A racing heart, restless nights; A tale of hyperthyroid patients

Hyperthyroidism, a condition that speeds up the body’s metabolism and can disrupt every part of life.

For Miriam*—not her real name—it started quietly, almost without notice. But what began as a subtle swelling in her neck soon spiraled into a life she barely recognized.

On a calm Sunday morning in Kisii town, as the streets slowly come alive with the chatter of vendors setting up their stalls, Miriam sits outside her modest rented apartment. 

She is renting it so that she can stay close to her children since she is a student at a teachers college in Kisii. 

“Today, I want to talk about a small but powerful gland in the body—the thyroid,” she says. “And how it almost took my life without me knowing.”

It was early 2023 when Miriam first noticed something strange—a swelling at the base of her neck. “At first, I thought it was just fatigue or stress. I had been working long hours and hardly sleeping,” she recalls. The signs were small at first—occasional sweating, a racing heart, restless nights—but they worsened quickly.

“I felt like my heart was pounding inside my chest even when I was sitting still. Sometimes I’d break out in sweat for no reason. I couldn’t sleep. My mind raced nonstop. I was terrified but had no idea why.”

Miriam’s experience is common, says Dr. Rosslyn Ngugi, Consultant Physician Endocrinologist and President of the Kenya Diabetes Study Group. “Hyperthyroidism happens when the thyroid gland becomes overactive. It releases excess thyroid hormones, pushing the body’s metabolism into overdrive.”

According to science, the thyroid gland is a small, butterfly-shaped organ located at the base of the neck, and it plays a crucial role in regulating the body’s metabolism by producing thyroid hormones—mainly thyroxine (T4) and triiodothyronine (T3). 

These hormones control how the body converts food into energy, influencing vital functions such as heart rate, body temperature, digestion, and overall energy levels. By managing the speed at which cells work, the thyroid gland ensures that the body’s systems function efficiently and stay balanced. 

When the thyroid produces too much hormone, as in hyperthyroidism, the body’s metabolism speeds up, causing symptoms like rapid heartbeat, weight changes, and anxiety. Conversely, too little hormone slows down metabolism, leading to fatigue and other health issues.

“This affects nearly every system in the body,” Dr. Ngugi explains. “It can cause rapid heartbeat, weight loss, anxiety, tremors, insomnia, digestive problems, and even changes in menstrual cycles.”

Interestingly, Miriam’s case was unusual. Instead of losing weight, she gained some.

“Many people expect hyperthyroid patients to lose weight quickly,” Dr. Ngugi says. “But some patients experience fluid retention or irregular appetite that can cause temporary weight gain. Side effects of treatment can also play a role.”

Miriam nods, “My appetite was high, and I gained weight, which confused me. I thought I was getting better, but my body was still racing.”

Things came to a head one afternoon when Miriam’s heart rate soared uncontrollably. Frightened, she rushed to a local clinic. 

The nurse checked her pulse and blood pressure, both of which were alarmingly high, and immediately referred her to a specialist. Around the same time, Miriam confided in her aunt, who had previously been diagnosed with a thyroid condition.

 “I shared my symptoms with her—how my heart was racing, how I couldn’t sleep, and how I’d been sweating for no reason,” Miriam recalls. Her aunt listened carefully and noted the similarities. 

“She told me she had also experienced swelling at the base of her neck and had lost weight rapidly. When she was tested, it turned out to be hyperthyroidism too.” That conversation was the first time Miriam considered that her symptoms might be related to her thyroid gland.

Blood tests revealed elevated levels of thyroid hormones T3 and T4, while thyroid-stimulating hormone (TSH) was very low. This confirmed hyperthyroidism.

Dr. Ngugi describes the process: “We use blood tests to confirm hyperthyroidism, then imaging like ultrasound or radioactive iodine uptake scans to see the gland’s activity. Antibody tests identify autoimmune causes like Graves’ disease.”

Miriam was prescribed a medication that slows down the production of thyroid hormones, helping to bring her overactive thyroid under control. She was also given beta blockers to ease symptoms such as rapid heartbeat, shaking, and anxiety. 

In certain cases—especially before thyroid surgery or radioactive iodine treatment—doctors may use antithyroid medications first to suppress the gland, and then carefully introduce levothyroxine in a process called "block and replace" therapy.

This approach stabilizes hormone levels and reduces the risk of the thyroid swinging from overactive to underactive too quickly. 

“The medications helped, but it was not easy,” Miriam admits. “Some days I felt almost normal. Other days, I was dizzy, nauseated, weak. It felt like a battle inside my body.”

