The thyroid is a small butterfly-shaped gland located at the front of the neck, and it performs a critical function: secreting hormones that regulate the metabolic and growth functions within the body.
It only weighs only about 20 grams, and most of the time, people don’t give much thought to it—it just does its job. But if something goes awry and it becomes hyperactive or underactive, it can greatly impact how you feel.
Over 200 million people globally suffer from thyroid issues, which affect women four to seven times more than men. Many sufferers have no clue that they even have an issue, because they don’t know what the symptoms are. Let’s take a closer look at the differences between hypothyroidism vs. hyperthyroidism.
What Is Hypothyroidism?
Hypothyroidism is when the thyroid gland is not performing as actively as it should and secretes less thyroxine (the thyroid hormone) than is required. It’s also called an underactive thyroid, and affects mostly women over the age of 60. Because it’s hard to spot, with few symptoms in the early stages, it can go undetected for years until the health issues like joint pain, obesity, infertility, and heart problems start to crop up. Once diagnosed, an underactive thyroid can be treated with synthetic thyroid hormones.
Symptoms of hypothyroidism include:
- Fatigue that won’t go away;
- Developing a sensitivity to the cold;
- A goiter (i.e., swelling in the neck, a classic hypothyroidism symptom);
- Muscle weakness;
- Poor memory;
- Slowed mental processes; and
- Thick, puffy skin.
When the body doesn’t make enough thyroxine, the body processes slow down; that’s why there is almost crippling fatigue with hypothyroidism. When fatigue carries on indefinitely, it’s time to visit your healthcare provider to discuss the possibility of an underactive thyroid.
Many things can cause hypothyroidism, but the most common is Hashimoto’s disease, an autoimmune disorder, in which the body attacks the thyroid, inflaming it and reducing its function.
What Is Hyperthyroidism?
The difference between hypothyroidism and hyperthyroidism is the amount of thyroxine secreted. When the thyroid is overactive, it creates too much thyroxine, and, like an underactive thyroid, this causes issues in every area of the body. Hyperthyroidism, also known as Graves’ disease, can accelerate the metabolic system causing drastic weight loss, profuse sweating, heart palpitations, irregular heartbeats (which can mean too fast or too slow, or anything outside the normal rhythm), anxiety, and irritability.
The combination of these symptoms is worth a trip to the doctor to sort out any thyroid issues. The faster a diagnosis is made, the quicker a treatment plan can be developed to get you on the path to feeling yourself again. One course of treatment involves radioactive iodine, which helps slow down the creation of excess thyroxine. Medication and dietary changes are other methods of treatment.
Other signs of an overactive thyroid include:
- Muscle weakness;
- Changes in the eyes (if anything looks different from the norm);
- Inability to concentrate; and
- Brittle hair.
Differences between Hypothyroidism and Hyperthyroidism
Below is a hypothyroidism vs. hyperthyroidism table, detailing the symptoms for each condition.
Hypothyroidism vs. Hyperthyroidism Symptoms
|Weight gain||Weight loss|
|Dry, pale skin||Profuse sweating|
|Sensitive to the cold||Sensitive to the heat|
|Crushing fatigue||Fatigued, but hyperactive|
|Sleepiness||Can’t sit still|
|Inability to concentrate||Nervousness|
|Heavy menstrual flow||Lighter menstrual flow|
|Loss of libido||Loss of libido|
|Hair loss||Hair loss|
|Itchy skin||Itchy skin|
The difference between hypothyroidism and hyperthyroidism is easy to explain. Hyperthyroidism revs up the body much like a car revs up when you hit the gas. The excess thyroxine produced by the body causes it to go into overdrive, hence the sleeplessness, diarrhea, tremors, and irritability. Basically, the body is kicked up and on edge. Patients have described suffering with an overactive thyroid as years of unending agony because of the severe itching of the skin, sleepless nights, anxiety, increases in blood pressure, hot flashes, and headaches. Your body feels as though it is attacking you, as though it’s difficult to be at ease in your own skin.
Hypothyroidism, on the other hand, does the opposite. An underactive thyroid creates a shutdown effect in the body. You feel incredibly tired and fatigued, like you could sleep all day because you simply have no energy. You gain weight because your metabolism becomes sluggish and you aren’t moving nearly as much as you used to. It can be mentally unnerving for people who are used to being alert and active all the time.
