For years, Harry Thorn thought his sleepless nights, constant sweating and anxiety were just part of who he was.
‘I would lie awake for hours with my heart pounding in my chest, struggling to get to sleep,’ says Harry, 27, a fat-loss coach who lives with his girlfriend, Ellie Trew, 27.
‘I also always felt on edge, but decided that was just my personality.’
He was also ‘hot all the time – so sweaty that at dinner parties or other social events I’d feel very self-conscious’.
In fact, he had an overactive thyroid gland. Yet Harry might have continued to be in the dark about it had it not been for a fitness test he took as part of his exercise science degree at university.
For the test, he had to cycle in a lab while wired up to a heart rate monitor.
‘Mine was flashing 110 beats per minute before we’d even started cycling,’ says Harry, from Guildford, Surrey.
The normal resting heart rate for most healthy adults is 60 to 100 beats per minute, according to US health guidelines.
Harry’s was so high his instructor came to check if the monitor was broken.
‘When he realized it wasn’t, he looked shocked and told me to get a medical assessment,’ he says.
At his doctor’s office, they found his resting heart rate was so high that they were concerned about the strain it was putting on his heart.
Weeks of tests – including blood pressure checks and an electrocardiogram (ECG) to assess his heart – brought no answers about the cause.
Harry Thorn, a fat-loss coach, only found out he had an overactive thyroid gland after a fitness test he took as part of his sports and exercise degree at university
‘It was only as a last resort, after about five appointments, that the doctor said, ‘Well, there’s one last thing we could test for – a thyroid problem – but it’s much more common in women’,’ recalls Harry.
Sure enough, two weeks later, blood test results revealed Harry had hyperthyroidism, also known as an overactive thyroid.
The condition develops when the thyroid gland in the neck produces too much thyroid hormone, which regulates numerous processes throughout the body, from heart rate to metabolism. When too much hormone is produced, many of these processes speed up.
Symptoms can include a racing heart, excessive sweating, heat intolerance, anxiety, tremors, diarrhea, insomnia and unexplained weight loss.
Because the symptoms are so nonspecific, they can easily be mistaken for stress, anxiety, overwork or simply having a naturally energetic personality, says Dr. Saira Hameed, a consultant endocrinologist at Imperial College Healthcare NHS Trust in London.
‘One of my patients felt so unwell with a racing heart, heat intolerance and insomnia that she went to the ER and was diagnosed with anxiety,’ she says. ‘It highlights the need to be a bit of a detective when diagnosing hormone-related illnesses.’
A red flag, she says, is if someone has ‘heat intolerance that can’t be explained by a mood disorder’.
‘That should prompt doctors to consider an overactive thyroid.’
In fact, while hyperthyroidism affects around 1 percent of women, it affects only 0.1 per cent of men. (Hypothyroidism – the opposite condition, in which the body doesn’t produce enough thyroid hormone – is also around eight times more common in women than in men.)
Harry’s overactive thyroid was caused by Graves’ disease, the most common cause of hyperthyroidism. It occurs when the immune system mistakenly attacks the thyroid gland, causing it to produce excessive amounts of thyroid hormone.
‘Autoimmune conditions, including those affecting the thyroid, are much more common in women than men,’ says Dr. Hameed, who is also the author of Signals: The Inside Story of Our Hormones.
‘We don’t fully understand why, but it’s thought that female hormones such as estrogen may make the immune system more active, while testosterone may have a protective effect.’
In theory, thyroid problems should actually be easier to spot in men than women, says Lyn Mynott, founder and chief executive of the charity Thyroid UK.
‘Symptoms of hyperthyroidism such as sweating, feeling unusually hot and fatigue can be mistaken for menopause in women rather than a thyroid problem,’ she says.
The challenge is that men – as was the case with Harry – sometimes delay seeking medical attention for their symptoms.
