes show less typical signs (this is referred to as "apathetic" hyperthyroidism), e.g. general fatigue or weight loss without noticeable heart symptoms. It is important to note that if symptoms such as persistent palpitations, unexplained weight loss or the eye symptoms described occur, a medical examination should be carried out as a matter of urgency. A simple blood test (TSH and free T3 and T4 levels) can determine whether hyperthyroidism is present. If necessary, a determination of antibodies (TRAK if Graves' disease is suspected) and an ultrasound or scintigraphy examination can be carried out to narrow down the cause and extent. Good to know: With consistent treatment, most symptoms of hyperthyroidism can improve significantly within weeks to a few months. Until the hormone levels are back in the normal range, the doctor may prescribe temporary beta-blockers to prevent palpitations, tremors and restlessness. At the same time, it is worth influencing your diet and lifestyle - you can find out exactly how to do this in the next section.

Diet for hyperthyroidism: supporting the body with the right food

A healthy, adapted diet can help with hyperthyroidism on several levels. Firstly, the body needs sufficient energy and nutrients to cope with the increased consumption and prevent weight loss and nutrient deficiencies. Secondly, certain symptoms can be alleviated through targeted food choices - for example, by limiting a diet that is very rich in iodine so as not to further fuel the excessive hormone production. Micronutrients (such as selenium), vitamins and secondary plant substances with an antioxidant effect can also relieve the thyroid gland and the immune system. Note: A review emphasizes that apart from moderate iodine intake and a good supply of selenium, only a few nutritional factors have been clearly proven to be beneficial in thyroid diseases:contentReference[oaicite:11]{index=11}:contentReference[oaicite:12]{index=12}. Nevertheless, a well-considered food selection can help to alleviate symptoms and improve overall health. Here you can find out which points you should pay attention to:

Moderate your iodine intake (no extreme iodine abstinence, but avoid excess)

Iodine is the basic building block of the thyroid hormones T3 and T4. Normally, without enough iodine there is no sufficient hormone production - which is why iodine deficiency often plays a role in hypothyroidism. In the case of hyperthyroidism, however, the opposite is the problem: the thyroid gland produces too many hormones despite a normal iodine supply. A high iodine intake can possibly boost this overproduction even further, especially if there are autonomous nodules in the thyroid gland:contentReference[oaicite:13]{index=13}:contentReference[oaicite:14]{index=14}. For this reason, people with Graves' disease and thyroid autonomy are often advised to avoid excessive amounts of iodine.

Specific tips:

• Seaweed and kelp: Kelp, nori, wakame & co. contain extremely high levels of iodine and should be avoided in hyperthyroidism. Some dietary supplements ("thyroid capsules") also rely on algae extracts with a high iodine content - such preparations are not suitable for hyperthyroidism patients.
• Sea fish in moderation: Sea fish and seafood also provide iodine, but in moderate amounts. You don't have to give up fish completely - one or two portions of sea fish per week are fine. Prefer varieties with a medium iodine content (e.g. salmon, herring) and don't eat large amounts of seaweed-containing sushi.
• Iodized table salt: In Germany, table salt is often enriched with iodine (approx. 15-25 µg per gram of salt). You don't have to strictly avoid it - this common iodization contributes to the basic supply. However, you should avoid an extremely salty diet (which would be unhealthy anyway). If you often eat out: ready meals, canteen meals and fast food usually contain plenty of iodized salt - so consciously limit your consumption here.
• Dairy products and eggs: Milk, dairy products and eggs also provide a moderate amount of iodine (depending on the iodine content of the animal feed). They can continue to be part of your diet - the aim is not to completely avoid iodine, but only to avoid overdoses.

Important: Complete iodine restriction is not advisable, as the body needs around 150-200 µg of iodine per day for many important metabolic functions. It is therefore a matter of moderation, not complete abstinence. Particularly if radioiodine therapy is planned, people often temporarily go on a low-iodine diet in advance to make the treatment more effective - such diets should only ever be followed on medical advice. As a general rule, the normal balanced diet in Germany provides around 180-200 µg of iodine per day (through iodized salt), which is fine. Only additional high-iodine supplements or extreme algae intake would be problematic. Therefore, keep an eye on your dietary supplements and talk to your doctor if in doubt.

