Background: Thyroid hormones are major regulators of energy metabolism and increased levels of the hormones (hyperthyroidism) results in an increase in the metabolic rate. Thyroid dysfunction causing alteration in hormone secretion leads to perturbations in the metabolic status. The hypermetabolic state may cause increased generation of reactive oxygen species (ROS), leading to oxidative stress in these patients. This study was carried out to verify our proposition by measuring the ROS in the terminally differentiated cells like the peripheral blood mononuclear cells of the patients.Methods: Flow-cytometric analysis of the ROS was carried out using 2 0 ,7 0 dichlorofluorescein diacetate in the isolated peripheral blood mononuclear cells of the subjects.Results: ROS generation was found to be 3-folds higher in hyperthyroids as compared with euthyroids and hypothyroids and this was not found to be gender specific.Conclusions: Hyperthyroidism results in ROS generation in patients, which can be detected flow cytometrically in the peripheral blood mononuclear cells. Hence, this could complement the other thyroid function tests facilitating the diagnosis and design of appropriate therapy. q 2005 International Society for Analytical Cytology