Hyperthyroidism vs. Hypothyroidism

What is Hypothyroidism?

Hypothyroidism or underactive thyroid refers to a condition wherein the thyroid fails to produce enough hormones. The thyroid, a small butterfly-shaped gland in the neck, produces hormones that help regulate different bodily functions, including the digestive system and heartbeat. The hormones the gland produces are T3 or triiodothyronine and T4 or thyroxine. Insufficiency of these hormones can cause the body to slow down.

Causes of Hypothyroidism

Men and women can have an underactive thyroid at any age. However, it's proven more common among women above 60. Some babies are born with hypothyroidism, too, which is why babies undergo blood spot tests when they're five days old in the UK. 

Take a look at the significant causes of hypothyroidism below:

Hashimoto's thyroiditis

This is an autoimmune thyroid disease wherein the immune system attacks the thyroid gland and prevents it from producing hormones. It's one of the leading causes of hypothyroidism that mainly affects middle-aged women. However, it can occur in children and men, too. Hashimoto's thyroiditis also runs in families. 

Radioactive iodine treatment 

Once your thyroid gland produces excessive thyroid hormone, you have hyperthyroidism. This condition can be treated through radioactive iodine, which reduces and regulates hormone production. However, the treatment also destroys thyroid cells and permanently causes thyroid hormone levels to become low.

Surgical removal of the thyroid gland

People with thyroid problems need to surgically remove the thyroid gland, which leads to a deficiency. It can be treated using thyroid medication, but if only a portion of the gland is removed, it can still produce enough hormones. 

Radiation therapy

Radiation therapy is commonly used for treating leukemia, lymphoma, and other forms of cancer in the head or neck. It can slow down or stop thyroid hormone production altogether, leading to hypothyroidism.

Medications

Certain medications can cause hypothyroidism, such as those used in treating cancer, heart disease, and mental health problems. Specifically, these medicines contain lithium, interleukin-2, anti-CTLA-4 medications, amiodarone, and stavudine.

Iodine deficiency

Iodine is vital in the production of thyroid hormone. Those suffering from iodine deficiency are most likely to also suffer from hypothyroidism. Good sources of iodine include dairy, seafood, eggs, and iodized salt. Those with iodine deficiency develop goiter or swelling at the base of the neck due to an enlarged thyroid gland. 

Pituitary disorders

People suffering from a disorder in the pituitary gland are most likely to have hypothyroidism. The gland, found in the brain, produces hormones necessary for normal bodily functions, including the thyroid gland. Pituitary disorders may be caused by pituitary tumors, radiation therapy in the brain, and medications containing dopamine and opioids.

Congenital disease

Children can have congenital hypothyroidism from birth. It's caused by abnormal development or lack of thyroid gland. Most babies don't show symptoms, while some have trouble feeding and are less active.

De Quervain thyroiditis

It's an uncommon condition, also known as subacute granulomatous thyroiditis. It's an upper respiratory infection that destroys thyroid cells and primarily affects women in the summer or autumn. Its symptoms include enlargement of the thyroid gland, pain in the jaw, throat, and neck, fever, body pain, and fatigue. 

De Quervain thyroiditis first causes hyperthyroidism and then hypothyroidism, lasting from two to eight weeks. Thyroid function may return to normal afterward though hypothyroidism may become permanent for some. 

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Types of Hypothyroidism

There are two types of hypothyroidism, namely primary hypothyroidism and secondary hypothyroidism. 

In primary hypothyroidism, the gland itself is the problem. It could be because it was damaged and can no longer produce enough hormones. Most of the time, the thyroid becomes damaged due to Hashimoto's thyroiditis. It's an autoimmune disease wherein the immune system attacks and kills tissues. In some cases, the thyroid is damaged because of cancer or treatments used for overactive thyroid.

In secondary hypothyroidism, the pituitary gland is the one that encounters a problem. Though the thyroid usually functions, the pituitary gland doesn't produce sufficient thyroid-stimulating hormone (TSH), which stimulates the thyroid gland to make more hormones. 