Sufficient calories, high-quality protein and high nutrient density

Due to the accelerated metabolism, your body consumes more calories than usual in the hyperfunction phase - a kind of "hypermetabolism". Your basal metabolic rate can be increased by 10-20%, in severe cases even more. At the same time, more of the body's own proteins are broken down, which can lead to muscle atrophy. To counteract this:

• Increase your energy intake: Make sure you consume enough calories so that your body does not have to draw on its own reserves (muscle protein, fat deposits). Eat regularly and reach for energy- and nutrient-dense foods: e.g. nuts, avocado, vegetable oils, wholegrain products. If you lose a lot of weight unintentionally, additional snacks and snacks between meals can be useful (e.g. a smoothie made from oat flakes, banana, nut butter and plant milk as a high-calorie drink).
• Incorporate high-quality protein: To maintain muscle mass, the body needs sufficient protein. Approx. 1.2-1.5 g protein per kg body weight is recommended in such "stress phases" (for 70 kg, this means ~85-105 g protein/day). Good sources are lean meat, fish, eggs, dairy products, pulses, tofu and nuts. Spread your protein intake throughout the day (about 20-30 g of protein at each main meal); this also supports muscle regeneration. If your normal diet is not sufficient, protein shakes or a quark with nuts as a snack can help.
• Increase nutrient density: Choose foods with a high micronutrient density to prevent vitamin and mineral deficiencies. Fresh vegetables, fruit, wholegrains, pulses, nuts and seeds provide lots of vitamins, minerals and antioxidants for relatively few calories. It is precisely because the body consumes or loses more vitamins and minerals in hyperthyroidism that a varied, wholesome diet is important. For example, the increased metabolic activity increases the need for B vitamins and magnesium. You also lose more electrolytes (especially potassium and magnesium) when you sweat a lot - so eat plenty of green leafy vegetables, beans, nuts and wholegrain products (sources of magnesium) and fruit (source of potassium).

Green smoothies or shakes are an appetizing way to take in lots of nutrients. For example, a smoothie made from spinach, mango, oatmeal, almond butter and yoghurt provides protein, calories, magnesium, B vitamins, calcium and antioxidants in one drink. So even on days when you don't have much of an appetite, you can take in a lot of goodness.

Important micronutrients: selenium, zinc, vitamin D, calcium & co.

Certain trace elements and vitamins play a special role in thyroid function and the consequences of hyperthyroidism. Here is an overview of the most important ones:

• Selenium: This trace element is essential for the thyroid gland. Selenium is a component of enzymes (deiodases) that convert thyroid hormones into their active form, as well as of antioxidant enzymes that protect the thyroid gland from oxidative stress. A good selenium status is associated with a more stable thyroid function. The following health claim is officially approved in the EU: "Selenium contributes to normal thyroid function." Practically all hyperthyroidism patients should therefore make sure they get enough selenium - especially those with Graves' disease with its autoimmune processes. Studies show that selenium supplementation alongside therapy can measurably reduce free thyroid hormones and raise TSH levels:contentReference[oaicite:15]{index=15}. In a meta-analysis of 10 studies, a positive effect was found after 6 months of selenium intake: fT4 and fT3 were lower, TSH higher than in the placebo group:contentReference[oaicite:16]{index=16}:contentReference[oaicite:17]{index=17}. However, this effect was no longer significant after 9 months - so there may only be a temporary benefit. Selenium is considered safe in the correct dosage; for Graves' disease, approx. 200 µg/day is often used for several months. Natural sources of selenium are Brazil nuts (even a single Brazil nut contains approx. 50-70 µg), fish, meat, wholegrain cereals and eggs. Note: If you want to take selenium as a supplement, discuss this with your doctor - he can determine your selenium level. Overdoses (>300-400 µg daily) should be avoided.
• Zinc: Zinc is involved in countless metabolic processes - including the immune system and tissue regeneration. Hyperthyroidism accelerates certain zinc losses (e.g. via the urine):contentReference[oaicite:19]{index=19}, which is why many hyperthyroidism patients have lower zinc levels than healthy people:contentReference[oaicite:20]{index=20}. Zinc deficiency can increase tiredness, hair loss and skin problems - all symptoms that can occur with hyperthyroidism anyway. Adequate zinc intake can therefore help to support the immune system as well as skin and hair (the official EU claim for zinc is "contributes to normal metabolism and normal function of the immune system"). Good sources of zinc include oatmeal, pumpkin seeds, pulses, beef, hard cheese and cashew nuts. A slightly increased requirement (about 15 mg instead of 10 mg daily) can usually be covered by a targeted diet. In the event of a severe deficiency, a zinc supplement may be useful temporarily - if in doubt, have your blood tested.
• Vitamin D and calcium: Hyperfunction accelerates bone loss. More calcium is released from the bones, which increases the risk of osteoporosis. It is essential to counteract this. Vitamin D is necessary for calcium to be absorbed from food and incorporated into the bones. Calcium itself is the main building material of the bone matrix. Many hyperthyroidism patients have vitamin D deficiency; in Graves' disease in particular, studies show significantly lower vitamin D levels than in healthy controls:contentReference[oaicite:21]{index=21}:contentReference[oaicite:22]{index=22}. Sufficient vitamin D (possibly as a supplement in consultation with the doctor, e.g. 1000-2000 IU/day in months with little sunshine) and a calcium-rich diet are therefore essential. Foods rich in calcium are mainly dairy products (quark, cheese, yoghurt), but also some vegetables (broccoli, kale), nuts/seeds (almonds, sesame) and calcium-enriched plant drinks. The aim should be to consume around 1000-1200 mg of calcium per day. Tip: A glass of milk, a slice of cheese and a cup of yogurt together provide around 700-800 mg of calcium. If necessary, have your vitamin D level checked by a doctor (25-OH-D value) - in the case of severe deficiency, a high-dose initial therapy is often prescribed to quickly replenish the stores. Conclusion: A good supply of vitamin D and calcium protects the bones during the stressful hyperfunction phase and should not be neglected.
• Magnesium and B vitamins: These two are examples of nutrients that are increasingly needed in hyperthyroidism. Magnesium is important for nerve and muscle function - it helps to calm the overexcited nervous system and relax the muscles (including the heart muscle). In addition, more magnesium is lost due to the faster metabolism and frequent sweating. A deficiency can manifest itself in calf cramps, nervousness and heart palpitations. Therefore, choose foods rich in magnesium: Whole grains, oatmeal, nuts, seeds, legumes, bananas and dark leafy vegetables. If necessary, a magnesium citrate preparation (300-400 mg) in the evening can help prevent night cramps - many patients report that it also improves sleep. B vitamins (especially B1, B6, B12) are essential for energy metabolism and nerve function. An increased metabolism means an increased need for B vitamins. Vitamin B1 (thiamine) in particular is used up more during a "turbo metabolism" (deficiency can contribute to tiredness and loss of appetite), and vitamin B6 is necessary for the formation of neurotransmitters (important for mood and sleep). Make sure you get a good supply of whole grain products, pulses, meat, fish, eggs and green vegetables. Moderate vitamin B complex supplementation can be considered, especially if your diet is unbalanced.
• Antioxidants: Excess thyroid hormones lead to oxidative stress - more free radicals are produced which can damage cells:contentReference[oaicite:23]{index=23}:contentReference[oaicite:24]{index=24}. Antioxidants are therefore valuable for counteracting cell damage. These include vitamin C, vitamin E, beta-carotene, selenium (see above), zinc (see above) and secondary plant substances (polyphenols, flavonoids, etc.). A diet rich in colorful vegetables and fruit provides many of these antioxidants. For example, berries, cherries, citrus fruits, peppers, green leafy vegetables and tomatoes are excellent sources of vitamin C and polyphenols. Spices and herbs also contain highly concentrated antioxidant substances - e.g. turmeric (curcumin) or Mediterranean herbs such as oregano, rosemary and basil. Use these generously not only for taste but also for health reasons. Tip: A cup of green tea a day provides catechins (polyphenols) with an antioxidant effect - however, green tea also contains caffeine, so only enjoy it in moderation (see below on caffeine).

