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Hypothyroidism vs. Hyperthyroidism

Though they sound similar, these conditions affect the body in different ways.
Hypothyroidism vs. Hyperthyroidism
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The thyroid is a small, butterfly-shaped gland at the base of your neck that produces thyroid hormones to regulate your body's energy use. When your thyroid hormone production changes, it affects virtually every system in your body.

Undiagnosed thyroid disease puts patients at risk for other ailments, such as cardiovascular diseases, osteoporosis, and infertility.


Hypothyroidism is the condition in which the thyroid does not produce enough thyroid hormones. When thyroid hormone production drops, your body's processes slow down and change.

The signs and symptoms of hypothyroidism vary, and issues often develop slowly over several years. 

Signs and symptoms of hypothyroidism

  • Fatigue
  • Increased sensitivity to cold
  • Constipation
  • Puffy face
  • Hoarseness
  • Muscle weakness
  • Elevated blood cholesterol level
  • Muscle aches, tenderness, and stiffness
  • Pain, stiffness, or swelling in your joints
  • Irregular menstrual periods
  • Thinning hair
  • Slowed heart rate
  • Impaired memory
  • Enlarged thyroid gland (goiter)

Causes of hypothyroidism

Studies point to family history, nutritional deficiencies, damage to the pituitary gland, certain medications, pregnancy, or other large hormonal events as the cause of hypothyroidism, but it's hard to say for sure what causes this condition. What we do know is that Hashimoto's thyroiditis causes an estimated 90% of all hypothyroidism. Hashimoto's is an autoimmune disease caused by your immune system attacking your thyroid gland.

Diagnosis of hypothyroidism

A hypothyroidism diagnosis is determined by symptoms and the results of thyroid blood tests. While many labs only look at thyroid-stimulating hormone (TSH) to assess thyroid function, it is also critical to measure Free Triiodothyronine (fT3), Free Thyroxine (fT4), and TPO antibodies. 

High TSH levels suggest your thyroid is not making enough thyroid hormones, but a TSH test alone doesn't give the full picture. A combination of test results helps to provide a comprehensive understanding of your thyroid function.

Similarly, it's helpful to test for TPO antibodies in your blood to understand a possible cause of your thyroid condition. If antibody levels in the blood are elevated, it suggests that your immune system is attacking normal, healthy tissue. 

Treatment of hypothyroidism

Treatment for hypothyroidism typically involves thyroid hormone replacement medication to restore adequate hormone levels. You'll likely start to feel better soon after starting treatment, though determining the proper medication and dosage can take some time. We are all unique with individual sensitivities. Our bodies will not all react the same way to a specific drug or dosage. Work with your thyroid doctor to find the treatment option that works best for you.


Hyperthyroidism is when the thyroid is overactive, producing more thyroid hormone than the body requires.  Like hypothyroidism, this condition affects almost every tissue and cell in the body by speeding up the body's processes.

Common symptoms of hyperthyroidism

  • Unintentional weight loss
  • Rapid heartbeat (tachycardia)
  • Irregular heartbeat (arrhythmia)
  • Pounding of your heart (palpitations)
  • Increased appetite
  • Nervousness, anxiety, and irritability
  • Tremor
  • Sweating
  • Changes in menstrual patterns
  • Increased sensitivity to heat
  • Changes in bowel patterns
  • An enlarged thyroid gland (goiter)
  • Fatigue, muscle weakness
  • Difficulty sleeping
  • Skin thinning
  • Fine, brittle hair

Causes of hyperthyroidism

Typically, your thyroid releases the right amount of hormones, but sometimes it produces too much of the hormone thyroxine (T4). Some causes of this overproduction may be Graves' disease, hyperfunctioning thyroid nodules (Plummer's disease), or thyroiditis (inflammation of the thyroid gland). Graves' is the most common cause of hyperthyroidism. It is an autoimmune disorder in which antibodies stimulate your thyroid gland to overproduce T4.

Diagnosis of hyperthyroidism

To diagnose hyperthyroidism, your doctor will want to assess your medical history, do a physical exam, and take a blood test. Testing thyroxine (T4) and thyroid-stimulating hormone (TSH) can confirm a diagnosis of hyperthyroidism. High levels of T4 and low or nonexistent levels of TSH may indicate an overactive thyroid. 

If your thyroid blood test suggests hyperthyroidism, your doctor may recommend a radioiodine uptake test, thyroid scan, or thyroid ultrasound to understand why your thyroid is overactive. 

Treatment of hyperthyroidism

There are several ways to treat hyperthyroidism. The best treatment for you depends on your age, physical health, the root cause of your overactive thyroid, and the severity of your disorder. Treatment may include radioactive iodine to shrink the thyroid gland, anti-thyroid medications to prevent your thyroid gland from producing too many hormones, beta-blockers to ease symptoms, or surgery to remove all or part of the thyroid gland.

Supporting a healthy thyroid

Beyond taking thyroid hormone replacement medication, you can support your thyroid with nutrition and lifestyle modifications

Manage stress levels

There is a direct relationship between your adrenal health and thyroid health. When the body is stressed, the adrenal glands produce cortisol. Studies suggest that elevated levels of thyroid-stimulating hormone are associated with high levels of cortisol. Find a stress management technique that you enjoy, like yoga, journaling, or time in nature.

Eat a nutrient-rich diet

While there is no one specific diet for thyroid health, you can focus on eating nutrient-rich, whole foods like fruits, vegetables, fatty fish, and lean proteins. Foods full of healthy fats like avocados, eggs, and nuts help support satiety, mood regulation, sleep, and energy. 

Find an exercise you enjoy

Working out with a thyroid condition can feel frustrating but is super important, especially for patients with hypothyroidism whose metabolism has slowed. A 20-minute walk is all you need to soak in some benefits. And remember, progress is progress, even if it's slow. If you have hyperthyroidism, clear any exercise with your doctor to avoid any heart complications with excessive movement. 

Make sleep a priority

Getting a good (or bad) night of sleep affects everything from how your body processes food to how it regulates blood sugar, remembers information, controls inflammation, and more. Consider your sleep environment, your wind-down routine, and schedule a bedtime.

A note from Paloma Health

Work closely with your thyroid doctor to monitor your thyroid hormone levels. Finding the right treatment and the proper dosage is a step-by-step process that takes time. We are here to help and make sure that process is straightforward and personalized.

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Katie Wilkinson

Katie Wilkinson, previously serving as the Head of Content and Community at Paloma Health, fervently explores the nexus between healthcare and technology. Living with an autoimmune condition, she's experienced firsthand the limitations of conventional healthcare. This fuels both her personal and professional commitment to enhancing patient accessibility to superior care.

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