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

hashimoto's hypothyroid infertility thyroid Mar 02, 2020

If you haven’t been diagnosed with a thyroid disorder, you know someone who has. Thyroid disorders are common, and about 12% of Americans will experience abnormal thyroid function at some point during their lives. If you’re really into numbers, here are some that might surprise you:

  • An estimated 20 million Americans have some form of thyroid disease.
  • Up to 60 percent of those with thyroid disease are unaware of their condition.
  • About 4.6% of the U.S. population (12 years old and older) has hypothyroidism.
  • Women are five to eight times more likely than men to have thyroid problems.
  • One woman in eight will develop a thyroid disorder during her lifetime.

That’s a lot of people! And chances are, you could be one of them.


Where is Your Thyroid and What Does it Do?

Your thyroid gland is a butterfly-shaped gland located in the lower front of your neck, just below your Adam’s apple. It wraps around the front side of your windpipe, and its two lobes are connected by a bridge (isthmus) in the middle.

Your thyroid’s job is to make thyroid hormones. It gets a signal from your pituitary gland to produce the two main thyroid hormones, T3 and T4. These are secreted into your blood and carried to every tissue in your body. Yes, EVERY SINGLE CELL in your body needs thyroid hormone! At their most basic level, these hormones help your body use energy, help you stay warm, and keep your brain, heart, muscles, and other organs working like they should.

What about when your thyroid doesn’t work so well? Many factors can contribute to decreased thyroid function. Two of the most common thyroid disorders are hypothyroidism and Hashimoto’s thyroiditis. They have overlapping symptoms and causes, but having hypothyroidism doesn’t mean you have Hashimoto’s, and having Hashimoto’s doesn’t mean you have hypothyroidism. They often go together, but they aren’t always joined at the hip…or at the thyroid! Let’s look first at hypothyroidism.


What is Hypothyroidism?

Hypothyroidism is caused by low levels (hypo) of circulating thyroid hormone in your body. When these levels get too low, your body’s cells can’t get enough thyroid hormone, and the processes mentioned above start slowing down. Hypothyroidism is diagnosed with a lab test, but it often brings with it uncomfortable symptoms because of your metabolic slow-down. If you have hypothyroidism, you may have experienced increased fatigue, dry skin, infertility, cold intolerance, forgetfulness, depression or mood changes, constipation, or hair loss. Since these symptoms are common for other conditions as well, you need to have a lab test to confirm low thyroid hormones before being diagnosed.


What Causes Hypothyroidism?

There are many reasons why your thyroid gland can stop producing enough hormone or why your body’s cells might not be able to use that hormone effectively.

Removal of your thyroid gland: If you’ve had your whole thyroid removed, this induces automatic hypothyroidism. If you’ve had part of your thyroid removed, the remaining section may be able to produce enough thyroid hormone, but this should be monitored over time.

Medications: some medications interfere with thyroid hormone production. If you are experiencing signs of hypothyroidism, ask your doctor or research your current medications to check for how they impact the thyroid.

Nutrient deficiencies: Adequate stores of B vitamins, vitamin D, zinc, selenium, iodine, and magnesium are needed for optimal thyroid hormone production and conversion. You also need to consume proper amounts of protein, fat, and carbohydrates to nourish your thyroid and allow for good hormone production.

Gut imbalances: Even your gut environment influences your thyroid health! If you have too few beneficial bacteria or too many harmful bacteria, yeast, parasites, or other pathogens, your thyroid gets a warning signal to power down. It helps you conserve energy by lowering your metabolism so your immune system has more power to fight these invaders.

Additionally, about 20% of your inactive T4 thyroid hormone is converted to active T3 in your gut. If your gut is not functioning optimally or if your gut tissue is inflamed, you won’t produce as much active T3, and you can experience symptoms of hypothyroidism even if your thyroid gland itself is healthy.

Other causes of gut dysfunction like constipation, antibiotic use, chronic stress, and high intake of processed grains and sugar can also negatively impact thyroid health.

Cellular resistance: Even if you produce enough thyroid hormone, your body’s cells might not be efficient at receiving and using it. Your body sends the signal back to your brain that it doesn’t have enough, your brain signals your thyroid to produce more hormone, more thyroid hormone goes out, but your cells can’t use it. This hypothyroid-like cycle continues.

Conversion problem: You might produce enough T4 thyroid hormone, but because of an undiagnosed infection or heightened stress, this inactive T4 is not converted to active T3 (the gasoline for your metabolism). Instead it converts into reverse T3 (like a brake for your metabolism) to help you fight the infection and to conserve energy that the stress is sucking out of you.

Autoimmune disease: In a healthy state, your immune system defends your body from invading bacteria, viruses, and other pathogens. When your immune system mistakes your own cells as foreign invaders, you’re the one who gets attacked! Hashimoto’s thyroiditis is when your immune system attacks your thyroid gland. That deserves it’s own discussion.


What is Hashimoto’s and How Do You Know if You Have It?