In addition to the nutrients mentioned, all essential vitamins and minerals should of course be taken in sufficiently. A lack of iron, for example, can exacerbate existing tiredness (and hair loss). Women with hyperthyroidism in particular often have low ferritin levels. Pay attention to your blood count and talk to your doctor about whether temporary iron supplementation is necessary. As a general rule, however, do not take high-dose supplements without consulting your doctor - many things can be regulated by a smart diet.

Medicinal herbs and natural remedies for hyperthyroidism

In phytotherapy and naturopathy, there are a number of herbs and plant substances that are traditionally used to calm an overactive thyroid gland. This field has not yet been extensively researched scientifically, but initial studies are providing interesting indications. Here are a few natural remedies that can provide relief(note: not yet confirmed by EFSA; further studies required):

• Lemon balm (Melissa officinalis): Lemon balm has long been thought to have a calming effect on nerves and (according to tradition) also on the thyroid gland. In fact, animal studies suggest that lemon balm extract can reduce thyroid activity. In a study on hyperthyroid rats, lemon balm extract led to a significant reduction in elevated T3 and T4 levels and an increase in previously suppressed TSH levels:contentReference[oaicite:25]{index=25} - an indication that lemon balm can modulate hyperthyroidism. The liver damage and inflammatory markers triggered by hyperthyroidism also improved in the animal model with lemon balm:contentReference[oaicite:26]{index=26}. Although these results still need to be confirmed in humans, they support the traditional application. In practice, many Graves' disease patients use lemon balm tea or tincture to alleviate restlessness. As a tea, you can drink 2-3 cups of lemon balm leaves a day (brew for about 10 minutes). Lemon balm is well tolerated. Please note: High-dose lemon balm extracts are not a substitute for thyreostatics prescribed by a doctor, but can have a supportive effect - it is best to discuss the intake of concentrated preparations with your therapist. (Not yet confirmed by EFSA; further studies required).
• Wolfsbane (Lycopus europaeus) and Bugleweed (Lycopus virginicus): Bugleweed enjoys a reputation as a natural "thyroid inhibitor". It is said to inhibit the release of thyroid hormones, especially in cases of mild hyperthyroidism. In fact, there are small clinical studies on this: In a German pilot study, patients with mild hyperthyroidism were given Lycopus extract for 3 months. Result: Symptoms such as palpitations decreased and thyroid levels tended to stabilize:contentReference[oaicite:27]{index=27}:contentReference[oaicite:28]{index=28}. In particular, one objective laboratory parameter - the increased excretion of T4 via the kidneys - improved under wolfstrapp, indicating relief:contentReference[oaicite:29]{index=29}. The authors concluded that Lycopus shows positive effects in mild forms and is well tolerated:contentReference[oaicite:30]{index=30}. An animal study also supports the effect: a Lycopus extract significantly reduced the typical cardiovascular symptoms in rats with induced hyperthyroidism:contentReference[oaicite:31]{index=31}:contentReference[oaicite:32]{index=32}. In North America, bugleweed tea is traditionally used to relieve palpitations and sweating. Important for users: Bugleweed should not be used if you are trying to conceive, pregnant or breastfeeding, as it can affect hormone levels. Wolfstrapp can also increase the effect of thyroid medication - therefore only use it after consultation if you are taking medication. As a tea, boiling water is often poured over 1 teaspoon of dried herb per cup (leave to infuse for 10 minutes; max. 2-3 cups/day). Please dose ready-made tinctures according to the manufacturer's instructions. Disclaimer: There is still limited data available on the safety of long-term use; it is best to use Wolfstrapp in courses and observe the effect.(Not yet confirmed by EFSA; further studies required).
• Valerian, passionflower & lavender: Although these plants do not directly affect the thyroid gland, they can alleviate typical symptoms. Valerian root, passionflower herb and lavender flowers have a calming and sleep-promoting effect - helpful for nervousness, palpitations and sleep disorders associated with hyperthyroidism. An evening cup of valerian or lavender tea can help you switch off better. These herbs are also available as ready-made preparations (tablets or drops). They are not addictive and are a natural alternative to synthetic sedatives. Many sufferers incorporate a herbal sedative into their evening routine in order to find peace despite a "highly tuned" metabolism. (As these medicinal plants do not have a direct effect on hormone production, no EFSA claim problems are to be expected here; their relaxing effect is traditionally known and recognized).
• Ashwagandha (Withania somnifera): This adaptogen herb is often cited for thyroid problems, but mostly in the context of hypothyroidism - there is evidence that ashwagandha may slightly increase thyroid hormone production, which could be useful in hypothyroidism. However, caution is advised in cases of hyperthyroidism: Some sources claim ashwagandha has a "balancing" effect, but scientific evidence for a benefit in hyperthyroidism is lacking. On the contrary, ashwagandha could actually increase thyroid activity. It is therefore not advisable to take ashwagandha if you already have hyperthyroidism (unless an experienced therapist specifically recommends it in individual cases). Instead, concentrate on the calming herbs above.

