Hashimoto’s vs Graves’ Disease: Differences & Similarities

Let me start off by saying that both Graves’ disease and Hashimoto’s thyroiditis are completely different disease states. 

Despite there being a big difference between these two disease states there is a surprising amount of overlap between them as well. 

This is why many patients probably get confused. 

Perhaps the most simple way to think about these conditions is that one results in hyperthyroidism (Graves’ disease) and the other results in hypothyroidism (Hashimoto’s thyroiditis). 

And while this is a simple way to look at these conditions it doesn’t account for the nuances in both conditions and can still leave patients somewhat confused. 

Perhaps a better way to understand these thyroid conditions is to look at their similarities and their differences. 

And today we are going to do just that. 

You are going to learn…

• The major differences between Graves’ disease and Hashimoto’s
• Where there is significant overlap in these two thyroid conditions and where they deviate
• Why the long-term consequences of both conditions tend to lead to the same condition (low thyroid)
• The symptoms found in both conditions
• More about the overlap in treatment options for both conditions
• And more

Let’s jump in: 

Both Conditions Are Similar and can Evolve Into One Another

To make matters more complicated, you should be aware that Hashimoto’s can turn into Graves’ disease and Graves’ can turn into Hashimoto’s.^[5] 

This has led many researchers to believe that these conditions are really two sides of the same coin.

To give you an idea of what I am talking about, consider these similarities: 

• They are both conditions that negatively impact the thyroid
• They are BOTH autoimmune conditions
• They share many of the same TRIGGERS and CAUSES
• Thyroid autoantibodies are commonly seen in both conditions
• They can BOTH result in hyperthyroidism (more on this below)
• They can BOTH result in hypothyroidism (more on this below)
• There is some overlap in natural treatment options between both conditions
• The long-term consequences of both conditions tend to result in LOW thyroid function or hypothyroidism
• BOTH can be treated by focusing on immune function

And while these similarities are quite profound, there are definitely some differences between the two: 

• Graves’ disease causes hyperthyroidism whereas Hashimoto’s thyroiditis CAN cause hyperthyroidism but is typically a disease characterized by hypothyroidism (low thyroid function)
• Graves’ disease causes additional problems such as thyroid eye disease
• Graves’ disease is associated with elevated antibodies to the TSH receptor
• The medical treatments for Graves’ disease are completely different from Hashimoto’s thyroiditis

Hyperthyroidism vs Hypothyroidism: It’s Not That Simple

Unfortunately, as I mentioned previously, it’s not as easy as just looking at thyroid function to determine which condition you have. 

Instead, you must look at a combination of your symptoms, the trend of these symptoms, your antibody status, and even some other lab tests. 

The reason is simple:

BOTH conditions can result in hyperthyroidism. 

Graves’ disease is characterized by hyperthyroidism which means that almost everyone who has Graves’ disease (untreated) will experience HYPERthyroid symptoms. 

If you tried to determine which thyroid condition you had just on the basis of your thyroid hormone status you would be wrong a large percentage of the time. 

Why?

Because patients with Hashimoto’s can ALSO experience HYPERTHYROID symptoms even though that disease is primarily characterized by hypothyroid (low thyroid) symptoms. 

Any condition which results in damage or inflammation to the thyroid gland, regardless of the antibodies present, may cause hyperthyroid symptoms. 

And because Hashimoto’s is an inflammatory condition of the thyroid gland, there are some people who experience bouts of hyperthyroidism. 

And while the percentage of patients with Hashimoto’s who experience hyperthyroid symptoms is low, it still does happen. 

Which can make diagnosis difficult. 

Because of this, you should never use your symptoms as a means to diagnose which thyroid condition you have. 

In addition to your symptoms, you should also look at your thyroid antibody status. 

Antibodies that are typically associated with Graves’ disease include antibodies to the TSH-R whereas antibodies typically associated with Hashimoto’s thyroiditis include anti-TPO antibodies and thyroglobulin antibodies. 

Common Symptoms found in Graves’ Disease

While you would never want to use your symptoms alone, they can still be valuable. 

Because Graves’ disease is associated with the TSH-R antibody it tends to ACTIVATE the thyroid gland. 

This activation results in the overproduction of thyroid hormone from the thyroid gland. 

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Some therapies that I've seen work particularly well include:

• Using zinc (over-the-counter supplement) - Zinc is involved in regulating your immune system^[3] but it also plays an important role in thyroid function. While you are supplementing with zinc you might as well grab additional nutrients that help your thyroid function found in this multivitamin. 
• Increasing your vitamin D level - Vitamin D also plays a very important role in immune function and most people with autoimmune problems have very low Vitamin D levels.^[6] You can easily improve your Vitamin D level with a vitamin D3 supplement. 
• Reducing your exposure to chemicals and other environmental compounds - Chemicals require removal from your body and can cause inflammation and damage if they are stored or sequestered into your fat cells.^[8] Look at the type of soaps you are using, what types of makeup you are using, etc. to see all of the chemicals that you are inadvertently putting into your body. 
• Eliminating or reducing your stress levels - Stress has been shown to suppress immune function!^[4] Manage your stress levels to the best of your ability. 
• Eating healthy organic whole foods - Organic whole foods provide your body with healthy nutrients as well as additional ingredients that reduce inflammation. Buying organic reduces your exposure to chemicals found on and in certain plants. 
• Taking fish oil - Taking the right kind of fish oil can help improve your omega-3 fatty acid ratios and reduce inflammation.^[7] 
• Avoiding a diet high in inflammatory industrial seed oils - Industrial seed oils, such as corn oil and canola oil, can cause inflammation and weaken certain cells in your body. Avoid these fats as much as possible. 

These therapies are EASY to implement and VERY safe. And you can see a full list of supplements approved for Graves' disease here and a full set of supplements approved for Hashimoto's here.

Medications Used to Treat Graves' Disease and Hashimoto's

This is where the therapies and treatments start to diverge. 

Therapies used to treat Graves' disease focus primarily on LOWERING thyroid function while therapies used to treat Hashimoto's primarily focus on INCREASING thyroid function. 

Treatments for Graves' disease include:

• Thyroid-blocking medications like methimazole and PTU
• Radioactive iodine ablation therapy (which destroys the thyroid gland with radiation)
• Thyroid surgery (known as thyroidectomy which completely removes the thyroid gland)

These therapies are all designed to reduce or slow down thyroid function. 

Treatments for Hashimoto's disease include:

• The use of prescription medications that contain thyroid hormone (including medications like levothyroxine, Synthroid, NDT, and so on)

These medications are meant to INCREASE thyroid function. 

The one thing to notice with these medications is that while they do impact thyroid hormone levels in the body they really don't do anything to treat the underlying cause of each condition. 

They are more of a management type of treatment as opposed to a "cure". 

Final Thoughts

Even though both Hashimoto's and Graves' disease have a lot of similarities, they are still different disease states and often present with the exact opposite symptoms. 

Whether you have Graves' disease or Hashimoto's you should know that BOTH conditions result from an impaired immune function and this is the area that you should focus on when it comes to treatment. 

This is also the area most ignored by conventional doctors such as endocrinologists and family practice doctors which means you may have to do a lot of the heavy lifting on your own. 

But rest assured knowing that you CAN impact your disease state and it may even be possible to reverse your condition (if you catch it early enough). 

Now I want to hear from you:

Are you confused about your thyroid condition?

Do you have Graves' disease or Hashimoto'? 

What type of symptoms are you experiencing right now? Do you find your symptoms confusing?

What type of treatments or therapies are you currently using? Are they working for you? Why or why not?

Leave your questions or comments below!