What’s the Difference Between Hypothyroidism and Hyperthyroidism?

Written by Institute for Natural Medicine Staff

Medically Reviewed by Sarah Daglis, ND, MS

Published March 5, 2025
Last Updated March 10, 2025

The thyroid gland is a powerhouse for metabolism, energy, and well-being. But when thyroid-producing hormones shift out of balance, it can lead to two serious conditions: hypothyroidism and hyperthyroidism. While both affect the body’s ability to regulate metabolic rate, they do so in opposite ways. An underactive thyroid (hypo) slows things down, while an overactive thyroid (hyper) speeds them up. If left untreated, these conditions can have widespread health effects.

What does the thyroid do—and why does it matter?

The small, butterfly-shaped thyroid gland in your neck has a major impact on everyday functioning. It produces two hormones, T3 (triiodothyronine) and T4 (thyroxine), which control metabolism, digestion, heart rate, and energy. The thyroid works with the pituitary gland and hypothalamus to keep everything steady.

Main distinctions: hypothyroidism vs. hyperthyroidism

The key difference between these conditions lies in hormone production.

Hypothyroidism happens when the thyroid doesn’t produce enough hormones. Metabolism slows, leading to fatigue and weight gain.¹
Hyperthyroidism occurs when the thyroid produces too much hormone. Symptoms include rapid heartbeat, weight loss, and restlessness.²

Find a Naturopathic Doctor

Experience the benefits of personalized natural healthcare with a trusted, licensed naturopathic doctor in your area.

Find an ND

Causes and risk factors

Hypothyroidism often develops when the immune system mistakenly attacks the thyroid gland, a condition known as Hashimoto’s thyroiditis. It can also stem from iodine deficiency since iodine is essential for thyroid hormone production. Certain medications, like lithium, may interfere with thyroid function, while thyroid surgery or radiation therapy can permanently reduce hormone production. In some cases, the condition is present at birth, a rare disorder called congenital hypothyroidism.

Hyperthyroidism, on the other hand, is most often caused by Graves’ disease, an autoimmune disorder that triggers excessive hormone production.³ Consuming too much iodine from diet or supplements can also overstimulate the thyroid. Another common cause is thyroid nodules, which independently produce excess hormones. Thyroiditis, or inflammation of the thyroid, can lead to a temporary surge in hormone levels. In rare cases, disruptions in the pituitary gland can throw off hormone regulation, further complicating thyroid balance.²

Symptoms of hypothyroidism and hyperthyroidism

Thyroid disorders can be tricky to diagnose because symptoms often mimic other conditions. Understanding the differences can help with early detection.

Hypothyroidism signs

Persistent fatigue and low energy
Weight gain, despite no change in diet
Dry skin and thinning hair
Sensitivity to cold
Brain fog, depression, and difficulty concentrating
Slowed heart rate
Constipation

Hyperthyroidism signs

Unexplained weight loss, even with increased appetite
Rapid heartbeat and heart palpitations
Feeling anxious, irritable, or restless
Excessive sweating and heat intolerance
Tremors (shaky hands) and muscle weakness
Trouble sleeping (insomnia)

If left untreated, both conditions can lead to more serious complications, such as heart problems, osteoporosis, or, in severe cases, life-threatening thyroid storms or myxedema coma.⁴

Who to see for a thyroid condition

If you have a thyroid condition, an endocrinologist is the specialist to visit. They focus on hormone-related disorders, including thyroid issues. A primary care doctor can also diagnose and manage hypothyroidism or hyperthyroidism.

The importance of thyroid testing

Since the symptoms of thyroid disorders can mimic other conditions, proper diagnosis is essential. Blood tests measuring TSH (thyroid-stimulating hormone), T3, and T4 levels provide a clear picture of thyroid function. A doctor may also recommend ultrasound imaging or antibody tests to determine the underlying cause.

