The difference between hypothyroidism and Hashimoto’s Thyroiditis

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Do you know the difference between Hashimoto's Thyroiditis and hypothyroidism? In this post, we'll dive into the differences and what it means for you.

Being diagnosed with an underactive thyroid is not a strange thing anymore.  So many women I know and hear of, have been diagnosed with an underactive thyroid. But for most people, the autoimmune condition, Hashimoto’s Thyroiditis, is the reason why their thyroids are underactive.  

Let’s have a look at the difference between having an underactive thyroid, and what it means when you are diagnosed with Hashimoto’s.

Understanding the underactive thyroid

When I was first diagnosed in 2003 with an underactive thyroid, I remember that all I wanted to do was sleep.  I got home from a day at work, went to lay down on the couch, falling asleep in an instant.  My husband would wake me up an hour later, having made dinner, and then by 8pm, I was back in bed, totally exhausted.  But worse, I couldn’t get up in the mornings.  We have been married for only 2 years, and that is no way to start a marriage!

The doctor, after doing blood tests, confirmed that I have an underactive thyroid.  

As she explained, it’s that my thyroid gland is not producing enough thyroid hormones that my body needs.  Hence, I was now hypothyroid.  


The symptoms of an underactive thyroid

Thyroid hormones play an important role in our bodies, including energy production, metabolism, and emotional resilience to name a few.  When your thyroid gland is not producing enough hormones for your body’s needs, you can experience one or more of these symptoms (as listed on NHS): 

  • Tiredness
  • Sensitivity to cold
  • Weight gain
  • Muscle cramps and weakness
  • Dry skin and scalp
  • Brittle hair and nails
  • Constipation
  • Depression
  • Brain fog
  • Irregular periods or heavy periods
  • Low or no libido
  • Carpal tunnel syndrome

Treating an underactive thyroid

Since your thyroid gland is not producing the number of hormones that your body needs anymore, it is important to provide the body with thyroid hormones.  This is usually in the form of thyroid hormone pills, and it can be either T4-hormones, T3-hormones or a combination of T4 and T3 hormones.  These hormones can be synthetic (T4-hormones and some T3-hormones) or sourced from natural sources (usually from bovine or pig thyroid glands).

Understanding Hashimoto's Thyroiditis

When I was first diagnosed with an underactive thyroid in 2003, the doctor simply told me “it’s one of those things, here you go, this is your script for your medication”.  I didn’t even think to ask more about what the possible reason was that caused the thyroid to be underactive in the first place. 

It is, however, an important question to ask, because knowing what is causing your thyroid to be underactive, goes a long way in understanding what you can do about it.

There are many reasons why your thyroid gland may be underactive:

  • Pituitary gland dysfunction,
  • Your body is not converting T4-hormones into the active T3-hormones,
  • Oestrogen levels that are too high,
  • Testosterone levels that are too high,
  • Pregnancy,
  • Medications and treatments, such as chemotherapy,
  • Hyperthyroidism or Grave’s Disease,
  • Iodine deficiency, and
  • The autoimmune condition, Hashimoto’s Thyroiditis

It is estimated by the American Thyroid Association, that most underactive thyroid cases, is because of the autoimmune condition called Hashimoto’s Thyroiditis.

This is an autoimmune condition, meaning that the immune system is attacking and destroying a part of the body, and in the case of Hashimoto’s Thyroiditis, the thyroid gland. 

As the immune system attacks the thyroid gland, it destroys thyroid gland cells.  Now the thyroid gland cannot produce the number of hormones anymore that the body needs, and you become deficient in thyroid hormones.  

Now here is where things get interesting.

Most conventionally trained doctors will NOT do the full thyroid panel, which includes two thyroid antibody tests.  Why do they refuse?  

In my experience, it is because their medical training has taught them that the treatment approach is the same, regardless of the reason – simply give a script for the missing thyroid hormones (usually always only T4-hormones).

Hashimoto’s has two components: the thyroid gland and the immune system.  While thyroid hormone pills are important to replace the missing thyroid hormones that your thyroid gland cannot make anymore, the aspect of the immune system is often completely ignored.  Why?  Because you cannot bottle and sell lifestyle changes, habits, and a change of diet!

Symptoms of Hashimoto's Thyroiditis

I didn’t always understand that when you have Hashimoto’s, you can experience both hypo and hyperthyroid symptoms. Once you know how it works, it can really help you along your health journey.

Remember how I explained that the immune system is attacking the thyroid gland and destroying thyroid gland cells?  When this happens, the destroyed thyroid gland cells release the thyroid hormones into your body  – basically dumping a surge of thyroid hormones into your bloodstream!

You are now experiencing symptoms of having an overactive thyroid while your body is now struggling to get the levels back down to normal levels.  Once it starts to normalize, your thyroid hormone levels will stabilize at a lower level than before.  Now you are even more underactive thyroid than you were before!

  • Fatigued yet unable to sleep,
  • Hair loss,
  • Cold sensitivity,
  • Constipation,
  • Weight gain and difficulty to lose weight,
  • Slowed metabolism,
  • Strangling sensation in your throat, 
  • Enlarged thyroid (goiter),
  • Times of excessive sweating, 
  • Rapid heart rate and heart palpitation,
  • Brain fog,
  • Poor memory,
  • Lack of concentration,
  • Loss of ambition and interest,
  • Anxiety
  • Depression,
  • Emotional mood swings,
  • Impatience and irritability, and
  • Sadness.

Treating Hashimoto's Thyroiditis

Many of the conventionally trained doctors will tell you there is nothing you can do.  Just take your thyroid hormones.  

The problem with this approach is that you are just looking at the first part of Hashimoto’s, namely the thyroid gland, while completely ignoring the second part, the immune system.

The great news is that there is a lot you can do to calm your immune system and reduce your antibodies.  These actions include eating more anti-inflammatory food and removing the inflammatory foods, managing your stress better, getting quality sleep, addressing any nutrient deficiencies, treating infections, and removing toxins.  There are options, like LDN, which could work, as well as herbal remedies that could also help to calm the immune system. 

The summary

Your thyroid gland can become underactive for many different reasons.  When it becomes underactive, it cannot produce the thyroid hormones anymore that your body needs.  I can really make you feel lousy!

One of the most common reasons why your thyroid gland is underactive, is the autoimmune condition called Hashimoto’s Thyroiditis.  This is when your immune system is activated and is attacking and destroying the thyroid gland, leading to an underactive thyroid over time with bouts of overactive thyroid symptoms.  


  1. Symptoms of an underactive thyroid, NHS,
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