Hypothyroidism and Hyperthyroidism: What’s the Difference?

The thyroid gland in the neck’s center looks like a little butterfly and is a part of the endocrine system. Producing hormones that regulate the body’s metabolism, thyroxine, and triiodothyronine hormones, the thyroid plays important roles. These hormones thyroxine (T4) and triiodothyronine (T3) play instrumental roles in regulating the body’s metabolism. Like a control center for the body, the thyroid-secreted hormones enable the body to maintain and use energy levels well. The heart and brain, muscles, and other organs function well due to the hormones.

According to WHO, the world has 750 million people who suffer from thyroid issues. Many do not know that the problem exists. Diagnosis and treatment are urgent and important because the thyroid condition affects every system in the body.

The Crucial Importance of the Thyroid Gland

Metabolic activity refers to each part of the complex bodily organs and their functions. The endocrine system of which the thyroid is an important part controls the bodily hormones. The thyroid hormones metabolize carbohydrates, fats, and proteins, all of them very important for proper functioning. Thyroid hormones also help in maintaining the heart rate, blood pressure, and physical temperature.

Thyroid Shortcomings

Thyroid problems occur when the thyroid gland functions improperly in 2 ways. Hypothyroidism and Hyperthyroidism seem similar but are essentially opposites in meaning.

  • Hypo refers to an underactive thyroid. Hypothyroidism indicates that the thyroid produces insufficient hormones.

  • Hyper refers to an overactive thyroid. Hyperthyroidism means that thyroid hormone production is excessive.

  • The crucial difference lies in the quantity of hormones produced by the thyroid gland.

  • Hypo and hyper show different symptoms but may overlap.

  • Enlarged thyroid gland, called goiter, affects both hypo and hyper cases.

  • Iodine deficiency in the diet causes goiter and the thyroid function suffers.

Symptoms of Hypothyroidism and Hyperthyroidism

Hypothyroidism Hyperthyroidism
Constipated stoolExhaustionSensitive to coldGaining weightDryness of skinAbsentmindednessLacking in energy Hand tremorsLoss of weightAnxietyFast heartbeat and hyperactiveTrouble in sleepingBrittle skinWeak musclesFeeling irritableReduced menstrual periods

Causes of Hypothyroidism and Hyperthyroidism

Hypothyroidism Hyperthyroidism
Hashimoto’s thyroiditis, an autoimmune diseaseThyroid removalPrevious radioiodine or surgical treatmentEarlier radiation for cancersConditions that affect the pituitary glandCongenital or family hypothyroidismMedications like amiodarone, anti-epilepsy drugs Graves’ disease, an autoimmune diseaseToxic nodular goiter inside the thyroid glandThyroiditis, a viral infectionPostpartum thyroiditis after childbirthConsuming excessive thyroid hormone

Diagnosis of Hypothyroidism and Hyperthyroidism

Healthcare professionals need to know personal and family histories in the task of diagnosis. A physical examination comes first to check for symptoms. If any weight changes have occurred, information must be given. The important tests are −

  • radioactive iodine uptake test

  • biopsy, if required

  • blood testing

  • ultrasound scanning

  • scanning the thyroid

Testing uses a blood sample in the laboratory for tests that include −

  • TSH (serum thyrotropin) testing verifies the extent of TSH present in the blood, whether low or high.

  • T4 testing with a high-level shows hyperthyroidism with low levels indicating hypothyroidism. Pregnancy, birth control pills, and corticosteroids also change T4 levels.

  • T3 testing is used to certainly diagnose hyperthyroidism if T4 is normal.

  • Thyroid antibody tests indicate the presence of Graves’ disease and Hashimoto’s disease.

Treatment for Hypothyroidism

According to the case’s age, weight, and intensity, prescription medications replace thyroid hormones with synthetic hormones. A blood test confirms the level of TSH or thyroid-stimulating hormone. Since TSH stimulates hormone production, high TSH indicates low hormones. Low TSH indicates high levels of hormones. Blood tests are repeated after 6 weeks of taking the medicine and the changes are noted.

The supplemental synthetic thyroid hormone is called L-thyroxine or levothyroxine. Levothyroxine is usually prescribed in different forms like capsules, liquids, or tablets. Doses require adjustments from time to time followed up by a blood test. The thyroid should resume normal functions of producing sufficient hormones after the completion of treatment. Symptoms should return to normal too.

Treatment for Hyperthyroidism

The course of treatment includes medications, radioiodine therapy, and surgery, according to the situation. Symptomatic treatment is the first stage. Beta-blockers medication starts the course. Beta-blockers control common symptoms like a fast heartbeat and tremors and reduce the intensity. Irritability reduces too. Further treatment depends upon the cause of hyperthyroidism. If Graves’ disease is the cause, methimazole (Tapazole) may be prescribed. Methimazole, or propylthiouracil are antithyroid medications that are administered in the first trimester for pregnant women. These drugs reduce the production of hormones by the thyroid gland.

Sometimes, medications fail to control the hormone levels and other solutions may be used. Surgery is an option to remove the thyroid gland partially. Radioactive iodine may be used to destroy the thyroid cells. Hyperthyroidism may require the common radioiodine therapy treatment. This treatment gets rid of the thyroid cells that generate excess hormones. The result of the treatment may be hypothyroidism. The danger of hypothyroidism is less severe and is easier to control through treatment.

Sometimes, a part of the thyroid gland needs to be deleted through surgery, resulting in hypothyroidism. Lobectomy is the surgical procedure to remove half of the thyroid along with the adenoma. The common treatment for several types of hyperthyroidism is the removal of almost the entire thyroid. The procedure is called a thyroidectomy, required by Graves’ disease too.

Thyroidectomy alone ensures an immediate end to hyperthyroidism. Surgery may not be resorted to often. Though hyperthyroidism has other treatments according to the condition, discuss the options with the healthcare professional. Study the risks and advantages of thyroidectomy versus medicines.

Thyroid Nodules

A few points are similar to both hypothyroidism and hyperthyroidism. Thyroid nodules are in common. Generally speaking, the nodules do no harm. Sometimes they result in a large thyroid size in hyperthyroidism or generate too much T4 thyroid hormone. What happens in Graves’ disease is similar because the thyroid gland produces excessive hormones as a result of attacking itself. Graves’ disease is an autoimmune disease that causes hyperthyroidism with excess thyroid hormone.

Avoid Complications with Early Treatment

Left undiagnosed and untreated, both hypo and hyper conditions could get serious. Yet, timely treatment should reverse the condition early enough and restore normal thyroid functions and hormone levels soon enough.

Hypothyroidism could last very long and end in death or coma if neglected. With the right diagnosis and treatment, normalcy may be regained within a few weeks.

Hyperthyroidism can get serious too but is treatable and the results should be positive. If surgery is prescribed, the resulting hypothyroidism requires medications.

If some of the signs or symptoms appear, it is wise to get checked by a health professional without delay. Follow the prescribed medications and avoid excessive worry.

Updated on: 29-Mar-2023


Kickstart Your Career

Get certified by completing the course

Get Started