Whole-health remedies and natural approaches

A balanced diet plays a vital role in thyroid function. For hypothyroidism, foods rich in iodine, selenium, and zinc—such as seaweed, Brazil nuts, and pumpkin seeds—promote hormone production.⁵ It’s best to minimize processed foods and incorporate healthy fats from avocados, olive oil, and fatty fish for hormonal stability.⁶ Some studies suggest limiting the intake of raw goitrogenic foods (like broccoli and cabbage), as high consumption may interfere with thyroid function. However, cooking these vegetables helps deactivate goitrogenic compounds.⁷

For hyperthyroidism, a calcium-rich diet can help counteract bone loss caused by excess thyroid hormones.⁸ Leafy greens, almonds, and dairy are excellent sources. An anti-inflammatory diet⁹ full of berries, nuts, and green tea can also help manage symptoms. Moderating iodine intake—found in seafood and iodized salt—helps prevent overstimulation of the thyroid.¹⁰

Herbal therapies

Ashwagandha, an adaptogenic herb, has been shown to support healthy thyroid levels in hypothyroidism.¹¹ Bladderwrack, a type of seaweed, is a natural source of iodine that may benefit those with iodine deficiency.¹²

For hyperthyroidism, bugleweed and lemon balm¹³ have natural thyroid-suppressing properties that can help slow excessive hormone production.

Lifestyle adjustments for thyroid health

Keeping stress in check is essential for thyroid health. When cortisol levels rise, they can throw hormone production off balance, making symptoms worse. Simple techniques like meditation, deep breathing, and gentle movement—such as tai chi or yoga—help calm the nervous system and reduce stress.¹⁴

Regular physical activity can boost metabolism and stabilize mood.¹⁵ Whether it’s a brisk walk, a light workout, or stretching, staying active keeps the body and mind in sync.

Sleep is just as important. Insufficient rest can make managing the symptoms of hypothyroidism and hyperthyroidism challenging.¹⁶ Prioritizing quality sleep helps the body regulate hormones and recover properly.

Medical treatment options

While natural approaches can support thyroid health, medical treatment is often necessary to manage symptoms effectively. The right approach depends on whether the thyroid is underactive or overactive.

Levothyroxine, a synthetic thyroid hormone, is the standard treatment. It helps restore proper hormone levels and stabilize metabolism. Regular monitoring is essential to ensure the correct dose, as needs may change over time.

Antithyroid medications like methimazole help reduce excessive hormone production in hyperthyroidism. In more severe cases, radioactive iodine therapy can shrink the thyroid gland and slow hormone release. Surgery may be necessary if medications don’t work or if large thyroid nodules cause complications.

Natural desiccated thyroid

Natural desiccated thyroid (NDT) is a medication made from dried pig thyroid glands. It contains both T3 and T4 hormones, mimicking what the human thyroid produces. Many people prefer NDT over synthetic options like levothyroxine, believing it offers better symptom relief.¹⁷ However, its hormone levels can vary slightly between batches, which may make dosing less precise. Some doctors hesitate to prescribe NDT due to this inconsistency and because research on its use is limited compared with synthetic treatments.

The big picture: managing thyroid health

Achieving thyroid balance requires a well-rounded approach, with the right treatments, proper nutrition, and healthy lifestyle choices. Small daily habits make a big difference. But professional guidance is also a must. A healthcare provider can assess symptoms, perform necessary tests, and recommend the best treatment plan.

