Graves’ disease occurs when the thyroid overproduces thyroid hormones, causing hyperthyroidism. Hashimoto’s disease includes an underactive thyroid that does not produce enough thyroid hormones, causing hypothyroidism. These are two different types of thyroid disease.

Graves’ disease and Hashimoto’s disease are both autoimmune conditions that affect the thyroid gland. Both conditions present distinct symptoms and impact an individual’s health differently.

While Graves’ disease typically results in hyperthyroidism, which causes an overactive thyroid, Hashimoto’s usually leads to hypothyroidism, or an underactive thyroid.

This article explores the differences and similarities between these two conditions, examining their causes, symptoms, treatments, and more.

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This section looks at the differences between Graves’ and Hashimoto’s disease.

What is Graves’ disease?

Graves’ disease is an autoimmune disease that leads to the overproduction of thyroid hormones. It is the most common cause of hyperthyroidism, affecting approximately 1.2% of people in the United States.

Graves’ disease occurs when the immune system mistakenly attacks the thyroid gland, causing it to enlarge and produce excessive hormones. This can lead to a variety of symptoms, including rapid heartbeat, weight loss, and anxiety. The condition mostly affects people over age 30 years and is more common in females.

Learn more about Graves’ disease.

What is Hashimoto’s?

Hashimoto’s disease, also known as Hashimoto’s thyroiditis or chronic lymphocytic thyroiditis, is another autoimmune disease where the immune system attacks the thyroid gland. However, with Hashimoto’s, the attack leads to inflammation and damage that gradually impairs the thyroid’s ability to produce hormones.

Hashimoto’s is the most common cause of an underactive thyroid, also known as hypothyroidism. According to the National Institute of Diabetes and Kidney Diseases (NIDDK), it is also 4 to 10 times more common in females than males. It often develops in people ages 30 to 50 years, although the disease may occur in teens.

The chance of developing Hashimoto’s also increases if other family members have the disease.

Learn more about Hashimoto’s disease.

FeatureGraves’ diseaseHashimoto’s disease
Nature of thyroid dysfunctionoveractive thyroid (hyperthyroidism)underactive thyroid (hypothyroidism)
Gender prevalencemore common in femalesmore common in females
Age of onsetover 30typically 30 and 50, although it may occur in teens
Common symptomsweight loss
rapid heartbeat
weight gain
Treatmentantithyroid medications
radioactive iodine uptake
thyroid hormone replacement therapy

Graves’ disease and Hashimoto’s disease have symptoms in common. Some may overlap, while others are different, helping to differentiate between the two conditions.

Symptoms of Graves’ disease

Graves’ disease often causes symptoms of hyperthyroidism, as well as problems with the eyes and skin. Common symptoms include:

More than 1 in 3 people with Graves’ disease also develop an eye disease called thyroid eye disease (TED), also known as Graves’ eye disease or Graves’ ophthalmopathy (GO).

Eye symptoms can include:

Learn the differences between Graves’ disease and hyperthyroidism.

Symptoms of Hashimoto’s disease

Hashimoto’s disease can cause a range of symptoms, including:

Learn more about the signs and symptoms of hypothyroidism.

Individuals experiencing symptoms of thyroid dysfunction, such as significant weight changes, unexplained fatigue, or changes in heart rate, should seek medical advice.

Early detection and treatment are crucial to managing both Graves’ disease and Hashimoto’s disease effectively.

Learn more about common thyroid disorders.

According to the NIDDK, the causes of Graves’ disease and Hashimoto’s disease are still unclear. However, the diseases may stem from a combination of genes and external factors, such as viruses.

Individuals with a family history of the conditions are also more likely to develop Graves’ disease and Hashimoto’s disease.

In Graves’ disease, the immune system produces antibodies called thyroid-stimulating immunoglobulin (TSI) that attach to the thyroid cells, causing them to produce excess hormones.

In Hashimoto’s disease and hypothyroidism, the immune system attacks the thyroid gland, leading to inflammation and damage. Other triggers may also include:

  • some medicines that treat bipolar disorder or other mental health conditions
  • medicines containing iodine that treat abnormal heartbeats
  • exposure to toxins, such as radiation

Learn more about the thyroid gland.

Doctors use thyroid tests to check how well the thyroid works and diagnose Graves’ disease or Hashimoto’s disease. A thyroid test may include:

If a doctor finds a nodule or lump in the neck during a physical exam or thyroid imaging test, individuals may require a fine needle aspiration biopsy to see if the lump is cancerous or noncancerous.

Learn more about how doctors diagnose hypothyroidism.

Treatment for Grave’s disease and Hashimoto’s disease requires different strategies.

Treatment for Graves’ disease

Treatment for Graves’ disease involves treating hyperthyroidism, including:

  • Medication: Antithyroid medications, such as methimazole or propylthiouracil, can help reduce thyroid hormone production. A doctor may also prescribe beta-blockers to reduce symptoms. However, they do not stop thyroid hormone production.
  • Radioactive iodine (RAI): This treatment permanently destroys the thyroid tissue, reducing hormone production.
  • Thyroid surgery: Doctors may recommend surgery to treat people with large goiters or people who are pregnant and cannot take antithyroid medicines.

Learn about foods to eat and avoid with hyperthyroidism.

Treatment for Hashimoto’s disease

Treatment for Hashimoto’s disease depends on whether it causes hypothyroidism. If hypothyroidism is not present, regular monitoring of symptoms and thyroid hormone levels is often sufficient.

If a doctor diagnoses hypothyroidism, treatment may include thyroid hormone replacement therapy. This includes a prescription of levothyroxine, a synthetic thyroid hormone that compensates for an underactive thyroid. It is available in pill, liquid, and soft gel capsule forms.

Certain foods and supplements can interfere with levothyroxine absorption, so individuals should follow guidelines correctly.

Learn more about food and diet with hypothyroidism.

Graves’ disease and Hashimoto’s disease both require treatment. If left untreated, a person can develop complications.

Complications of Graves’ disease

Without treatment, Graves’ disease can cause serious complications, including:

Learn about the long-term effects of Graves’ disease.

Complications of Hashimoto’s disease

Individuals with Hashimoto’s disease can develop hypothyroidism. Without treatment, hypothyroidism can lead to several complications, including:

Without treatment, hypothyroidism can also cause complications during pregnancy.

Learn more about what happens if hypothyroidism is left untreated.

With appropriate treatment, individuals with Graves’ disease or Hashimoto’s disease can manage their symptoms effectively and lead healthy lives. Regular monitoring and adjustments in treatment are necessary to maintain optimal thyroid function.

There is no definitive way to prevent Graves’ disease or Hashimoto’s disease due to their autoimmune nature. However, managing stress, avoiding excessive iodine intake, and regular medical check-ups may help reduce the risk of triggering these conditions.

Graves’ disease and Hashimoto’s disease, also known as Hashimoto’s thyroiditis, are autoimmune conditions affecting the thyroid gland. However, they both lead to opposite conditions, such as hyperthyroidism and hypothyroidism. Despite their differences, both conditions require careful management and medical intervention.

Early diagnosis and treatment can significantly improve the quality of life and prevent serious complications. Understanding these conditions’ symptoms, causes, and treatments enables patients to seek timely medical advice and maintain their health.