Hyperthyroidism versus hypothyroidism

Health experts urge people to educate themselves and to act early when dealing with thyroid disease. Dr. Ruchi Gaba, an endocrinologist and assistant professor of medicine at Baylor, outlines different thyroid conditions.

The thyroid is a small, butterfly-shaped gland in the lower part of the neck. The gland secretes the thyroid hormone that controls the metabolism, growth and development of the body. An under or overactive thyroid gland can create an imbalance in the metabolism and alter the regulation of several body functions.


Hyperthyroidism, an overactive thyroid, is a state where there is excessive thyroxine hormone production from the thyroid gland. The metabolism is increased and can cause various symptoms:

A doctor comforting a patient

  • Losing weight despite a good appetite
  • Shakiness
  • Nervousness
  • Irritability
  • Anxiety
  • Heart palpitations
  • Menstrual irregularities
  • Brittle nails
  • Thinning of hair
  • Diarrhea
  • Muscle weakness
  • Swelling/lump in the lower part of the neck
  • Eye symptoms: blurriness, bulging of eyes, grittiness and watering

The most common cause of hyperthyroidism is Graves’ diseases, an autoimmune disorder, which is more prevalent in women than men. Thyroid nodules can also become overactive and produce excessive thyroid hormones, causing hyperthyroidism. Thyroiditis, or inflammation in the thyroid gland, is another cause of hyperthyroidism. It can occur post viral infection or in young women post pregnancy.


Hypothyroidism, an underactive thyroid, is a condition in which the thyroid gland does not produce enough hormones for the body, leading to an underactive metabolism. Symptoms of hypothyroidism include:

  • Fatigue
  • Weight gain
  • Constipation
  • Dry skin
  • Brittle nails
  • Cold intolerance
  • Lower extremity swelling
  • Puffy face
  • Menstrual irregularities
  • Depression

Hypothyroidism is difficult to recognize because the symptoms are mostly nonspecific and can vary based on the severity of the condition. It can easily be missed, so Gaba recommends doing thyroid function tests to diagnose hypothyroidism.

There are many possible causes of hypothyroidism, including an autoimmune disease, certain medicines, or even surgical removal of a part of the thyroid gland. Prevalence for hypothyroidism increases with age and is also more common in women. Some young women can develop thyroid issues during and post pregnancy. Those with a personal or family history of autoimmune disease or thyroid disease are more predisposed to thyroid problems.

“A lot of these thyroid conditions are due to autoimmune disorders, which are familial, so there is not much we can do to prevent them,” Gaba said. “Be vigilant about your symptoms if you recognize something is not right and reach out to your doctor to do a thyroid function test.”


Although difficult to prevent, thyroid conditions offer different treatment options. Hypothyroidism is treated with synthetic thyroid hormone replacement, which is a daily pill. Treatment options for hyperthyroidism include:

  • Anti-thyroid medications
  • Radioactive iodine
  • Surgery, where a part or the whole thyroid is removed if other treatments fail

Gaba does not recommend a specific diet for people with these conditions, but does recommend a healthy lifestyle to help promote thyroid health, including exercising at least 30 minutes a day five days a week, along with eating less refined and processed foods, and cutting back on high carbohydrate and fatty foods.

For appointments with a Baylor Medicine endocrinologist, call 713-798-4736, and find more online about endocrinology services.

-By Homa Shalchi

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