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Understanding Hashimoto’s Vs. Hypothyroidism

Hashimoto’s disease and hypothyroidism are two of the most common conditions affecting the thyroid gland. Due to their similarity, the two conditions are often confused with one another, which can lead to treatment and management errors.

Hashimoto’s is actually the leading cause of hypothyroidism, which means many people have Hashimoto’s disease, which eventually becomes hypothyroidism down the road. In addition to Hashimoto’s disease, several other conditions can lead to hypothyroidism. Therefore, it’s important to have a solid understanding of Hashimoto’s to seek the right treatment to prevent it from becoming hypothyroidism.

What is Hypothyroidism?

To understand the difference between Hashimoto’s and hypothyroidism, we need to start by understanding what hypothyroidism is and how it affects the body.

Hypothyroidism is a condition that affects your thyroid gland, which plays a major role in the endocrine system.

Your thyroid is responsible for releasing hormones that help regulate vital bodily functions, including the following:

  • Metabolism
  • Body temperature
  • Heart rate
  • The rate at which you grow and develop

Hormones from the thyroid gland also help your digestive system process food and eliminate waste from the body.

The thyroid gland is crucial for your growth and development as a child and into adulthood. Because of these many important functions, having a properly functioning thyroid gland is important.

scientist with a vial in his hands in a lab

Unfortunately, people with hypothyroidism have an underactive thyroid gland that does not produce adequate hormones. Due to this hormone insufficiency, people with hypothyroidism may experience a wide variety of problems ranging from unwanted weight gain to heart and body temperature regulation problems.

Different Types of Hypothyroidism

While hypothyroidism is always a condition due to an underactive thyroid gland, this can happen for many reasons. Hashimoto’s is one of the most common reasons, but it’s far from the only one.

Ironically enough, people can develop hypothyroidism due to the treatment they receive for hyperthyroidism, a condition that occurs when an overactive thyroid gland produces too many hormones. To fix this issue, doctors often prescribe medications that slow down your thyroid to bring it to normal levels. However, when the treatment is too effective, it can lead to hypothyroidism.

Another potential cause of hypothyroidism is that you underwent surgery to remove all or part of your thyroid gland. Surgery may be a necessary consequence of thyroid cancer or hyperthyroidism. While your thyroid can often function with only half of it intact, this isn’t always the case. Therefore, if surgery results in not having enough thyroid hormones in your system, you can develop hypothyroidism.

In addition to surgeries and hyperthyroidism treatment, certain medications can cause hypothyroidism. These medications include lithium, interleukin, amiodarone, and several others. These medications impede your thyroid’s ability to function, leading to insufficient hormone production and hypothyroidism.

Finally, it’s possible to develop hypothyroidism because of an iodine deficiency. Iodine is a mineral that the thyroid needs to produce hormones. However, due to the body’s inability to naturally produce iodine, it’s necessary to ingest enough of it in your food and drink. If you don’t consume enough foods that contain iodine, it can lead to a deficiency, which can lead to hypothyroidism.

What is Hashimoto’s Disease?

Hashimoto’s disease, also known as Hashimoto’s thyroiditis, is an autoimmune disorder where your immune system mistakenly attacks the thyroid gland, mistaking it for a foreign invader.

As a result, your thyroid doesn’t produce enough hormones, which leads to hypothyroidism. However, this process takes place slowly and develops over months or even years. Eventually, as your immune system inflicts more and more damage on your thyroid, hypothyroidism then develops.

While Hashimoto’s can affect anyone at any age, those at a significant risk are:

  • Biological females
  • People in their thirties, forties, and fifties
  • Individuals with a family history of Hashimoto’s
  • People with another type of autoimmune condition that can lead to Hashimoto’s

Why Does Hashimoto's Disease Get Confused With Hypothyroidism?

For any disease that affects the thyroid gland, there are a limited number of results that can happen. The primary possibilities are that your condition will result in hyperthyroidism (an overactive thyroid gland) or hypothyroidism (an underactive thyroid gland.)