Footnotes

1
Jansen HI, Boelen A, Heijboer AC, Bruinstroop E, Fliers E. Hypothyroidism: The difficulty in attributing symptoms to their underlying cause. Front Endocrinol (Lausanne). 2023 Feb 6;14:1130661. https://doi.org/10.3389/fendo.2023.1130661
2
Cooper DS. Hyperthyroidism. Lancet. 2003 Aug 9;362(9382):459-68. https://doi.org/10.1016/S0140-6736(03)14073-1
3
Wiersinga WM. Graves’ disease: can it be cured? Endocrinol Metab (Seoul). 2019 Mar;34(1):29-38. https://doi.org/10.3803/EnM.2019.34.1.29
4
Wall CR. Myxedema coma: diagnosis and treatment. Am Fam Physician. 2000 Dec 1;62(11):2485-90. https://www.aafp.org/pubs/afp/issues/2000/1201/p2485.html
5
Triggiani V, Tafaro E, Giagulli VA, et al. Role of iodine, selenium and other micronutrients in thyroid function and disorders. Endocr Metab Immune Disord Drug Targets. 2009 Sep;9(3):277-94. https://doi.org/10.2174/187153009789044392
6
Alkhatib D, Shi Z, Ganji V. Dietary patterns and hypothyroidism in U.S. adult population. Nutrients. 2024 Jan 28;16(3):382. https://doi.org/10.3390/nu16030382
7
Manappallil RG, Muralidharan R, Shalu S, Haneef F. Hashimoto’s thyroiditis aggravated by goitrogenic diet presenting as rhabdomyolysis worsened by alcohol intake. BMJ Case Rep. 2021 Jul 9;14(7):e243385. https://doi.org/10.1136/bcr-2021-243385
8
Annerbo M, Hultin H, Stålberg P, Hellman P. Left-shifted relation between calcium and parathyroid hormone in Graves’ disease. J Clin Endocrinol Metab. 2014 Feb;99(2):545-51. https://doi.org/10.1210/jc.2013-2500
9
Duntas LH. Nutrition and thyroid disease. Curr Opin Endocrinol Diabetes Obes. 2023 Dec 1;30(6):324-329. https://doi.org/10.1097/MED.0000000000000831
10
Braverman KD, Pearce EN. Iodine and hyperthyroidism: a double-edged sword. Endocr Pract. 2024 Nov 5:S1530-891X(24)00810-3. https://doi.org/10.1016/j.eprac.2024.10.014
11
Sharma AK, Basu I, Singh S. Efficacy and safety of ashwagandha root extract in subclinical hypothyroid patients: a double-blind, randomized placebo-controlled trial. J Altern Complement Med. 2018 Mar;24(3):243-248. https://doi.org/10.1089/acm.2017.0183
12
Stansbury J, Saunders P, Winston D. Promoting healthy thyroid function with iodine, bladderwrack, guggul and iris. J Restor Med. 2012 Jan;1(9):83-90. https://restorativemedicine.org/wp-content/uploads/2012/09/Promoting-Healthy-Thyroid-Function-with-Iodine-Bladderwrack-Guggul-and-Iris.pdf
13
Yarnell E, Abascal K. Botanical medicine for thyroid regulation. Altern Complement Ther. 2006;12:3, 107-112. https://doi.org/10.1089/act.2006.12.107
14
Jahnke R, Larkey L, Rogers C, Etnier J, Lin F. A comprehensive review of health benefits of qigong and tai chi. Am J Health Promot. 2010;24(6):e1-e25. https://journals.sagepub.com/doi/10.4278/ajhp.081013-LIT-248
15
Tian L, Lu C, Teng W. Association between physical activity and thyroid function in American adults: a survey from the NHANES database. BMC Public Health. 2024 May 10;24(1):1277. https://doi.org/10.1186/s12889-024-18768-4
16
Green ME, Bernet V, Cheung J. Thyroid dysfunction and sleep disorders. Front Endocrinol (Lausanne). 2021 Aug 24;12:725829. https://doi.org/10.3389/fendo.2021.725829
17
Heald AH, Taylor P, Premawardhana L, Stedman M, Dayan C. Natural desiccated thyroid for the treatment of hypothyroidism? Front Endocrinol (Lausanne). 2024 Jan 8;14:1309159. https://doi.org/10.3389/fendo.2023.1309159

This article is provided by

The Institute for Natural Medicine, a non-profit 501(c)(3) organization. INM’s mission is to transform health care in the United States by increasing public awareness of natural medicine and access to naturopathic doctors. Naturopathic medicine, with its person-centered principles and practices, has the potential to reverse the tide of chronic illness overwhelming healthcare systems and to empower people to achieve and maintain optimal lifelong health. INM strives to fulfil this mission through the following initiatives:

Education – Reveal the unique benefits and outcomes of evidence-based natural medicine
Access – Connect patients to licensed naturopathic doctors
Research – Expand quality research on this complex and comprehensive system of medicine

About The Author(s)

Writer

Institute for Natural Medicine Staff

Our dedicated content team of professional staff writers represents decades of experience covering essential natural health topics in an accessible, evidence-based, and engaging way. Guided by a shared passion for holistic well-being, each and every one of our writers strives to empower our readers to take charge of their health.

Supported by a rigorous fact-checking and medical editing process from licensed naturopathic doctors that examines the latest in peer-reviewed research, our team brings their in-depth knowledge of natural health practices into every piece of content we produce. We strive to be the gold standard for evidence-based natural medicine, providing trustworthy information and inspiring narratives to help you live your best health, naturally.

Explore Endocrinology & Thyroid Health & Women's Health Articles

Explore

What’s the Difference Between Hypothyroidism and Hyperthyroidism?

In this article:

What does the thyroid do—and why does it matter?

Main distinctions: hypothyroidism vs. hyperthyroidism

Causes and risk factors