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Hashimoto's vs. Hypothyroidism: What's the Difference?

A Look at Autoimmune Thyroid Disease and Underactive Thyroid Conditions


Updated May 29, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Hashimoto's vs. Hypothyroidism: What's the Difference?
In the area of nutrition, promising findings from a number of research studies have pointed to the value of the mineral selenium in helping to combat autoimmune thyroid disease.

Some studies have shown that selenium supplementation at the typically safe dose of 200 mcg per day can return elevated thyroid antibody levels to normal, or reduce them significantly, therefore warding off development of full autoimmune thyroid disease, and resulting hypothyroidism. For more information, see Seleniun and the Thyroid.

Ultimately, however, the autoimmune attack on the thyroid makes the gland slowly less able to function, and eventually, the thyroid becomes underactive. When hypothyroidism itself can be measured by blood tests, many practitioners will finally diagnose the hypothyroidism, and treat the patient with thyroid hormone replacement drugs.

Autoimmune Thyroiditis Atttacks

In some cases, the thyroid becomes particularly inflamed, known as a thyroiditis attack. Dr. Steven Langer, author of the book Solved: The Riddle of Illness, refers to thyroiditis as like an "arthritis of the thyroid." He explains that just as arthritis attacks the joints with pain and inflammation, thyroiditis can mean pain and inflammation in the thyroid for some sufferers. And in particular, during a thyroiditis attack, common symptoms are anxiety, panic attacks, heart palpitations, swelling in the thyroid area, problems swallowing, and frequently, problems sleeping.

"Thyroiditis attacks classically happen in the middle of the night," says Dr. Langer, which can be particularly troublesome in terms of the ability to sleep.

Dr. Langer suggests taking some calcium/magnesium, which are nutrients that have a sedative effect, along with a pain reliever to relieve inflammation -- buffered aspirin or ibuprofen -- before you go to bed, this might help. He's found that this helps about two-thirds of his patients suffering from nighttime thyroiditis symptoms.

Reducing swelling is a key aspect of dealing with thyroiditis attacks, according to Dr. Langer. "Just as with arthritis, an anti-inflammatory pain reliever doesn't cure the problem, but it temporarily ameliorates the symptoms."


Many people with Hashimoto's disease end up hypothyroid, the situation where the thyroid is either underactive or, eventually, totally unable to function.

Hashimoto's disease is a disease, and is the leading cause of hypothyroidism, which is a condition. The other causes of hypothyroidism include, among others:

  • Graves' disease and hyperthyroidism treatments including radioactive iodine treatment (RAI) and surgery
  • thyroid cancer treatment, including surgery to remove all or part of the thyroid
  • surgical removal of all or part of the thyroid as a treatment for goiter or nodules
  • use of antithyroid drugs (such as Tapazole or PTU) to reduce thyroid activity
  • use of certain drugs, such as lithium
The diagnosis and treatment of hypothyroidism itself is a detailed topic, and you can read more about it here at the site:


Thyroid, 2001 Mar;11(3):249-55, "One-year prophylactic treatment of euthyroid Hashimoto's thyroiditis patients with levothyroxine: is there a benefit?"

June 2001 Findings of the 83rd Annual Meeting of the Endocrine Society, Denver, Colorado

Beckett GJ, Arthur JR. "Selenium and endocrine systems." J Endocrinol. 2005 Mar;184(3):455-65.

Oct. 2002, The Journal of Clinical Endocrinology & Metabolism, Vol. 87, No. 4 1490-1498

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