Hashimoto’s thyroiditis is more than just a thyroid problem. It’s a problem with your immune system. Your white blood cells (the soldiers of your immune system) mistake your thyroid cells and the enzymes they produce as invaders and attack these healthy cells as if they were pathogens. This autoimmune attack destroys your thyroid tissue, and eventually fewer healthy thyroid cells and enzymes are left to make enough thyroid hormone. This destruction in healthy tissue causes hypothyroidism.

A Hashimoto’s autoimmune attack can go on for up to 10 years without showing a problem on your thyroid lab results, so it’s important to measure your levels of both thyroid peroxidase (TPO) and thyroglobulin (Tg) antibodies. Having these antibodies gives evidence of the autoimmune attack and diagnoses you with Hashimoto’s. When you check for them before you have a thyroid problem, you’re more likely to catch rising numbers before they get out of control and before too much of your thyroid tissue is damaged.

Hashimoto’s is the most common autoimmune disorder, and it’s the number one cause for hypothyroidism. This is why I’ll emphasize once again that it’s so important to check your thyroid antibodies early and before your basic labs show that you have a thyroid problem!

But here’s the real problem.

Upwards of 90% of people with hypothyroidism have Hashimoto’s disease, and most of them don’t know it. Why isn’t Hashimoto’s being diagnosed? Why do over 90% of people (maybe you’re one of them) who take thyroid medication not know what’s really causing their thyroid dysfunction?

Because their antibody levels aren’t being checked!

To understand the true cause behind over 90% of the diagnoses of hypothyroidism, you must see the bigger picture that includes ALL of your thyroid labs, especially your thyroid antibodies.

TSH, the main lab that’s checked to evaluate thyroid function, can remain “normal” for years while an autoimmune attack is going on. This is why when TSH is the only lab used to evaluate thyroid function, over 90% of Hashimoto’s diagnoses will be missed. Maybe your TSH has already started to rise, but your TSH alone will never tell your whole thyroid story.

You might have low thyroid hormone levels, but by themselves they can’t diagnose “why” they’re declining. You might need more thyroid medication to support your thyroid and to feel better, but if you have Hashimoto’s disease, increased dosages will never be the prescription to helping you feel like a normal human again.

You’ve got to look deeper to discover the real reason behind your thyroid’s dysfunction. More thyroid medication won’t calm down an autoimmune attack, and it will never be the root-cause solution to fully addressing and healing from Hashimoto’s.


Can You Heal From Hypothyroidism or Hashimoto’s?

The short answer is a resounding yes! Depending upon what is causing your thyroid gland to under-function and how long those factors have been at play, you might never be “cured” of hypothyroidism. You can, however, add replacement thyroid hormone, supportive supplements, and integrate nutritional and lifestyle habits that allow your thyroid gland to be completely controlled and you to feel that your health has been restored.

Hashimoto’s thyroiditis requires a deeper level of healing to calm your immune system, restore inflamed or damaged tissue, and rebalance your immunity that has been overstimulated for so long. As with non-autoimmune hypothyroidism, medications, supplements, and lifestyle interventions can help restore and rebalance your thyroid health. Additionally, looking deeper to discover gut imbalances, restore damaged gut tissue, address food sensitivities, identify nutrient deficiencies, and rebalance unmanaged stress all become essential to calming your immune system and putting your Hashimoto’s into remission.


How Does Hypothyroidism Affect My Fertility?

Hypothyroidism and fertility aren’t friendly companions. It is a leading cause of difficulty in achieving and maintaining pregnancy, because when your thyroid can’t sustain the metabolic processes in your own body, it’s not likely to try to support another life within you. Hypothyroidism can interfere with your reproductive hormones causing menstrual abnormalities, irregular cycles, and it can prevent you from ovulating altogether.

In addition to addressing an under-functioning thyroid, calming an internal autoimmune fight is of utmost importance if you’re hoping to conceive. When your body is under attack against itself, it constantly flies a red-flag danger warning to signal to your reproductive system that now is no time to try to support a new life. It’s having a hard enough time fighting to sustain you every day, so your reproductive hormones power down and fertility declines.

If pregnancy does occur, the rates of miscarriage, preterm birth, low birth weight, and neurological developmental issues are higher in women with elevated thyroid antibodies.

If you have been struggling to conceive or have experienced multiple miscarriages, it is essential for you get proper and complete thyroid testing before you try to conceive again. Request a full thyroid hormone panel for proper diagnosis (TSH, free T3 and T4, reverse T3, TPO and Tg antibodies), and be sure to monitor these regularly throughout your pregnancy and while breastfeeding. You’ll also need to support your thyroid health and total body wellness with nourishing foods, nutrients, and lifestyle habits.


Hypothyroidism and Hashimoto’s thyroiditis are two related conditions that diminish your thyroid and whole-body health. Both are common causes of infertility and will likely require more than just another prescription to bring about your complete healing.

Have you been told you just have a sluggish thyroid, that you need more thyroid hormone, or that your symptoms are normal for your age or stage in life? Maybe there’s something more to those thyroid numbers, and we can get to the root of those together! Let me know here or let's schedule a time to talk.









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