In primary care, patients frequently attribute weight loss and palpitations to stress or anxiety, especially during psychosocially demanding periods. While psychological explanations are common, premature attribution may delay recognition of underlying organic disease. This case illustrates how hyperthyroidism was uncovered after reassessing symptoms initially framed as anxiety-related.A 34-year-old woman presented to a family medicine clinic requesting help for “stress-related weight loss and anxiety.” She reported fatigue, sleep disturbance, intermittent palpitations, and a 7-kg unintentional weight loss over three months. She had no prior chronic illness or regular medication use. The patient initially linked her symptoms to work-related stress and caregiving responsibilities. On focused review, she also described heat intolerance and discomfort in warm environments. Physical examination revealed resting tachycardia (102 bpm) and fine tremor, without palpable goiter. Given the discordance between psychosocial attribution and physical findings, targeted laboratory tests were ordered. Results showed suppressed TSH (<0.01 mIU/L) and elevated free T4 (3.1 ng/dL), consistent with hyperthyroidism. The patient was promptly referred to endocrinology for definitive management.This case reframes hyperthyroidism as a condition masked by patient-led psychosocial interpretation rather than physician oversight, highlighting a subtle diagnostic trap in primary care.Non-specific symptoms attributed to anxiety warrant structured reassessment. Simple examination findings and basic laboratory tests can prevent diagnostic delay.Hyperthyroidism and anxiety share overlapping features. Anchoring on psychosocial explanations may obscure endocrine pathology unless actively challenged.Primary care physicians play a key role in re-evaluating symptom narratives. Unintentional weight loss accompanied by tachycardia should prompt thyroid testing, regardless of apparent psychosocial context.