What’s The Difference Between Graves’ Disease and Hashimoto’s Thyroiditis?

Occasionally someone will ask me what the difference is between Hashimoto’s Thyroiditis and Graves’ Disease, and so I figured I’d write a brief blog post which discusses the main differences and similarities between these two conditions.  First of all, both Graves’ Disease and Hashimoto’s Thyroiditis are autoimmune conditions that affect the thyroid gland.  However, they both affect the thyroid gland differently, and because of this the treatment for managing the symptoms are also different.

Let’s take a look at the similarities and differences between Graves’ Disease and Hashimoto’s Thyroiditis:

Here Are The Similarities Between Graves’ Disease and Hashimoto’s Thyroiditis:

1. Both Graves’ Disease and Hashimoto’s Thyroiditis are Autoimmune Thyroid Conditions.  Both of these are autoimmune conditions which affect the thyroid gland.  And so while managing the thyroid symptoms frequently is necessary, the overall goal should be to restore the health of the immune system.

2. Both Graves’ Disease and Hashimoto’s Involve The Triad of Autoimmunity.  The triad of autoimmunity involves 1) a genetic predisposition, 2) an environmental trigger, and 3) a leaky gut.  To be honest, it hasn’t been proven that everyone with an autoimmune condition has a leaky gut, although the evidence is very strong.  But assuming this is true, then the goal with both Graves’ Disease and Hashimoto’s Thyroiditis should be to detect and remove the environmental trigger, along with doing things to heal the gut.  Of course nothing can be done for the genetic predisposition, but the good news is that the autoimmune component can be reversed if the trigger is removed and the gut is healed.

3. Most Endocrinologists Don’t Address The Autoimmune Component.  Unfortunately, most endocrinologists focus on the thyroid gland, while not doing anything to improve the health of the immune system.  This comes down to the training they receive in medical school.

4. Both Graves’ Disease and Hashimoto’s Can Be Treated Naturally.  Even though there isn’t a permanent cure for autoimmune thyroid conditions, following a natural treatment protocol can help to reverse the autoimmune component.  And so it is possible to get into remission and then maintain your health thereafter.

Here Are The Differences Between Graves’ Disease and Hashimoto’s Thyroiditis:

1. Graves’ Disease and Hashimoto’s Thyroiditis Affect the Thyroid Gland Differently.  Most people reading this know that Graves’ Disease is typically associated with hyperthyroidism, while Hashimoto’s Thyroiditis is usually associated with hypothyroidism.  And the reason for this is because the immune system attacks different parts of the thyroid gland with different autoimmune conditions.  So with Graves’ Disease the immune system attacks the TSH receptors, which causes the thyroid gland to secrete an excess amount of thyroid hormone.  Here is an article I wrote on the symptoms of hyperthyroidism.  “On the other hand, Hashimoto’s Thyroiditis involves damage to either thyroglobulin, which is a protein of the thyroid gland, or thyroid peroxidase, which is an enzyme involved in the production of thyroid hormone.  Here is an article I wrote on the symptoms of hypothyroidism.

2. Graves’ Disease and Hashimoto’s Thyroiditis are characterized by different thyroid autoantibodies.  I mentioned how with Graves’ Disease the immune system attacks the TSH receptors, and because of this, most people with this condition will have TSH receptor antibodies, with the most common type being thyroid stimulating immunoglobulins.  On the other hand, Hashimoto’s Thyroiditis typically involves either thyroglobulin antibodies, thyroid peroxidase antibodies, or in some cases both of these antibodies are elevated.

Can Someone Have Both Hashimoto’s Thyroiditis and Graves’ Disease At The Same Time?

It is possible for someone to have the antibodies for both Graves’ Disease and Hashimoto’s Thyroiditis.  This is actually common, as a lot of people with elevated thyroid stimulating immunoglobulins also have elevated thyroid peroxidase antibodies.  Some people have elevated thyroid stimulating immunoglobulins and elevated thyroglobulin antibodies.  And there are some people who have all three thyroid antibodies elevated.

This doesn’t necessarily mean that people with the antibodies for both Hashimoto’s Thyroiditis and Graves’ Disease will have symptoms of both hypothyroidism and hyperthyroidism.  For example, many people with elevated thyroid stimulating immunoglobulins and thyroglobulin antibodies will primarily experience hyperthyroid symptoms initially.  However, if the autoimmune component isn’t addressed then they very well might become hypothyroid in the future due to damage to the thyroid gland.  With that being said, there are some people with both types of antibodies who do experience a fluctuation of hypothyroid and hyperthyroid symptoms.

Keep in mind that if someone does have the antibodies for both Hashimoto’s Thyroiditis and Graves’ Disease then the treatment approach will be similar to someone who only has one type of antibody.  In other words, the primary goal is to reverse the autoimmune component.  However, the symptom management will of course differ depending on whether the person is experiencing hyperthyroid or hypothyroid symptoms.

So hopefully you understand some of the similarities and differences between Graves’ Disease and Hashimoto’s Thyroiditis.  Both of these are autoimmune conditions that affect the thyroid gland, and both involve the triad of autoimmunity.  However, these conditions affect the thyroid gland differently, and they are characterized by different thyroid autoantibodies.  And it is possible to have the antibodies for both Hashimoto’s and Graves’ Disease.  The good news is that it is possible to reverse the autoimmune component of these conditions.