To summarize: There are some herbal helpers that could relieve accompanying symptoms or slightly influence thyroid activity. But remember: natural herbs are no substitute for conventional medical therapy - especially for moderate or severe hyperthyroidism. Use them as a supplement to improve your well-being and inform your doctor about any herbal remedies you are taking (to avoid interactions).

Food and stimulants: what to avoid or limit

Some foods and stimulants can exacerbate the symptoms of hyperthyroidism. You should pay particular attention to the following things:

• Caffeine and stimulant drinks: coffee, black/green tea, energy drinks and cola contain caffeine (or tein) - this stimulates the cardiovascular system and can exacerbate symptoms such as palpitations, tremors, nervousness and insomnia. If you notice that caffeine gives you an extra "buzz", significantly reduce your consumption or temporarily stop drinking caffeinated drinks altogether. Switch to decaffeinated variants or herbal teas (lemon balm, camomile, peppermint). Chocolate also contains some caffeine and theobromine, which has a stimulating effect - so enjoy it in moderation. Tip: A small morning coffee is a part of quality of life for many people; if you don't want to do without it, drink it with plenty of milk (the protein reduces the caffeine effect somewhat) and avoid other sources of caffeine for the rest of the day. However, you should really avoid energy drinks - the combination of high-dose caffeine and sugar unnecessarily boosts your metabolism and raises your pulse and blood pressure.
• Alcohol: Alcoholic drinks put a strain on the body and can promote palpitations and hot flushes. Especially in combination with caffeine (e.g. mixed drinks such as vodka energy), alcohol is poison for an already overtaxed organism. Excessive alcohol consumption also weakens the immune system. There's nothing wrong with an occasional glass of wine or beer in moderation - but during periods of severe symptoms, it's better to avoid alcohol altogether. Your body already has enough stress, it doesn't need to break down ethanol as well.
• Smoking: (Not a food, but important.) Smoking worsens the course of Graves' disease - in particular the endocrine orbitopathy (eye involvement) is much more severe in smokers. Smokers have a higher risk of pronounced eye problems. If you smoke, try to quit during the acute phase - for the sake of your thyroid and your eyes.
• Adiet very high in sugar: An overactive metabolism often goes hand in hand with a craving for sweets - paradoxical, as you are losing weight anyway. Nevertheless, bars, cakes, soft drinks etc. should only be enjoyed in moderation. Large amounts of sugar cause your blood sugar to go on a rollercoaster and increase your inner restlessness. It is better to eat complex carbohydrates (whole grains, fruit), which cover your needs without causing extreme blood sugar spikes. In addition, a permanently high sugar intake can promote inflammatory processes, which would be counterproductive in the case of autoimmune hyperthyroidism (Graves' disease).
• Food that is difficult to digest: As the intestines are "on turbo" anyway, very fatty and rich foods can lead to diarrhea and bloating. Make sure your food is easy to digest: steaming, steaming or boiling is better than deep-frying and frying. Many small meals are often better tolerated than a few large ones.
• Soy and gluten (for autoimmune hyperthyroidism): Opinions are somewhat divided here. Soy does not contain iodine, but there is evidence that large amounts of soy (due to the phytoestrogens) can affect the thyroid gland - in animal studies, for example, the effect of thyroid medication was weakened by excessive soy intake:contentReference[oaicite:33]{index=33}:contentReference[oaicite:34]{index=34}. For hyperthyroidism patients without medication, soy is not prohibited, but enjoy it in moderation and not as a staple food. One or two servings of tofu or soy drink a day are unproblematic; I would avoid high-dose soy protein supplements. Gluten is the focus of attention because autoimmune thyroid diseases such as Graves' disease and coeliac disease (gluten intolerance) frequently occur together. Even without coeliac disease, some experts suspect that gluten could affect the intestinal barrier and fuel autoimmune processes. However, there is currently no clear evidence that a gluten-free diet "cures" Graves' disease. Some patients do report an improvement when they give up wheat and the like - but this depends on the individual. My advice: If you have no medical need (negative coeliac test) and tolerate gluten well, you don't have to eat strictly gluten-free. Pay more attention to quality (whole grains instead of white flour) and watch your body. If you are obviously unwell on a gluten-containing diet, talk to your doctor about trying a gluten-free diet. But don't expect miracles - in most cases it won't bring much benefit and the sacrifice would be significant. Priority should really be given to the points mentioned above (iodine, micronutrients, caffeine, etc.).