‘Once men do seek medical advice, hyperthyroidism can sometimes be identified more quickly because the symptoms are often easier to recognize, such as excessive sweating, feeling unusually hot, trembling, anxiety and diarrhea,’ she adds.
Even so, it’s important they do seek treatment because, left untreated, an overactive thyroid can lead to serious complications.
‘These include severe mood disturbances, including mania; heart rhythm problems such as atrial fibrillation; weakening of the bones leading to osteoporosis; and strain on the heart that can eventually result in heart failure,’ says Dr. Hameed.
Looking back, Harry says he now realizes he had ‘probably been dealing with symptoms for years’.
‘During a workout at the gym, I had to sit down and deliberately calm myself, taking deep breaths because my heart was pounding so hard it hurt.’
He also found himself constantly feeling overheated, sweaty and uncomfortable. What’s more, he was always hungry.
Dr Saira Hameed, a consultant endocrinologist, says though men often delay seeking care, when they do ‘hyperthyroidism can sometimes be picked up more quickly’
Harry is now on a low maintenance dose of carbimazole, which he says means he is ‘no longer tired and wired all the time’ and his ‘concentration and focus are also a lot better’
‘I had an increased appetite, which I was taking advantage of to try to gain muscle,’ he says. ‘I could eat four meals every evening – no problem – and was probably consuming 6,000 calories a day.
‘I’d convinced myself the symptoms were just who I was. I never considered there could be a medical reason behind them.’
Following his diagnosis, doctors explained that while Graves’ disease is a lifelong condition, the symptoms of an overactive thyroid can usually be controlled with treatment.
Harry was prescribed carbimazole, a medication that reduces the amount of thyroid hormone his body produces.
He says: ‘I was told to take higher doses until my thyroid hormone levels started to come down.
‘After a month or two, my dose had increased to 45–50mg – higher than the 30–40mg generally prescribed for moderate to severe hyperthyroidism – but my body didn’t tolerate it well and I became dangerously dehydrated.
‘The doctor explained that high doses can sometimes put stress on the liver and kidneys. Luckily, the medication had already started lowering my thyroid hormone levels, so I was gradually moved on to lower doses.’
Dr Hameed explains: ‘Graves’ disease can wax and wane. In some people, the overactive thyroid lasts for around 12 to 18 months before entering a period of spontaneous remission, when thyroid hormone levels return to normal. However, this is often followed by a relapse.’
Not all cases respond to medication, and some people may need treatment with radioactive iodine or surgery to reduce the amount of thyroid hormone the thyroid gland produces.
Harry is now on a low maintenance dose of carbimazole.
‘I take 5mg once a week, sometimes every two weeks. I’ve tried coming off it before, but the flare-ups come back.
‘I also get symptoms if I eat too many high-calorie or fatty foods, like sugary doughnuts. That will almost always trigger a flare-up. I’m much more aware of my triggers now.’
Dr Hameed says there is no prescribed diet for people with hyperthyroidism.
‘If someone has a very fast heart rate or shaky hands, it’s sensible not to drink too much caffeine, as this can make those symptoms worse,’ she says.
‘Once thyroid hormone levels are under control, there’s no need to follow any specific diet.
‘However, Harry clearly knows his own body and has found certain foods don’t agree with him, so he’s sensibly avoiding them.’
Harry says his medication has made a huge difference.
‘I’m no longer tired and wired all the time, and my concentration and focus are also much better. I know my triggers and I’ve got my nutrition sorted.
‘I think men can be guilty of brushing things off when it comes to their health, but if you’re constantly feeling on edge, overheating or experiencing a racing heart, it’s worth speaking to your doctor.’
Dr Hameed agrees, saying: ‘Men, don’t leave things or try to explain them away. Speak to your doctor and ask about thyroid blood tests. They are quick and easy to arrange and will identify thyroid disease if it is the cause of your symptoms.
‘We have very good treatments, but it’s important we make the diagnosis as soon as possible.’