Screen Shot 2015-12-21 at 12.30.42 PMIt’s frequently asked in patient forums: why do some people have a Hypothyroid diagnosis, and others have a Hashimoto’s diagnosis?? Aren’t they the same…or not?


Hypothyroidism means your thyroid isn’t producing enough thyroid hormones. And in many cases, the cause can be genetic (a thyroid problem passed down via your genes). This was apparently true of the creator of this site, Janie Bowthorpe. Or, you could be severely iodine deficient, since thyroid hormones need iodine to exist. Or it can be caused by hypopituitary, or a traumatic physical injury to your neck and head, or from the removal or radiation of your thyroid gland, or from Lyme, or from toxins…on and on. STTM has listed several causes, and the STTM book has even more.

  • Primary hypo means it’s a problem right in the gland.
  • Secondary hypo means it’s due to a problem in the messaging to the gland via the TSH such as with hypopituitary.
  • Tertiary hypo is the result of a failure in the hypothalamus gland in releasing the hormone TRH, which in turn tells the pituitary to release the TSH–the latter which messages the thyroid.

Hashimoto’s Disease

Hashimoto’s (also called Hashi’s) is an autoimmune problem, meaning your gland is being attacked by your own confused immune system. Either the protein in your thyroid called “thyroglobulin” is being attacked, or the thyroid enzyme “peroxidase” is being attacked. Both can result in thyroid cells being destroyed over time, so you can vacillate between hyper symptoms due to the dumping of thyroid cells in your blood (anxiety, higher heartrate, etc) and hypo symptoms due to having less thyroid (fatigue, depression, sluggishness. Having enlarged, non-cancerous thyroid nodules are common, as experienced by many Hashi’s patients, as well as stated by well-known clinics–the latter who might say up to 95% are non-cancerous.

So in a nutshell:

Hypothyroidism defines a state of sluggish thyroid function and metabolism.

Hashimoto’s defines an autoimmune disease process which can result in symptoms of hypothyroidism. 

Another way to put it: Hypothyroidism is a problem with your thyroid gland: Hashimoto’s is a problem with your immune function.

It’s stated that there are far more patients with Hashimotos than simply Hypothyroidism as defined above. But we are seeing more and more patients just with hypothyroidism, possibly due to all the toxins we are exposed to in our food, water and air, plus less iodine in our soils–both which can negatively affect thyroid function.

What is similar about both?

  1. Swollen glands: Though this is far more common and pronounced with Hashimoto’s disease (and can be called a goiter), some patients without a hint of the autoimmune version can see their gland swell slightly as a result of the hypothyroid state. Even pregnancy can cause this swelling due to an increase in the human chorionic gonadotropin (HCG) hormone.
  2. Sluggishness: Since the attack on the thyroid can result in lessened thyroid function, Hashi’s can produce the same sluggish, low metabolism symptoms as can simple hypothyroidism.
  3. Treatment: Both conditions usually result in hypothyroid medications. Contrary to what we hear from many medical professionals, Hashi’s patients have soared on Natural Desiccated Thyroid as much as non-Hashi’s patients have. Hashi’s patients seem to need to raise a little faster (to counter the increase in antibodies, then to improve immune function), plus they may need other supports to counter antibodies like Selenium.

What is dissimilar about both?

  1. Hashimoto’s patients will eventually see a rise in either or both of their thyroid antibodies, called Anti-TPO or Anti-thyroglobulin. (We have noted that a large body of patients have “some” antibodies below the range without having Hashimoto’s, by the way, nor do they see it happen later.)
  2. The majority of Hashimoto’s patients need to avoid gluten: those with regular hypothyoidism often don’t need to avoid gluten (but may manage their intake due to the high levels of modern gluten levels in foods)
  3. Though both sides can have inflammation, Hashi’s patients tend to have more frequent and higher markers of inflammation due to the attack on the thyroid itself. Regular hypothyroid patients ‘may’ see inflammation markers due to atherosclerosis from the lowered metabolism or higher concentrations of triglycerides.
  4. Hashimoto’s patients can find themselves with the onset of other autoimmune diseases, especially as they age. 

STTM graphic Hashis vs Hypo UPDATED



* Read how Hashimoto’s is one of several forms of thyroiditis.

* Should thyroid patients pay attention to the TSH once treatment starts??

* All about Hashimoto’s disease

* How patients use natural desiccated thyroid