Hypothyroidism can really knock a person off their game and without knowing why it has happened, it can cause a lot of mental anguish. When such drastic changes in mood, behavior, and energy levels strike, it’s imperative to discuss it with a doctor to try to get you back to normal, especially since the underlying condition can be treated.
So, hypothyroidism vs. hyperthyroidism: which is worse? There isn’t a simple answer. Both feel awful in their own way, whether it’s a matter of being anxious, nervous and irritable, or feeling sleepy and drained, and gaining weight rapidly. Approximately one percent of the U.S. population has hyperthyroidism, whereas hypothyroidism is much more common, affecting five percent of the population 12 and over. Medically, however, hyperthyroidism may have more concern attached to it because of the possibility for high blood pressure, which on its own can lead to heart attack and stroke.
Similarities between Hypothyroidism and Hyperthyroidism
The key similarity between hypothyroidism and hyperthyroidism is the thyroid and its production of thyroxine. But there are some symptoms that both conditions share, such as the development of a goiter, as well as muscle weakness, hypertension, and a loss of libido. Erectile dysfunction is a shared symptom across both conditions, and so is itchy skin and hair loss.
Suffering from Both Hypothyroidism and Hyperthyroidism
As unbelievable as it sounds, some people can and do suffer from both thyroid issues, though the symptoms don’t present themselves simultaneously. It could be a flare-up of thyroiditis, in which the patient has hypothyroidism but the thyroid occasionally goes into overdrive, presenting symptoms of hyperthyroidism, even though it’s still on its way to burning out. So you might experience weight loss and fatigue (and yet still feel hyperactive), plus nervousness, and then a few months later the opposite starts to happen: crushing fatigue, weight gain, depression, and dry skin.
In some rare cases, Hashimoto’s disease and Graves’ disease coexist in the patient, putting them through cycles between an overactive and underactive thyroid. If you have hypothyroidism with hyperthyroidism symptoms, talk to your doctor about getting a full antibody profile to determine if both are, in fact, present.
Diet for Hypothyroidism and Hyperthyroidism
Diet plays a big role in managing thyroid issues, but when considering hypothyroidism vs. hyperthyroidism diets, both will have different foods that need to be avoided or included. Below are food lists for both major thyroid conditions.
Foods to Eat for Hypothyroidism
- Whole grains
- Fresh fruits and vegetables
- Seaweed (this is very high in iodine, which is essential to thyroid function)
Foods to Avoid for Hypothyroidism
- Cruciferous vegetables (cauliflower, broccoli, cabbage)
- Fatty foods (fried foods, as well as high levels of fat found in mayonnaise, meats, and dairy)
- Sugary foods (avoid desserts, soda, candy bars)
- Processed foods
- Excess fiber (do not eat more than 35 grams of fiber per day)
Foods to Eat for Hyperthyroidism
Foods to Avoid for Hyperthyroidism
- High-glycemic carbs (white flour, sugary items, juice, low-fiber cereals)
- Unhealthy fats (trans fats, saturated fats)
- Alcohol and caffeine
- Cruciferous vegetables (cauliflower, broccoli, cabbage)
- Soy, but it can be eaten in limited amounts
Precautions for Hypothyroidism and Hyperthyroidism
As you go through the process of treating and understanding your thyroid disease, a number of precautions need to be kept in mind:
- See your doctor regularly so progress can be measured.
- Thyroid medication should not be used to lose weight. Weight will be regulated on its own once the thyroid is under control.
- If you’re diabetic, keep track of your blood sugar levels as directed by your doctor.
- Note that thyroid therapy can cause temporary hair loss.
Better Lifestyle, Better Living with Thyroid
Living with a thyroid condition is not as awful as it may sound. It just means you need to understand what to do to make sure you live as full and comfortable a life as possible. Some lifestyle changes you can make include:
- Being diligent about testing your thyroid levels;
- Understanding the signs and symptoms of too much or too little thyroxine;
- Knowing when to take your thyroid medication;
- Following any diet that has been recommended, because it will make a difference;
- Exercising, even if it only means walking vigorously 30 minutes a day;
- Unwinding when you can—in fact, making de-stressing a priority is a good idea; and
- Sleeping at night for at least seven hours.
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