Last Updated on February 3, 2025 by Carrie Korem, FNTP
The two thyroid autoimmune diseases that many struggle with are Graves’ and Hashimoto’s. While both are autoimmune disease, there are differences between the two. Let’s walk through Hashimoto’s disease vs. Graves’ disease so we can understand each of them.
What is Hashimoto’s?
Hashimoto’s is an autoimmune condition where your immune system attacks your thyroid tissues.
It’s important to understand that Hashimoto’s is an immune system issue that can affect the thyroid. But, it’s not inherently a thyroid issue.
How is Hashimoto’s diagnosed?
Hashimoto’s is most often diagnosed when TPO (thyroid peroxidase) antibodies and/or TgAb (thyroglobulin antibodies) are elevated.
These antibodies can be present even when TSH, T4, T3, FT4 and FT3 levels are normal.
Thyroid Peroxidase Antibodies
TPO (thyroid peroxidase) is the key enzyme that helps your thyroid make thyroid hormones. Anti-TPO is an antibody that attacks TPO. This is the lab that is most often used to diagnose Hashimoto’s.
A normal anti-TPO level is usually below 30. Keep in mind that it’s normal to have a small amount of TPO antibodies in the blood.
TgAb Test
TgAb (thyroglobulin antibodies), sometimes referred to as TAA (thyroid antithyroglobulin antibody) are antibodies that attack thyroglobulin. Thyroglobulin is a protein produced and used by the thyroid to make T3 and T4.
An optimal TgAb level is 0.
What causes Hashimoto’s?
There are many different root causes for thyroid autoimmune disease, but here is the basic list (click here for a more comprehensive list):
Stress
Diet
Synthetic chemicals or toxins
Food additives
Heavy metals
Infections
Pharmaceuticals
Digestive issues (intestinal hyperpermeability)
Dental infections
Amalgam fillings
Root canals
Breast implants
Radiation
Trauma
In my practice, I’ve seen that there are always multiple root causes and gut issues and stress are always the primary two on the list, and then there are often 1-2 additional root causes.
What are the Symptoms of Hashimoto’s?
There are hundreds of symptoms, but here is a list of some of the most common symptoms:
Hypothyroidism
Hyperthyroidism
Depression
Exhaustion
Brain fog
Unexplained or excessive weight gain or loss
Loss of outer third of eyebrows
Dry or coarse hair
Nervousness
Irritability
Increased sweating
Heart racing
Hand tremors
Muscle cramps
Anxiety
Difficulty sleeping
Reduced libido
Hives
Rashes
Anemia
High cholesterol
Constipation
Thinning of your skin
Fine, brittle hair or hair loss
Weakness in your muscles—especially in the upper arms and thighs
More frequent bowel movements
Low Vitamin D
Low B12 or ferritin
Excessive appetite or loss of appetite
Irregular menstrual cycles
Water retention
Lots of energy (often too much)
When to see a doctor:
Always see a doctor if you have Hashimoto’s.
How do conventional medical doctors treat Hashimoto’s disease?
A doctor may put you on thyroid hormone replacement if you have low thyroid hormones, but outside of this, there isn’t a conventional treatment for antibodies, so usually you’re left on your own to figure this out. Or, you will be told that there isn’t anything you can do for your antibodies, that your thyroid will eventually stop working and that you’ll be on meds for the rest of your life.
This is what happened to me. Thankfully, I learned that there are so many things you can do to work on your root causes and to put antibodies into remission!
Can Hashimoto’s antibodies go into remission?
Absolutely! I saw this happen for myself and I see it happen consistently for my clients and members of my thyroid course. You can heal the immune system and bring the body back into balance!
Can you take holistic steps for Hashimoto’s while working with a doctor?
Yes. You can take thyroid hormone replacement and work with a conventional doctor while also taking holistic steps to work on your root causes.
What is Graves?
Graves’ disease is an autoimmune condition in which the antibody TSI (thyroid stimulating immunoglobulin) is elevated, and often FT4 and FT3 levels are also elevated.
There is often an excess amount of thyroid hormones circulating in the body, which leads to hyperthyroidism.
The TSI antibodies can be present even when TSH, T4, T3, FT4 and FT3 levels are normal.
It’s important to note that many who have Graves’ disease also have Hashimoto’s Disease.
How is Graves’ diagnosed?
TSI antibodies:
The TSI antibody (sometimes referred to as TRAb or TSHR) is an antibody that mimics TSH by telling the thyroid to make excess FT4. This also often creates an excess of FT3 and a decrease in TSH.
In some cases, the TSI antibody blocks thyroid hormone production instead.
A optimal TSI level is <1.
Positive TSI results are strongly indicative of Graves’ disease, but do not always correlate with the presence and severity of hyperthyroidism.
The most important thing to understand is that TSI antibodies are an immune system issue that can then affect the thyroid. It’s not inherently a thyroid issue.
So even if you irradiate the thyroid, or remove it, there is still going to be an immune system issue present in the body.
What Causes Graves’?
