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Underactive or overactive thyroid: Know the signs, symptoms and differences


Underactive or overactive thyroid: Know the signs, symptoms and differences

A small, butterfly-shaped gland located in the front of your neck plays an oversized role keeping your body working properly, so when it malfunctions, it can wreak havoc.
The thyroid gland produces hormones that affect nearly every tissue and organ of the body. It’s part of the endocrine system and helps the body metabolize fats, proteins and carbohydrates. It also helps maintain blood pressure, body temperature and heart rate.
“These hormones regulate body energy, metabolism and keep the brain, heart and other organs working as they should,” explains board-certified, fellowship-trained Tidelands Health endocrinologist Dr. Gauri Dhir. “Thyroid hormones are an essential elixir of life.”
When the gland fails to deliver these essential hormones at proper levels, it can cause a variety of symptoms such as heart palpitations, anxiety, weight loss or gain, tremors and a sensitivity to hot or cold temperatures. More than 12 percent of the U.S. population will develop a thyroid condition during their lifetime. An estimated 20 million Americans have some form of thyroid disease, according to the American Thyroid Association. More women than men experience thyroid conditions.

Types of thyroid disease

When the thyroid is working property, it secretes hormones known as thyroxine and triiodothyronine. Thyroxine is produced by the thyroid in much greater quantities than triiodothyronine.
When the thyroid doesn’t produce enough thyroxine, the cause is often primary hypothyroidism, which means the thyroid itself isn’t working properly. In rare cases, the pituitary gland – which produces a hormone that tells the thyroid gland how much thyroxine to produce – is the root cause of the issue, which would result in a diagnosis of secondary hypothyroidism.

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By contrast, if the thyroid makes too much thyroxine, it typically leads to a diagnosis of overactive thyroid or hyperthyroidism. An underactive thyroid is more common.
Thyroid disease is diagnosed with a blood test that evaluates thyroid and pituitary function.


Although hypothyroidism and hyperthyroidism have different signs and symptoms, there can be some overlap.
Hypothyroidism’s common symptoms include fatigue, cold intolerance, weight gain, constipation, depression and forgetfulness.
Because these symptoms can be caused by a variety of different conditions, a test is the “only way to be sure that the symptoms are related to the thyroid,” says Dr. Dhir, who practices at Tidelands Health Endocrinology in Myrtle Beach.
Hyperthyroidism’s common symptoms are related to anxiety and can include palpitations, increase in body temperature, decreased menstrual flow, fatigue, excessive sweating, increased weight loss, tremors and bulging eyes. Some patients may also have swelling in the front of the neck, which is called a goiter.
A blood test and imaging are often used to confirm a diagnosis of hyperthyroidism, Dr. Dhir explains.

Treatment for thyroid disease

To treat hypothyroidism, a medication known as levothyroxine is often prescribed. For hyperthyroidism, patients are typically prescribed anti-thyroid medication or radioactive iodine, which causes the gland to shrink.

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For patients with hyperthyroidism who can’t tolerate radioactive iodine or anti-thyroid medications, surgery (known as a thyroidectomy) is an option to remove most the gland, which in turn will require lifelong treatment with levothyroxine.

Living with thyroid disease

Up to 60 percent of people with thyroid disease are unaware of their condition. But once diagnosed, it is typically treatable. If left untreated, it can lead to more serious conditions such as cardiovascular disease, increased risk of osteoporosis, arrhythmias and infertility. But the good news is most thyroid diseases, although life-long conditions, can be managed with medical care.
“It’s important to talk to your doctor about any symptoms you may be having and maintain annual checkups and lab work that could detect an emerging issue before it begins to disrupt the way the body functions,” Dr. Dhir says.


Dr. Gauri Dhir is a board-certified physician who provides a range of care to treat diabetes, obesity, thyroid disorders, osteoporosis and adrenal and pituitary disorders. 

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