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Discovering the Differences between Hyperthyroidism and Hypothyroidism: Understanding your Hormones

Our endocrine system is a complex network of communication, where hormones are the main protagonists that allow our body functions to be carried out in the best way possible.


Among the organs of this system is the thyroid gland, located in the anterior region of the neck, and is responsible for the production of substances that have key metabolic functions in our body, such as the thyroid hormones.


The thyroid produces mainly two hormones known as T3 and T4. Both hormones have iodine in their structure, and that is why diet plays a fundamental role in the production of hormones and thyroid function.


However, we should know that there are other structures in our nervous system that regulate hormone production such as the hypothalamus and the pituitary gland, the latter being especially important for diagnosing thyroid problems.


The pituitary produces a hormone called TSH (thyroid stimulating hormone). It is important to understand that between the pituitary gland and the thyroid gland there is constant communication, because if the thyroid gland decreases the production of thyroid hormones, the pituitary gland produces more TSH to stimulate the production and maintain normal levels of hormones in the blood.


Functions of thyroid hormones


  • Regulates the reproductive system in men (promotes the process of spermatogenesis) and in women (helps follicle maturation and ovulation).

  • Stimulates linear growth and bone maturation.

  • Participates in lipid and protein metabolism.

  • Regulates body temperature

  • Modulates heart rate, cardiac contractility and blood pressure.

  • In pregnancy, it plays a fundamental role in the normal development of the central nervous system of the fetus.

  • In the postnatal period, the development of the nervous system depends exclusively on thyroid hormones synthesized in the thyroid gland of the newborn.


So what happens when the gland does not function as it should?


It causes thyroid disorders such as hyperthyroidism and hypothyroidism with symptoms in multiple systems and organs. Furthermore, according to the American Thyroid Association, women are five to eight times more likely than men to develop thyroid disease.


HYPERTHYROIDISM


It is defined as a syndrome characterized by clinical and biochemical manifestations of increased thyroid hormones. The most frequent causes are Graves' disease, toxic adenoma, multinodular goiter, and drugs.


According to the American Thyroid Association, Graves’ disease is an autoimmune disease that leads to a generalized overactivity of the thyroid gland because the body starts to produce antibodies against the gland’s cells. This is the most common cause of hyperthyroidism in the United States and it is 7-8 times more common in women than men.





Symptoms


Symptoms include hot skin, increased sweating, heat intolerance, alopecia and brittle nails. Tachycardia, weight loss (due to increased basal metabolism), increased appetite, eyelid retraction, and shortness of breath are also common.


Other behavioral changes may include anxiety, irritability, nervousness, and in severe cases, depression, agitation or psychosis.


Diagnosis


It is made through a laboratory study to determine the amount of TSH and free T4 in the blood. In these cases, TSH is decreased and T4 is elevated.


HYPOTHYROIDISM


It is the clinical situation caused by an insufficient production of thyroid hormones. It may be subclinical (without symptoms) or clinical (with various symptoms and signs). Possible causes include severe iodine deficiency, chronic autoimmune thyroiditis, thyroid surgery, radioiodine treatment, radiotherapy of the head, neck and thorax, and drugs.






Symptoms


The patient with clinical hypothyroidism may have asthenia, dry skin, cold intolerance, muscle cramps, voice aggravation and constipation. Other symptoms related to very severe hypothyroidism such as carpal tunnel syndrome, and sleep apnea appear several weeks before the onset of profound hypothyroidism.


Diagnosis


A laboratory test showing an elevated TSH and low T4 will provide a diagnosis of primary hypothyroidism.



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