Symptoms of Hypothyroidism

A thyroid test at home can help you determine if you have thyroid problems. Meanwhile, you can check for these symptoms of underactive thyroid:

• Weight gain
• Hair loss
• Muscle aches and pains
• Fatigue/tiredness
• Sensitivity to the cold
• Dry skin and hair
• Depression
• Slow movements and thoughts
• Lack of sex drive
• Constipation

The intensity of the symptoms depends on the severity of hypothyroidism. However, many symptoms can be experienced with old age, which often misleads women and doctors to believe it's menopause. 

Treatments for Hypothyroidism

Many individuals suffering from hypothyroidism are usually given levothyroxine, a daily hormone replacement, as treatment. It replaces the thyroxine hormone, which the thyroid gland fails to produce sufficiently. The treatment also includes regular blood tests until your body has reached the ideal dose of levothyroxine. 

Your doctor will start you off with a low dose that will increase gradually as your body responds. Some immediately feel better at the start of the treatment, but some won't notice any improvement for months. Once you start taking the correct dose, you'll monitor your hormone levels through a blood test done once a year. 

On the other hand, if your blood tests show you have hypothyroidism but don't have the symptoms, your doctor will monitor your hormone levels and prescribe levothyroxine once you start having the symptoms. 

Meanwhile, ensure a balanced diet to help improve your thyroid health. Include iodine-rich food like shellfish, dairy, eggs, fish, and fortified plant milk. Always remember that too much iodine can also be harmful.

Health Risks of Hypothyroidism

Did you know hypothyroidism can lead to serious health problems when left untreated? For one, it slows down the heart, weakens it, and can cause permanent damage in the long run. It also occurs with other autoimmune diseases such as diabetes, coeliac disease, lupus, rheumatoid arthritis, and adrenal gland-related disorders.

In pregnant women, hypothyroidism can pose severe complications if not treated immediately. For instance, it can cause miscarriage and pre-eclampsia. It can also affect the development of the newborn child. 

What is Hyperthyroidism?

Hyperthyroidism is a condition wherein the thyroid gland produces too much thyroid hormone. It's also referred to as overactive thyroid. One of its significant effects on the body is that it speeds up metabolism, thus, causing weight loss, irregular heartbeat, and hand tremors.

Causes of Hyperthyroidism

Many medical conditions can cause hyperthyroidism. Here are some of them:

Overactive thyroid nodules

This condition has three names: toxic adenoma, Plummer disease, and toxic multinodular goiter. It occurs when a thyroid adenoma produces too much thyroid hormone. The adenoma, a gland separated from the rest of the gland, forms noncancerous lumps that cause the thyroid to grow bigger than normal.

Graves' Disease

This is an autoimmune disorder wherein the immune system attacks the thyroid gland, which causes it to produce too much thyroid hormone. It's the most common cause of hyperthyroidism.

Thyroiditis

It occurs due to inflammation of the thyroid gland or an autoimmune disorder. The inflammation causes extra thyroid hormone in the thyroid, leading to bloodstream leakage. Specifically,

The types of thyroiditis that can cause hyperthyroidism include:

• Subacute thyroiditis is characterized by enlarged and painfully inflamed thyroid
• Postpartum thyroiditis affects those who recently gave birth
• Painless thyroiditis accompanied by an enlarged thyroid

Excessive iodine

Though the thyroid gland needs iodine to produce thyroid hormone, the amount of iodine in your body also affects how much hormone it makes. If you consume lots of iodine, your thyroid will produce more thyroid hormone than necessary. Iodine is found in many food sources, like seaweed, which contains a lot of it. Also, cough syrups and heart medicines are known for having high iodine content.

Taking too much thyroid hormone medicine

Some individuals take thyroid hormone medicine to treat hypothyroidism. If you take too much, you're most likely to have hyperthyroidism. See your doctor yearly for regular thyroid hormone check-ups. Your doctor may adjust your dose if needed. Also, some medicines can interact with thyroid hormone medicine. Always check with your doctor before taking any new medication.

