If you're dealing with unpleasant symptoms like fatigue, weight changes, irregular menstrual cycles, and more, a thyroid condition could be to blame. Hashimoto’s thyroiditis and Graves' disease, both autoimmune thyroid conditions, can have a profound impact on your health and quality of life – including your reproductive health – but “they couldn’t be more different,” explains Caroline Thomason, RD CDCES, dietitian and diabetes educator in Washington, D.C.   

So, what are the differences between Hashimoto's and Graves' disease? To understand this, we must first dive into autoimmune conditions as a whole. 

woman touching her thyroid

What is an autoimmune disease, anyway?

An autoimmune disease is a condition in which the immune system, which is designed to protect the body from foreign invaders like bacteria and viruses, mistakenly attacks the body's own cells and tissues. Normally, the immune system can distinguish between the body's own cells and harmful invaders, but in the case of autoimmune diseases, this ability is compromised, leading to immune responses against healthy cells.

There are over 100 known autoimmune diseases, according to The Cleveland Clinic. Some common ones include psoriatic arthritis, lupus, type 1 diabetes, multiple sclerosis, and celiac disease. The exact cause of autoimmune diseases is not fully understood, but a combination of genetic and environmental factors is believed to play a role. 

Autoimmune symptoms can vary widely depending on the specific condition and the body parts affected. However, a few of the more symptoms include fatigue, joint pain, muscle weakness, and inflammation. Treatment for autoimmune conditions often involves managing symptoms and suppressing the immune system to prevent it from attacking healthy tissues. This can be done through medications and lifestyle changes, but the approach varies depending on the type of disease and its severity.

Hashimoto’s thyroiditis: What you need to know 

Hashimoto's thyroiditis, often referred to as Hashimoto's disease, is an autoimmune disorder that affects the thyroid gland. The thyroid is a small, butterfly-shaped gland located in the front of the neck, and it plays a crucial role in regulating the body's metabolism by producing hormones.

doctor examining a women's neck for thyroid issues

In Hashimoto's thyroiditis, the immune system mistakenly attacks the thyroid tissue. This autoimmune response leads to inflammation and gradual destruction of the thyroid cells, impairing the gland's ability to produce thyroid hormones. As a result, Hashimoto's thyroiditis is a common cause of hypothyroidism, a condition where the thyroid doesn't produce enough thyroid hormones.

If you are experiencing symptoms such as fatigue, weight gain, intolerance to cold, muscle and joint pain, constipation, dry skin, and menstrual changes, it may be time to ask your healthcare provider for a full thyroid panel, including antibodies. 

If you are found to have hypothyroidism or Hashimoto's, treatment generally involves thyroid hormone replacement therapy in the form of oral medication. This can help alleviate symptoms and restore the thyroid hormone balance in the body. While the autoimmune component of Hashimoto's can't be completely cured, managing the condition with medication and regular monitoring can effectively control symptoms and maintain thyroid function. 

woman touching her neck

Graves' Disease: The opposite of Hashimoto's

Graves' disease is another autoimmune disorder that affects the thyroid gland, but unlike Hashimoto's Thyroiditis, it leads to hyperthyroidism, a condition where the thyroid produces an excessive amount of thyroid hormones. 

In Graves' disease, the immune system produces antibodies that stimulate the thyroid to produce more hormones than the body needs. These antibodies, called thyroid-stimulating immunoglobulins (TSIs) or thyrotropin receptor antibodies (TRAbs), mimic the action of thyroid-stimulating hormone (TSH). TSH is a natural hormone that signals the thyroid to release more thyroid hormones. The overproduction of thyroid hormones in Graves' disease can lead to a range of symptoms and health issues.

Common symptoms of Graves' disease include:

  • Hyperactivity and restlessness
  • Weight loss despite increased appetite
  • Irregular or rapid heartbeat (palpitations)
  • Heat intolerance and increased sweating
  • Tremors in the hands and fingers
  • Enlarged thyroid gland (goiter)
  • Fatigue
  • Muscle weakness
  • Protruding eyes 

Like Hashimoto's, Graves' disease is typically diagnosed through blood tests measuring thyroid hormone levels and the presence of specific antibodies. Imaging studies, such as a thyroid scan or ultrasound, may also be used to assess the size and function of the thyroid gland. 

Treatment options for Graves' disease include antithyroid medications to reduce the production of thyroid hormones, radioactive iodine therapy to shrink the thyroid, or, in some cases, surgery to remove part or all of the thyroid gland. Additionally, beta-blockers may be prescribed to manage symptoms such as rapid heartbeat and tremors. Like other autoimmune diseases, Graves' disease requires ongoing management and monitoring under the care of a licensed healthcare provider. 

two women talking on the sofa

Nutrition for Graves' disease and Hashimoto's

While Graves' disease and Hashimoto's are both autoimmune disorders affecting the thyroid, they lead to opposite thyroid conditions. However, whichever condition you're dealing with, a nutritious and balanced diet consisting of plenty of fruits, vegetables, lean proteins, and whole grains is a cornerstone of managing any autoimmune disease effectively. 

Individuals with Hashimoto's may also benefit from increasing their intake of selenium-rich foods like Brazil nuts, eggs, and brown rice to potentially aid in reducing symptoms, while for those with Graves' disease, it's typically recommended to avoid excess iodine consumption, as this mineral can exacerbate symptoms. Antioxidant-rich foods, such as berries, spinach, and beans, can also help support overall health and immune function.

As always, it's important to consult with a healthcare provider or a nutritionist to ensure these adjustments align well with your individual health needs before making any dietary changes. But the good news is that both Graves' disease and Hashimoto's can be managed and your quality of life improved through medications and lifestyle changes as advised by your doctor. 

Lauren Manaker MS, RDN, LD, CLEC, is an award-winning fertility registered dietitian with over 20 years of experience. She is a three-time author, freelance writer, and consultant. Her book, Fueling Male Fertility, has helped countless men who are trying to conceive make evidence-based nutrition decisions that support their fertility. She also manages the Instagram account @LaurenLovesNutrition, where she shares evidence-based fertility and pregnancy-focused nutrition information. Lauren and her husband, Matt, conceived their daughter after a 5-year fertility journey, which included three rounds of IVF. She lives in Charleston, South Carolina, and is enjoying life in the Lowcountry with her little family.