CONCLUSION Nutrition: A diet adapted to hyperthyroidism means eating enough, but consciously. Give your body enough calories and protein to prevent breakdown; provide yourself with all the vitamins and minerals to cover the additional requirement; only add iodine in moderation (no excesses); and avoid anything that adds to the "turbo" (e.g. excessive caffeine, sugar, alcohol). This will create an environment in which your body can stabilize better. Many sufferers report that they feel much better with these adjustments: Heart palpitations become more bearable, weight stabilizes, muscle weakness decreases - you regain an overall sense of control.

It is also interesting to note that the general diet may have an influence on the risk of hyperthyroidism. In a large prospective study, the risk of hyperthyroidism was around 52% lower in vegans than in omnivores:contentReference[oaicite:35]{index=35}. Although this does not prove causality, it does suggest that a predominantly plant-based, wholefood diet could be beneficial to thyroid health - perhaps because of the more moderate iodine consumption and the many antioxidants. In any case, there is no harm in eating more plant-based foods.

Lifestyle & other tips for hyperthyroidism

Stress management

Mental stress can noticeably worsen symptoms of hyperthyroidism - there is even evidence that high levels of stress can be a trigger for Graves' disease. Therefore, pay particular attention to mental balance. Relaxation techniques such as progressive muscle relaxation, yoga, breathing exercises or meditation can calm the overexcited nervous system and relieve the heart and psyche. Consciously plan daily relaxation breaks - just 10 minutes of deep abdominal breathing or a guided meditation in the evening can help to reduce adrenaline levels. Walks in the fresh air also have a balancing effect. Try to reduce major psychosocial stressors (as far as possible). Your body is already in "stress mode" due to excess hormones - any additional relief is worth its weight in gold.

Sleep hygiene

Many people with hyperthyroidism struggle with sleep disorders. Good sleep is extremely important for regeneration. Therefore, create an optimal sleeping environment: cool, dark and quiet. Avoid screen work or exciting activities late at night - give your body time to wind down. A relaxing evening ritual can help (e.g. a warm bath with lavender oil, a cup of herbal tea, some reading). You can use herbal remedies such as valerian or passion flower (see above) before going to bed. Your doctor may temporarily prescribe a mild sleeping pill or a beta blocker for the night - don't be afraid to accept such help so that you can get your much-needed sleep. As soon as your thyroid levels normalize, experience has shown that your sleep will also improve significantly.