Symptoms of Hyperthyroidism

Hyperthyroidism is hard to diagnose because its symptoms are like other health problems. You can take a thyroid test at home once you experience the following:

• Sudden weight loss
• Tachycardia or fast heartbeat
• Arrhythmia or irregular heartbeat
• Heart palpitations
• Anxiety, nervousness, and irritability
• Increased hunger
• Sweating
• Tremors in hands and fingers
• Changes in the menstrual cycle
• Goiter or enlarged thyroid gland that looks like swelling at the neck's base
• Tiredness
• Increased sensitivity to heat
• Insomnia
• Brittle hair
• Muscle weakness
• Frequent bowel movements
• Increased appetite

Thyroid Function Test

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Thyroid Function & Autoimmune Reaction Test

Assess thyroid function and indicate abnormal thyroid immune activity.

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Treatments for hyperthyroidism

There are many ways how doctors treat patients to ensure their thyroid hormone levels are back to normal. Getting the right treatments immediately is imperative to avoid complications and long-term health problems. You'll also get immediate relief from the symptoms. However, treatments may vary depending on your hyperthyroidism's causes, symptoms, and severity. 

Your doctor will also consider your age, possible side effects or allergies to certain medicines, other health conditions like heart disease, and whether you're pregnant. 

Here are some of the most common hyperthyroidism treatments available:

Anti-thyroid medicine

Doctors give this medicine to prevent the thyroid gland from producing many hormones. It includes methimazole and propylthiouracil. Once taken, you'll see improvement in your condition from several weeks to months.

Those given anti-thyroid medications usually must take them from 12 to 18 months. Your doctor may lower the dose after or completely stop the treatment depending on the outcome of your thyroid test and if you have reached normal thyroid hormone levels. 

In rare cases, anti-thyroid medications, especially propylthiouracil, can cause severe liver damage. That's why it's only recommended if patients can't take methimazole. Those allergic to these medicines may develop fever, joint pain, hives, or skin rashes. Infection may also occur in severe cases. 

Beta-blockers

Beta-blockers won't affect thyroid hormone levels but can effectively lessen symptoms like rapid heart rate, palpitations, and tremors. Some doctors would prescribe them to treat symptoms until hormone levels are normal. They cause fatigue and sexual problems. These medications aren't given to those who have asthma.

Radioiodine therapy

This treatment shrinks the thyroid gland as it takes up radioiodine. Hyperthyroidism symptoms lessen after several months of this therapy. It slows down thyroid activity, causing the thyroid gland to be underactive. This can lead to hypothyroidism, and you may need to take medicine to improve your thyroid hormone levels.

Thyroidectomy

This is one of the least used hyperthyroidism treatments. It's a surgery that involves removing a portion of or the whole thyroid gland. It's commonly used to treat hyperthyroidism among pregnant women. It's also recommended for people who can't take anti-thyroid medicine and those who can't have radioiodine therapy. 

This surgery can damage the vocal cords. It can also affect the parathyroid glands, the four tiny glands behind the thyroid. They're responsible for controlling calcium levels in the blood. If the parathyroid glands need to be removed during surgery, you must take medicine to ensure your blood calcium stays in a normal range.

The Best Thyroid Test at Home

Hypothyroidism and hyperthyroidism can lead to serious health problems when left untreated. The sad part is their symptoms are like those of other health conditions. To determine if you have either of the two, take a reliable thyroid test at home, such as Vitall's Thyroid Function Home Test Kit.

This thyroid test aims to assess thyroid function and detect abnormal activities in the thyroid gland. It's a hormonal test that involves a simple and accurate finger-prick blood home test kit you can do at home. Collect your thyroid function blood sample yourself or visit a clinic where competent staff can get the blood sample for you. Another option is to request a nurse to collect your sample at your convenience.

The test will check two crucial thyroid hormones, namely the free thyroxine, which helps increase metabolism, and the Thyroid Stimulating Hormone or TSH, released by the pituitary gland and responsible for regulating thyroxine production.

Hypothyroidism vs Hyperthyroidism Summary Table