Hashimoto's vs Hypothyroidism

Hashimoto's vs Hypothyroidism

What is Hypothyroidism?


About 5% of the general population lives with hypothyroidism, and another 5% on top of that is estimated to be undiagnosed. The main cause in the U.S.  is autoimmune in origin from Hashimoto’s Thyroiditis. Hypothyroidism mostly affects women, and the onset of symptoms can progress slowly over time, resulting in most diagnoses occurring between ages 30-50.   

Hypothyroidism is a condition where someone has abnormally low levels of thyroid hormones. The thyroid gland, located in the neck, is responsible for secreting thyroid hormones, which are responsible for many bodily functions, including regulating energy and metabolism. In bloodwork, it is typical to see higher TSH and lower T3 and T4 in cases of hypothyroidism. If the condition is caught early enough, during what can be known as subclinical hypothyroidism, changes can be made to prevent the thyroid from continuing to lower in work capacity. This imbalance can be caused by many things, including nutrient deficiencies, chronic dieting, or autoimmunity. Working with a provider that is well-versed in hypothyroidism is a great place to start with improving overall thyroid function. 


Hypothyroidism or Hashimoto’s


If autoimmunity is involved in hypothyroidism, this is often due to Hashimoto’s, the most common cause of hypothyroidism. The real difference between hypothyroidism and Hashimoto’s is that hypothyroidism is underactivity of the thyroid, whereas Hashimoto’s is breaking down of the thyroid due to an overactive and misdirected immune system. So, those who are diagnosed with Hashimoto’s also experience hypothyroidism, but it does not always occur the other way around.


So, what is Hashimoto’s Thyroiditis?

What happens in Hashimoto’s: antithyroid antibodies attach to the thyroid gland and break down the tissue. The body’s immune system essentially gets confused and starts attacking itself. So, this can lead to symptoms of hypothyroidism presenting in the case where Hashimoto’s Thyroiditis is the actual underlying issue. These antibodies can be measured in a blood test to determine if an autoimmune condition is present. High levels of the two antithyroid antibodies Thyroid Peroxidase Antibodies (TPO) and Thyroglobulin Antibodies (Tg) may be indicators that Hashimoto’s Thyroiditis is present. 


Common Symptoms of Hypothyroidism or Underactive Thyroid:

  • Weight gain
  • Irregular Menstrual Cycles
  • Fatigue
  • Poor concentration
  • Elevated Blood Pressure
  • Facial Edema
  • Cold and dry skin
  • Brittle nails
  • Constipation
  • Depression
  • Joint and Muscle Pain
  • Elevated Blood Pressure


Undiagnosed or untreated hypothyroidism may have significant life-long health impacts and is associated with a decreased quality of life. It is important to work with a healthcare professional to determine if hypothyroidism is present, if the origin is autoimmune or a decline in function, and the best lifestyle approach for management.


What are the causes?

There are a few potential causes of hypothyroidism. Deficiencies in vitamin D and selenium are associated with an underactive thyroid. Other environmental factors may be involved in the development of Hashimoto’s Thyroiditis. Hashimoto’s thyroiditis is an auto-immune condition, and it may be triggered by a presence of other auto-immune conditions.


You may be more likely to develop Hashimoto’s Thyroiditis if you also have:

  • Celiac Disease
  • Lupus
  • Rheumatoid Arthritis
  • Type 1 Diabetes
  • Other Autoimmune Conditions


During pregnancy, changes in the immune system may occur as well, potentially instigating the onset of Hashimoto’s Thyroiditis.  


Dietary considerations when managing hypothyroidism or Hashimoto’s Thyroiditis:

Have you heard of goitrogenic foods? They are foods that have a negative impact on thyroid function for those with hypothyroidism or Hashimoto’s Thyroiditis when consumed in very large amounts. Examples of these types of foods include cruciferous veggies like kale, broccoli, and Brussel sprouts. Before you completely give up on eating these foods, something to note is that when cooked, the goitrogens are inactivated and no longer pose a threat to healthy thyroid function! So, think sauteed kale and steamed broccoli instead of raw cabbage salads.


A low-carb, high-protein, and moderate-fat diet approach may be beneficial for reducing the antithyroid antibodies that are attacking the thyroid and reducing its function. In one study, this type of diet was found to significantly decrease TPO and Tg, compared to a general low-calorie diet, which actually increased these antithyroid antibodies. A reduction in serum levels of TPO and Tg antibodies can lower overall inflammation, especially in the thyroid, and help to restore its function. 


Some nutrient deficiencies may inhibit proper thyroid function. Selenium is a micronutrient with antioxidant properties that plays a role in metabolizing thyroid hormones. When deficient, supplementation of selenium has been shown to have an impact on decreasing TPO and Tg antithyroid antibodies. Another micronutrient to consider is Vitamin D, as a deficiency is linked with autoimmune thyroid disorders. Supplementation of vitamin D has been shown to have a positive effect on reducing autoimmune activity in the thyroid with significant reductions in serum antithyroid antibody levels. As always, consider addressing any nutritional deficiencies through foods and consult with a provider prior to using supplements. 


Overall, it is important to recognize the big picture: a balanced diet is recommended for maintaining optimal, healthy thyroid gland function. 


It is important to get bloodwork done routinely and work with a healthcare provider that is well-versed in the management of hypothyroidism and Hashimoto’s Thyroiditis. Be sure to talk with your doctor before making any changes to your lifestyle or diet.



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