Moderate exercise

You may feel exhausted and shaky, but complete rest is not ideal in the long term. Light physical activity - adapted to your current condition - can be helpful to counteract muscle loss, lift your mood and stimulate your appetite. It is important not to overdo it: as long as the hyperfunction is not under control, avoid high-intensity sport (no marathon running, no HIIT training), as this could overload the heart and circulation. Moderate endurance sessions such as walks, cycling on flat stretches, easy swimming or gentle yoga are better. Listen to your body: if you feel your heart racing or dizzy, take a break. On good days, you can also try light strengthening exercises (with your own body weight or small dumbbells) to keep your muscles toned. It's not about performance, but about well-being and maintaining function. Even 20-30 minutes of daily exercise in the fresh air has a positive effect - it also improves sleep and reduces stress. As soon as your values are back to normal, you can gradually increase the amount of exercise.

Fluid balance

Increased sweating and a fast metabolism mean you lose more fluid and electrolytes than usual. So make sure you drink enough - around 2.5 to 3 liters per day (preferably water, unsweetened herbal tea or diluted juice spritzers). If you sweat a lot, isotonic drinks or broth can also be helpful to compensate for salt loss. A good indicator that you are drinking enough is almost colorless urine and when you don't feel thirsty at all. Especially when you are nervous and distracted, it is easy to forget to drink - so it is best to always have a glass of water to hand.

Regular medical check-ups

This may sound obvious, but it should be emphasized: Have your thyroid levels monitored closely, especially during the adjustment phase of therapy. This is the only way the doctor can optimally adjust the dose of medication. Hyperthyroidism can change dynamically - there are phases in which the hyperthyroidism suddenly flares up again (e.g. a relapse in the case of Graves' disease), or times in which it recedes. If your symptoms change (such as a renewed increase in palpitations or weight loss despite treatment), speak to your doctor immediately. A transition to hypofunction (e.g. if the medication was too strong or after radioiodine therapy) must also be recognized quickly. You are on the safe side with laboratory checks every 4-6 weeks at the beginning.

Eyes and specialists

The following applies to Graves' disease in particular: If you notice eye complaints (feeling of pressure, double vision, bulging eyes), consult an ophthalmologist at an early stage. Endocrine orbitopathy should be treated by a specialist ophthalmologist. There are therapeutic measures (eye drops, prism glasses and, in severe cases, high-dose cortisone or radiation) to protect the eyes. You can relieve mild eye problems yourself with cool compresses or moisturizing eye drops. At night, it helps to keep your head slightly elevated to reduce swelling of the eyelids. And - as already mentioned above - stop smoking, as it can massively aggravate eye involvement.

Patience and the psyche

Hyperthyroidism is also a psychological challenge - the constant inner turmoil, the physical changes and possibly the stress of living with an autoimmune disease. Don't underestimate these factors. It is completely normal to feel overwhelmed, anxious or depressed at times. It is important to talk about it - with friends, family or in a support group. Just knowing that others are going through similar things can be very relieving. Don't be afraid to seek professional support from a psychologist or psychotherapist to help you cope with anxiety and mood swings. Always remember: hyperthyroidism is treatable and the vast majority of people regain a normal balance. The hyperthyroidism phase is usually temporary (months to a few years). Keep in mind that it will get better. Your task is to take good care of yourself during this time - medically and lifestyle-wise - so that you emerge stronger.

In conclusion: With the right combination of medical therapy, an adapted diet, moderate exercise, consistent relaxation and close medical support, you can successfully get hyperthyroidism under control. Every little building block helps you to feel better and support your body on the road to recovery. The thyroid gland is an amazingly regenerative organ - give it the time and support it needs. The chances are very good that you will soon be back in balance.

Important note: The measures mentioned serve to support and accompany conventional medical therapy. Under no circumstances do they replace the treatment recommended by your doctor. If symptoms persist or are severe, please always seek medical advice.

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