From a functional perspective, three of the most common root causes are chronic stressors and/or some kind of toxicity in the body combined with some kind of gut issue (leaky gut, gut dysbiosis, IBS, etc.)
Here are different kinds of stressors that can be root causes. And, before you jump past this one, please know that everyone has varied levels of stress in their lives and it is always something to consider when you have thyroid disease.
Mental stress – being overworked, having too much on your plate, trying to take on too many things at once, etc.
Emotional stress – depression, anxiety, anger, irritability, feeling overwhelmed, lack of enjoyable activities
Physical stress – exercising too much, lack of sleep, staying up too late, a physical injury like a concussion, broken bone, or sprain
Chronic illness – constantly getting sick with things like bronchitis, the cold or flu, sinus infections, allergies, etc.
Chronic disease – autoimmunity, heart disease, diabetes, kidney disease, respiratory disease, etc.
Surgery – any kind
A poor diet – processed foods, an abundance of sugars, using foods and drinks as stimulants when tired.
Environmental – synthetic chemicals in the environment, extreme hot or cold temperatures, pollution, unfiltered water, etc.
Synthetic ingredients – those in body care and skincare products, house cleaners, etc.
Medications – some medications can cause nutrient deficiencies or other side effects that put stress on the body.
A change in your regular schedule or routine – a new baby, starting a new job or school, night shift work, etc.
Radiation – from wifi, cell phone towers, smart meters, bluetooth, baby monitors, security systems, wiring errors in the home, magnetic fields, power lines, dirty electricity, artificial lighting, etc.
Dental work – including amalgam fillings or amalgam filling removal, root canal infections, or other dental infections.
Other kinds of stressful situations or events – car accident, a death in the family, being in an abusive relationship, a cross-country move or just moving into a new home.
Here are some various toxins that can be root causes for Graves’ disease:
Environmental – synthetic chemicals in the environment, pollution, unfiltered water, etc.
Synthetic ingredients – those in body care and skincare products, candles, fragrances, house cleaners, etc.
Medications – some medications can cause nutrient deficiencies, contain toxins (such as food dyes, heavy metals, preservatives, etc.) or have other side effects that put stress on the body.
Heavy metals – this could be from exposure in the environment, in the water, air or food, from amalgam fillings or an amalgam filling removal, medications, etc.
Mold exposure – from your home or workplace, food, in the air, etc.
Here are some various gut issues that can be a root cause for Graves’ disease:
Digestion issues and/or gut dysbiosis – this includes leaky gut, candida, SIBO, low stomach acid (which cause symptoms like heartburn, indigestion, gas, bloating, etc.), IBS, Colitis, etc.
There is always some kind of gut issue when it comes to autoimmunity, so this is definitely something to keep in mind!
What are the symptoms of Graves’?
Here is a list of some of the most common symptoms:
Hashimoto’s
Hyperthyroidism
Anxiety
A fine tremor in the hands or fingers
Panic Attacks
Insomnia
Fatigue
Heat sensitivity
Rapid or irregular heartbeat
Sensitivity to heat
Bulging eyes
Sweating
Weight loss
Change in menstrual cycles
Muscle weakness
Diarrhea and frequent bowel movements
Goiter
When to see a doctor:
Always, always, always work closely with your practitioner when you have Graves’ disease. Elevated thyroid hormones can cause all sorts of health issues and so you want your doctor to be monitoring you.
Every client that I’ve worked with who has Graves’ also works with their doctor. I personally think this is the best way do to things even if you want to do things more holistically.
Can you take holistic steps for Graves’ while working with a doctor?
Yes. You can work with a conventional doctor while also taking holistic steps to work on your root causes. In fact, I highly encourage you to do so. When the body is presenting with Graves’, oftentimes the body is also hyperthyroid and this can become dangerous. So, it’s incredibly important to be closely monitored by your doctor.
Can you have both Graves’ and Hashimoto’s?
Yes. It is possible to have both Graves’ and Hashimoto’s antibodies.
Can Graves’ antibodies go into remission?
Absolutely! I’ve seen this happen for many of my clients and members of my thyroid course (confirmed by their doctor).
How can I learn more about the holistic steps I can take for Graves’ and/or Hashimoto’s?
I have four fantastic options for you!
- To download my 50 of my top tips to support the thyroid and immune system naturally, tap here. I’ll also send you an educational email every few days to help you learn how to support your body naturally.
- If you’d like to learn from first steps you can take to help support your thyroid, check out my class, “5 Keys to Thyroid Hormone Balance”. It’s just 45 minutes and I promise you’ll learn something new!
- If you’re looking for a step-by-step plan for Hashimoto’s or Graves’ that truly works (no more piecing together info!), check out my 90-Day Thyroid Reset Program.
- Book a consult with me for one-on-one help. Here’s info about what working with me looks like.
Disclaimer: The purpose of this post is to give an overview of Hashimoto’s and Graves’ from a holistic perspective. Due to biochemical individuality there can be many various reasons for the root causes of thyroid disease, and many ways to help improve thyroid in balance in the body. This information is not intended to take the place of your doctor’s advice.
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