The medications can cause side effects such as nausea, fatigue, and dizziness, especially early on. Dr. Ngugi says, “Patients need close monitoring. Treatment can last from 12 to 24 months. If hormone levels don’t stabilize, other options like radioactive iodine therapy or surgery might be needed.”

There’s also a risk of swinging too far—developing hypothyroidism, where the thyroid becomes underactive.

“This is common after radioactive iodine ablation or thyroid surgery, when the gland is partly or fully destroyed,” Dr. Ngugi explains. “Thyroid inflammation can also cause fluctuating hormone levels.”

Miriam’s doctor regularly monitors her thyroid hormones to catch changes early. “It’s a delicate balance,” she says. “Sometimes I worry the disease will never leave me.” Even though it feels better now after surgery. I am back in school.

The Impact on Women’s Health

Hyperthyroidism affects more than just energy and metabolism. For Miriam, it disrupted her reproductive health.

“My periods became irregular, then stopped,” she says quietly. “I was scared. I wondered if I would ever have more children.”

“Thyroid hormones are critical for reproductive health. Hyperthyroidism can cause amenorrhea—absence of periods—and infertility. If untreated during pregnancy, it increases risks like miscarriage, premature labor, and developmental problems in the baby,” Dr. Ngugi says on the risk. 

Women planning to conceive should first stabilize their thyroid function. “We carefully adjust medications during pregnancy to protect mother and child,” she adds.

Battling Misconceptions and Stigma

Miriam also faced social stigma. “Some people said I was bewitched or just stressed or depressed. Others told me to try herbal remedies instead of going to the hospital,” she recalls.

“Unfortunately, these misconceptions are common, especially in communities with limited awareness about thyroid disease,” says Dr. Ngugi. “There is no herbal cure for hyperthyroidism. Some herbs might relieve stress but could contain excess iodine, which worsens the condition.”

Mental Health and Coping

Living with hyperthyroidism took a toll on Miriam’s mental health. “I felt overwhelmed and scared,” she says. “I started seeing a counselor who taught me breathing exercises and mindfulness. That helped calm my racing thoughts.”

6 Months Later: Living with Awareness

Six months later since her diagnosis, Miriam’s condition is more stable.

“My thyroid levels are under control. My appetite feels normal,” she says. “I’ve learned to listen to my body and take things slowly.”

But the fear of relapse remains. “I can’t ignore warning signs anymore.”

She hopes sharing her story will raise awareness. “So many women suffer in silence, misdiagnosed or dismissed. If your body feels like it’s running on overdrive—don’t ignore it. Seek help.”

A Different Journey: Laura’s Story

Laura* is 38, a mother of three. For her, hyperthyroidism disrupted life plans. “I had to delay having more children because my body wasn’t ready, and I didn’t want to risk complications,” she shares.

After treatment, Laura developed hypothyroidism, requiring lifelong hormone replacement therapy.

“This happens in many cases, especially after radioactive iodine treatment or surgery,” Dr. Ngugi explains. “Patients must understand this and get ongoing care.”

Laura says, “It was difficult at first, but now my levels are stable, and I feel more in control.”

Fast Facts About Hyperthyroidism

What it is: Overactive thyroid gland producing excess hormones, speeding up metabolism.

Common causes: Graves’ disease, toxic nodular goitre, thyroiditis, excessive iodine intake, over-treatment of hypothyroidism.

Symptoms: Rapid heartbeat, unexplained weight loss or gain, anxiety, tremors, excessive sweating, insomnia, fatigue, frequent bowel movements, irregular or absent periods.

Diagnosis: Blood tests measuring TSH, T3, T4; antibody screening; imaging scans such as ultrasound or radioactive iodine uptake.

Treatment: Antithyroid drugs (carbimazole, propylthiouracil), beta blockers, radioactive iodine therapy, surgery.

Complications if untreated: Infertility, heart problems, osteoporosis, pregnancy complications, mental health issues.

Living with Hyperthyroidism

Living with hyperthyroidism means adapting to a body that often feels out of sync, unpredictable, and vulnerable. It’s a rollercoaster of symptoms, emotions, and treatments. But with the right care, support, and awareness, patients like Miriam and Laura continue their journeys with resilience and hope.

If you or someone you know experiences symptoms like a rapid heartbeat, unexplained weight changes, anxiety, or changes in menstrual cycles, don’t hesitate to seek medical advice. Your body’s pace matters—listen to it.

“Thyroid disorders, especially hyperthyroidism, are often overlooked. Early diagnosis and treatment let patients live full, healthy lives,” Dr. Ngugi echoes.