Since hypothyroidism and Hashimoto’s both cause an underactive thyroid gland and hormone deficiencies, they can be mistaken for one another. Additionally, because of their similarities, hypothyroidism and Hashimoto’s cause similar signs and symptoms.

Both conditions can cause:

  • Chronic fatigue
  • Feelings of lethargy
  • Unexpected weight gain
  • Changes in your voice
  • Constipation
  • Inability to handle cold temperatures
  • Dry skin
  • An irregularly slow heartbeat and low heart rate
  • Fragile or brittle nails
  • Muscle aches
  • Insomnia and other sleep problems
  • Changes in your mood, including depression and anxiety
  • Lumpy or thick thyroid nodules

All of these symptoms are characteristic of Hashimoto’s and hypothyroidism. However, because Hashimoto’s is a precursor to hypothyroidism, your symptoms will likely be milder and come and go. When you have full-blown hypothyroidism, your symptoms tend to linger and be more severe.

If Hashimoto’s develops into hypothyroidism, it can lead to life-threatening symptoms and issues. While these instances are rare, they are possible without receiving corrective treatment. Potentially life-threatening complications of hypothyroidism and Hashimoto’s include extremely low blood pressure, excessive swelling, falling into a coma, and death.

How Do Doctors Diagnose Hashimoto’s vs. Hypothyroidism?

Another reason it is challenging to decipher between Hashimoto’s and hypothyroidism is that they are very difficult to diagnose. These complications are partly due to the symptoms of both conditions being very similar and also because many other conditions can cause the same symptoms.

Your doctor may need to incorporate the following processes in order to diagnose you with Hashimoto’s or hypothyroidism properly:

  • Have a medical consultation and perform a physical evaluation. During this process, your doctor can examine your thyroid glands for inflammation and discuss your symptoms and medical history to see if they match up with the symptoms of hypothyroidism or Hashimoto’s. Your medical history will help determine any present risk factors associated with Hashimoto’s and hypothyroidism.
  • If your doctor suspects a thyroid condition, they may run additional tests to confirm or rule out Hashimoto’s and hypothyroidism.

Your doctor may conduct further testing for a suspected thyroid condition. These tests will check the levels of the following hormones and antibodies:

  • TSH
  • TSH receptor antibodies
  • T3
  • T4
  • Thyroglobulin antibodies
  • TPO

If there are irregularities in the amounts of any of these hormones, you may have Hashimoto’s or hypothyroidism. To differentiate between the two, your doctor will require additional testing to check for anti-thyroglobulin antibodies and anti-thyroid peroxidase. Doctors check for these entities because they are common with Hashimoto’s but are not typically present in hypothyroidism.

Managing Hashimoto’s and Hypothyroidism

Some of the primary methods for treating either condition include:

Because hypothyroidism results in hormone deficiencies, hormone replacement therapy is the primary treatment for this condition. While there are several different medication options, levothyroxine is the most common. This medication contains hormones that replace those that your body cannot produce on its own.

It’s important to receive ongoing treatments and checkups if you take levothyroxine because your needs might change. As such, you might need to increase or decrease your dosage accordingly. In general, hormone replacement therapy is a lifelong treatment because once your thyroid stops producing hormones, there’s no way to repair it.

While the treatment for Hashimoto’s disease is similar to that of hypothyroidism, there are some differences. As with hypothyroidism treatment, Hashimoto’s often requires hormone replacement therapy in the form of levothyroxine. However, because Hashimoto’s is also an autoimmune condition, you may need additional medications to manage your immune system.

On top of that, it’s necessary to monitor your thyroid antibody levels and make adjustments if they get out of hand. Getting plenty of rest, exercising, and a balanced diet are all healthy lifestyle modifications that can help you manage the symptoms of Hashimoto’s disease.

Final Thoughts

While Hashimoto’s disease and hypothyroidism are similar and can cause similar symptoms, they are two different conditions that require condition-specific treatments. Therefore, it’s important to consult a medical professional to get a concrete diagnosis so that you can start the appropriate course of treatment.

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